脉冲Nd:YAG激光辅助极固宁脱敏剂治疗老年牙本质过敏症的临床研究

目的：研究脉冲Nd：YAG激光辅助极固宁脱敏剂治疗老年牙本质过敏症的临床效果。方法：实验组用脉冲Nd：YAG激光1W（30mJ／cm^2、15Hz）照射120sec后，涂擦极固宁脱敏剂3次;对照组强采用极固宁脱敏剂3次。结果：实验组即刻、3个月及6个月有效率分别为87．29％、81．36％和75．42％，对照组的有效率为79．09％、63．64％和52．73％。即刻两组差异无屁著性（P〉0．05），而3个月、6个月差异有显著性（P〈0．01）。结论：脉冲Nd：YAG激光辅助极固宁脱敏荆治疗老年牙本质过敏症是一种高效、作用持久、使用安全的方法。     

老年人根面龋3种材料修复的疗效分析

目的:探讨修复老年人根面龋较理想的材料。方法:将216颗根面龋患牙,分别采用Dyract复合体、光固化复合树脂和玻璃离子水门汀充填修复。随访观察1-2年。结果:观察1年,3种材料修复成功率有显著性差异,Dyract复合体成功率(96.2%)最高;观察2年,Dyract复合体成功率94.9%,明显高于玻璃离子水门汀的成功率77.9%(P<0.01)和光固化复合树脂的成功率61.4%(P<0.01),差异均具有显著性。结论:Dyract复合体是修复根面龋较为理想的材料。     

酸蚀处理影响Dyract复合体修复楔状缺损的临床效果的研究

目的：采用改良的USPHS系统评估酸蚀处理对Dyract复合体修复楔状体缺损的临床效果的影响。方法：酸蚀处理后用Dyract修复楔状缺损牙160颗,不酸蚀处理直接用Dyract修复142颗,用改良的USPHS系统对2年后的临床疗效进行评估。结果：实验组的成功率为92．5％,对照组的成功率为80．98％。两组成功率相比差异有显著性,两 组成边缘密合性和边缘着色指标上差异有显著性,实验组优于对照组。结论：在用Dyract复合体充填楔状缺损前用酸蚀处理牙釉质和牙本质可以改善修复体与牙齿的边缘密合程度。     

脉冲Nd:YAG激光在修复牙齿楔状缺损中的临床观察

目的评价脉冲Nd：YAG激光在修复牙齿楔状缺损中的临床效果。方法将73例患者的376颗楔状缺损牙随机分为三组，分别用激光（A组）、酸蚀（B组）、及激光＋酸蚀（C组）处理缺损区，再用光固化复合树脂充填。治疗后12个月及24个月复查并对各组的充填成功率进行统计学分析。结果激光组与酸蚀组比较无显著性差异。激光＋酸蚀组与激光组、酸蚀组比较均有显著性差异。结论脉冲Nd：YAG激光照射处理楔状缺损区可提高牙面与光固化树脂粘接力，提高充填的成功率。     

脉冲Nd:YAG激光照射牙本质后对光固化树脂充填体边缘微渗漏的影响

目的研究脉冲Nd：YAG激光照射牙本质后对光固化树脂充填体边缘微渗漏的影响，以探讨脉冲Nd-YAG激光在龋病治疗中的临床应用意义。方法选用正畸要求拔除的正常双尖牙30颗，随机分为A。B，C三组，每组10颗，用高速裂钻备洞（洞长、宽为3mm；洞深为2mm），A组为对照组，常规酸蚀树脂充填；B，C两组分别用50mJ，10Hz和100mJ，10Hz的脉冲Nd：YAG激光能量照射窝洞牙本质壁30s后树脂充填，分别用体视显微镜和扫描电镜观察充填体边缘和洞壁结合情况。结果．体视显微镜下观察：A组的牙本质洞壁与光固化树脂充填体间染料渗入较多，着色较深；B、C组的牙本质洞壁与光固化树脂充填体间染料渗入较少，着色较浅。扫描电镜下观察：B、C组的牙本质洞壁与光固化树脂充填体间裂隙明显小于未经激光处理的对照组。结论脉冲Nd：YAG激光处理牙本质后进行光固化复合树脂充填，可以减少充填体微渗漏，有利于充填的成功．     

口腔内科学——龋病及牙体硬组织非龋性疾病

FL-Bond自酸蚀黏结剂对暴露根面脱敏的临床疗效，Solidex瓷聚体嵌体修复后牙Ⅱ类窝洞的临床观察，用色度学方法研究牙齿漂白剂增白牙齿的效果，复合体充填乳牙龋术后即刻评价指标的筛选，三种方法修复楔形缺损疗效对比，乳牙牙本质钙元素的电子探针测定及其与龋病的关系     

Dyract和银汞合金治疗下颌第一乳磨牙龋病的临床评价

目的比较光固化单组分复合体Dyract和银汞合金治疗下颌第一乳磨牙邻面龋的效果。方法采用单盲自身对照的设计方法，用光固化单组分复合体Dyract和银汞合多治疗40名患者80颗下颌第一乳磨牙远中邻面龋。结果实验组疗效优于对照组。经统计学处理差异有显著性（P＜0．05）。结论用光固化单组分复合体治疗下颌第一乳磨牙邻面龋可以明显提高修复体的临床效果。     

Dyract复合体在中老年楔状缺损和(或)根面龋治疗中的应用

1　临床资料　　应用 Dyract复合体治疗中老年楔状缺损和 (或 )根面龋 ,1年后复查 30例 94牙 ,患者年龄 5 0～ 74岁 ,楔状缺损 80牙 ,根面龋 14牙。所有病例治疗前均无牙髓病变。按 Dyract说明书完成患牙修复 ,根面龋去净龋坏 ,可不作抗力、固位形。近髓深洞用光固化氢氧化钙护髓 (厚 0 .5 mm)。疗效标准　成功 :充填体形态正常 ,与洞壁密合 ,无染色和变色 ,轻微磨耗 ,牙髓活力正常。失败 :充填体脱落 ,与洞壁有缝隙有染色和变色 ,明显磨耗 ,出现牙髓病变 ,出现任一项均为失败。2　结果与讨论楔状缺损复查 80牙 ,成功 75牙 ,成功率 93.7% ;…     

3种充填材料治疗老年根面龋的临床研究

目的 选择老年根面龋充填治疗的理想材料。方法 269颗患牙分成3组,分别用Dyract复合体、光固化复合树脂和玻璃离子水门汀(FujiⅡ)充填治疗,随访18～24个月。结果 Dyract复合体成功率95.6％,明显高于光固化复合树脂的67.1％(P<0.05),而与玻璃离子水门汀的成功率89.52％之间无显著性差异(P>0.05).结论Dyract复合体是治疗老年根面龋的较理想材料。     

Nd：YAG激光对自酸蚀粘结系统和牙本质粘结力的影响

目的探讨Nd：YAG激光对牙本质自酸蚀粘结系统的影响。方法选用因正畸拔除的新鲜前磨牙42颗，随机分为3组，每组14颗；牙面预备暴露牙本质；分别采用Adper^TM Prompt^TM粘结剂＋F2000树脂充填，Nd：YAG激光照射＋Adper^TM Prompt^TM粘结剂＋F2000树脂充填，Adper^TM Prompt^TM粘结剂＋Nd：YAG激光照射＋F2000树脂充填。评价各组树脂与牙本质之间剪切强度。结果Nd：YAG激光照射＋Adper^TM Prompt^TM粘结剂＋F2000树脂充填组的剪切强度明显大于其余2组，其余2组之间剪切强度对比无明显差异。结论先采用脉冲Nd：YAG激光照射后使用Adper^TM Prompt^TM粘结剂组获得最大粘结力。     

Nd:YAG激光治疗牙本质过敏症的临床疗效观察

目的 :探讨Nd :YAG激光治疗牙本质过敏症的疗效。方法 :15 3例患者的 2 70颗患牙 ,随机分为 2组 ,分别用Nd :YAG激光和Gluma脱敏剂进行治疗后观察疗效。结果 :实验组治愈率为 92 .5 9% ,有效率为94.0 7% ;对照组治愈率为 49.62 % ,有效率为 71.84%。结论 :2种治疗方法的疗效有显著性差异 (P <0 .0 1) ,激光治疗牙本质过敏的效果优于Gluma脱敏剂。     

RECOLITE治疗老年人静止根面龋伴牙本质过敏症的临床研究

目的:观察RECOLITE(脱敏王)治疗老年人静止根面龋伴牙本质过敏症的疗效.方法:实验组使用RECOLITE,对照组使用0.48mol/L的氟化钠溶液.记录第3次治疗后的疗效及实验组3个月后的随访结果.结果:实验组:显效50颗(90.90%),有效3颗(5.45%),无效2颗(3.63%),总有效53颗(96.36%);对照组:显效23颗(40.90%),有效29颗(52.72%),无效3颗(5.45%),总有效52颗(94.90%).两组总有效率差异无显著性(P＞0.05),显效率差异显著(P＜0.05).3个月后实验组疗效:显效43颗(89.58%),有效3颗(6.25%),无效2颗(4.16%),总有效46颗(95.83%).结论:RECOLITE对老年人静止根面龋既有消毒作用又对其伴牙本质过敏症具有治疗作用.     

A comparison between the occluding effects of the Nd:YAG laser and the desensitising agent sensodyne on permeation through exposed dentinal tubules of endodontically treated teeth: an in vitro study

OBJECTIVE: Dentine hypersensitivity may occur due to loss of covering enamel and/or loss of cementum after gingival recession, resulting in exposure of cervical dentine and patency of dentinal tubules. The effect of thermally cooled pulsed neodymium:yttrium-aluminium-garnet (Nd:YAG) laser on the permeability and structural appearance of the root canal wall was investigated in vitro. The aim of this study was to compare the occluding effect of Nd:YAG laser with that of sensodyne on exposed dentine. MATERIAL AND METHODS: Forty freshly extracted human maxillary anterior teeth were collected at random. Root canal obturations were performed using master apical file no. 60 k-type for obturated teeth. All teeth were stored in 100% humidity at 37 degrees C for 48h to allow time for the sealer to set. Dentine of 35 teeth was exposed by removing the cementum, and the remaining five teeth represented a negative control group. Specimens were examined using stereomicroscopy to show the surface topography of the dentine substrate before and after treatment with Nd:YAG laser or sensodyne. RESULTS: A double-blind technique was used when taking measurements of ink penetration (in mm) for each group. Teeth treated by Nd:YAG laser showed the least ink penetration, followed by teeth treated by sensodyne. The positive control group demonstrated complete ink penetration and the negative control group showed no ink penetration. Stereomicroscopic examination of specimens treated with Nd:YAG laser showed deposition on the dentinal surface, and specimens treated with sensodyne showed partial deposition. Untreated specimens were free of deposition and the tubules remained patent. CONCLUSION: There is no significant difference in the occluding effect of Nd:YAG laser and sensodyne toothpaste. Both treatments have a promising effect on the reduction of permeation through exposed dentinal tubules. However, the occluding effect of Nd:YAG laser occurs within seconds whereas that of sensodyne takes at least 3 weeks.     

激光照射加窝沟封闭治疗中老年人早期根面龋的临床观察

目的：观察Nd:YAG激光照射后光敏窝沟封闭剂封闭,治疗中老年人早期根面龋的临床效果。方法：用脉冲Nd:YAG激光照射龋损区,然后用光敏窝沟封闭剂封闭,定期复查。结果：治疗组83例早期根面龋齿中,成功69例,有效11例,失败3例,疗效明显优于对照组。结论:Nd:YAG激光照射后用窝沟封闭剂封闭对早期根面龋有较好的疗效。     

脉冲Nd:YAG激光治疗慢性根尖周炎的临床疗效评价

目的 分析脉冲激光治疗慢性根尖周炎的临床疗效.方法 收集门诊68例慢性根尖周炎患者.其中36例常规根管预备后,采用激光辅助治疗和根向激光直接治疗的方法,另外32例则采用常规根管治疗做对照.通过患牙松动度、窦道愈合程度、咀嚼功能以及X线片骨质阴影区评价两者疗效.结果 激光治疗后有效率是88.89%,而常规根管治疗法则为62.50%.结论 脉冲激光对治疗慢性根尖周炎症有辅助作用,可以作为常规根管治疗的辅助手段.     

脉冲Nd：YAG激光与氟化钠联合应用预防根面龋的扫描电镜研究

目的研究脉冲钕钇铝石榴石（neodymium-doped yttrium aluminum garnet,Nd：YAG）激光与氟化钠联合应用预防根面龋的作用。方法 48颗因正畸拔除的健康牙用指甲油开窗后随机分为4组：对照组、激光处理组各14颗,氟化钠处理组、激光氟化钠处理组各10颗。4组各10颗置于变形链球菌细菌悬液中行人工致龋。取所有标本牙的开窗区牙体组织,扫描电镜下观察正常根面牙骨质、激光照射后的根面牙骨质及人工龋根面牙骨质表面的超微结构改变。结果电镜下,氟化钠组、激光组、激光氟化钠组的硬组织脱矿、胶原纤维断裂等龋损改变均较对照组轻,其中激光氟化钠组改变最小。结论激光照射可改变牙骨质表面形态;激光照射与氟化钠对根面龋的发生均有一定的预防作用,二者联合应用效果更好。     

Er：YAG激光对根面牙本质与玻璃离子间抗剪切强度的影响

目的：研究铒：钇铝石榴石（Er：YAG）激光照射对老年人根面牙本质与玻璃离子水门汀间的抗剪切强度的影响。方法：收集20颗老年人（≥60岁）和20颗年轻人（≤20岁）完整离体恒牙,用金刚砂车针磨除近中釉牙骨质界部位的牙釉质及牙骨质,暴露根方牙本质。老年人牙齿随机分为 G 1组和 G2组,年轻人牙齿随机分为 M1组和 M2组,每组10颗。采用不同的方式处理根面牙本质：G1组和 M1组用 Er：YAG激光照射,G2组和 M2组仅用金刚砂车针制备。将牙齿包埋于自凝塑料,制备根面使用 GC Fuji Ⅸ GP CAPSULE 玻璃离子充填。样本冷热循环后,置于万能材料试验机测定其抗剪切强度,并行统计学分析。结果：抗剪切强度比较显示：G1组＞G2组,M1组＞M2组,G1组＞M1组,G2组＞M2组（P＜0．05）。结论：Er：YAG激光照射可以提高牙本质与玻璃离子间抗剪切强度;老年人牙齿可以获得比年轻人更高的抗剪切强度。     

Effect of Nd:YAG laser combined with fluoride on the prevention of primary tooth enamel demineralization

Most studies dealing with the caries preventive action of Nd:YAG laser have been done in permanent teeth and studies on primary teeth are still lacking. The aim of this study was to evaluate in vitro the effect of Nd:YAG laser combined or not with fluoride sources on the acid resistance of primary tooth enamel after artificial caries induction by assessing longitudinal microhardness and demineralization depth. Sixty enamel blocks obtained from the buccal/lingual surface of exfoliated human primary molars were coated with nail polish/wax, leaving only a 9 mm2 area exposed on the outer enamel surface, and randomly assigned to 6 groups (n=10) according to the type of treatment: C-control (no treatment); APF: 1.23% acidulated phosphate fluoride gel; FV: 5% fluoride varnish; L: Nd:YAG laser 0.5 W/10 Hz in contact mode; APFL: fluoride gel + laser; FVL: fluoride varnish + laser. After treatment, the specimens were subjected to a des-remineralization cycle for induction of artificial caries lesions. Longitudinal microhardness data (%LMC) were analyzed by the Kruskal-Wallis test and demineralization depth data were analyzed by oneway ANOVA and Fisher's LSD test (á=0.05). APFL and APF groups presented the lowest percentage of microhardness change (p<0.05). Demineralization depth was smaller in all treated groups compared with the untreated control. In conclusion, Nd:YAG laser combined or not with fluoride gel/varnish was not more effective than fluoride alone to prevent enamel demineralization within the experimental period.     

Effects of Nd:YAG laser pulpotomy on human primary molars

The purpose of this study was to compare the effects of Nd:YAG laser pulpotomy to formocresol pulpotomy on human primary teeth. Patients with a primary tooth that required pulpotomy because of pulpal exposure to caries, were selected for this study. After removal of coronal pulpal tissue, Nd:YAG laser at 2 W, 20 Hz, 100 mJ or a 1:5 dilution of formocresol was introduced into the canal orifice for complete hemostasis. IRM paste was then placed over the pulp stump, and the tooth was restored either with composite resin or stainless steel crown. Sixty-eight teeth were treated with Nd:YAG laser and followed up for 6 to 64 months. Clinical success was achieved in 66 out of the 68 teeth (97 %), and 94.1 % were radiographically successful. In the control group, 69 primary molars were treated with formocresol and followed up for 9 to 66 months; 85.5 and 78.3% achieved clinical and radiographic success, respectively. The success rate of Nd:YAG laser pulpotomy was significantly higher than that of formocresol pulpotomy. The permanent successors of the laser-treated teeth erupted without any complications.     

The sealing ability of an epoxy resin root canal sealer after Nd:YAG laser irradiation of the root canal

AIM: To evaluate ex vivo the effect of Nd:YAG laser irradiation with and without black ink on instrumented root canal walls, and the degree of both coronal and apical microleakage of filled root canals. METHODOLOGY: Seventy-two single-rooted teeth were instrumented up to a size 40 K-file, and then divided into six groups of 10 teeth: groups 1 and 4 remained unlased and acted as control groups, groups 2 and 5 were treated with a Nd:YAG laser (Fidelis Plus, Herzele, Belgium), groups 3 and 6 were treated with a laser and black ink; the remaining 12 teeth served as positive and negative controls. The laser was operated at 1.5 W, 15 Hz, four times for 5 s with a 20-s interval. Groups 4-6 were filled using cold lateral condensation of gutta-percha and AH26. After storage in water for 48 h at 37 degrees C, through-and-through leakage (L in microL day-1) was measured for 48 h under a pressure of 1.2 atm using a fluid transport model and recorded as L=0 (L1), 010 (L3). After the assessment of leakage with the fluid transport model, the teeth were immersed in rhodamine B solution for 48 h at 37 degrees C. Apical and coronal dye leakage was scored after longitudinal splitting of these teeth. All teeth of groups 1-3 were split longitudinally and observed under SEM for evaluation of remaining smear layer. RESULTS: Through-and-through leakage was only observed in the group lased with black ink (two samples-L2). Apical and coronal dye leakage was observed in all groups; there were no statistically significant differences amongst the three experimental groups. The through-and-through leakage, measured with the fluid transport model in two teeth of group 6, was confirmed in the dye leakage test (rhodamine B dye was observed along the total length of the root filling). There was evidence of melted and ablated root canal dentine in the laser-treated groups. These findings were more obvious in root canals lased in association with black ink. All apical foramina in the lased group remained patent. CONCLUSIONS: Nd:YAG laser irradiation with black ink increased the amount of melted and ablated dentine areas compared with that without black ink. Nd:YAG lasing in association with black ink did not result in a reduction of either coronal or apical microleakage in root filled teeth.