Er��YAG�������ϲ�ͬ�����Ӧ��������ֱ�Ӹ������ٴ������о�

??Objective    To compare clinical success rates of Er??YAG laser combined with different capping agents for direct pulp capping in primary teeth and evaluate the pain during treatment. Methods    A total of 60 teeth of 60 children between the age of 3 and 5 years were selected for this study. All the samples were randomly assigned to the following 4 groups??n=15???? Er??YAG laser+MTA??the exposed area was sealed with MTA after Er??YAG laser for caries removal and cavity preparation??Er??YAG laser+calcium hydroxide??CH????the treated area was sealed with CH paste after Er??YAG laser for caries removal??dental handpiece+MTA??the exposed pulp was sealed with MTA after dental handpiece for caries removal??dental handpiece+CH??CH was applied after dental handpiece for caries removal. The depth of cavity preparation was recorded while the child felt painful. At the 3-??6-??12-and 24-month recall examiations??the effect was observed by X-ray. Results    The proportion of the depth of cavity preparation??superficial dentin??middle dentin??deep dentin??by handpiece and Er??YAG laser was 50%??40%??10% and 0.67%??20%??79.33%??respectively. The two patterns of cavity preparation revealed significant difference??P < 0.05??. At the 3-??6-??12-month recall examiations??the success rates of the laser groups were higher than the handpiece groups??while they had no significant difference??P > 0.05??. At the 24 months??the success rates of the laser groups were 93.3%. They showed significantly higher success rates than the handpiece groups??P < 0.05??. The success rates of handpiece+MTA and handpiece+CH were 80%??12/15??and 73%??11/15????which did not reveal any significant difference. Conclusion        Er??YAG laser combined with pulp capping agents can be recommended for direct pulp therapy in primary teeth??and Er??YAG laser will result in a slight pain??thus the children will be inclined to accept and complete the treatment. The clinical effect of MTA shows no statistical difference compared with CH.     

������մɱ�����ɰ�������ʱ���Er��YAG���⴦�����֬��ǿ��Ӱ���о�

目的探讨氧化锆陶瓷表面不同粒径Al2O3颗粒喷砂及牙本质表面Er：YAG激光处理对树脂黏结强度的影响。方法2011年2—10月在山西医科大学口腔医院选取25颗完整人前磨牙,制作50个牙块,暴露牙本质。其中10个牙块表面用35％磷酸酸蚀处理,40个牙块表面用Er：YAG激光蚀刻处理。制作氧化锆陶瓷片50个,20个不做处理,其余30个（每组10个）在0．4MPa压力下分别接受120、80、40μm粒径Al2O3颗粒喷砂20s。试件分为5组（每组10个）：A、B组分别由35％磷酸酸蚀和Er：YAG激光蚀刻的牙块与未做处理的陶瓷片黏结;C、D和E组分别由120、80、40μm粒径Al2O3颗粒喷砂的陶瓷片与Er：YAG激光蚀刻的牙块黏结。各组分别进行黏结强度测试？结果A组的黏结强度[（8．71±0．86）MPa]低于B组[（10．94±0．93）MPa],两组差异有统计学意义（P〈0．05）;C、D和E组的黏结强度[（13．49±1．53）、（13．97±0．83）、（17．11±1．51）MPa]均高于B组,差异有统计学意义（P〈0．01）;C、D组的黏结强度低于E组,差异有统计学意义（P〈0．01）;但C与D组间差异无统计学意义（P〉0．05）。结论氧化锆陶瓷片表面Al2O3颗粒喷砂和牙本质表面Er：YAG激光蚀刻处理可增加氧化锆陶瓷与牙本质间的树脂黏结强度。     

Er��YAG�������������������������ٴ�Ч���Ƚ��о�

目的比较Er:YAG激光排龈法和排龈线排龈法的临床效果。方法选择2010年6—8月到山西医科大学口腔医院口腔修复科就诊因美观要求或固位需要采用龈下边缘金属烤瓷单冠修复的36例患者的62颗患牙,随机分为两组:Ⅰ组采用排龈线排龈法,Ⅱ组采用Er:YAG激光排龈法。对两组的牙预备体、牙龈止血效果、印模和模型清晰程度以及1周后牙龈健康状况进行评价。使用数字分级法(NRS)调查患者的疼痛程度。结果两种排龈法获得的牙预备体、印模和模型满意度以及1周后牙龈健康状况差异均无统计学意义(P>0.05),而牙龈止血效果满意度差异有统计学意义(P<0.05),Er:YAG激光排龈法牙龈止血效果优于排龈线排龈法。Er:YAG激光排龈法90.3%的患者无疼痛,而排龈线排龈法83.9%的患者有轻度疼痛。结论排龈线排龈法和Er:YAG激光排龈法均为较好的排龈方法。而在牙龈止血方面,Er:YAG激光排龈法明显优于排龈线排龈法。     

Er��YAG�����ڸ��������е�Ӧ���о���չ

由于根管系统的复杂性。传统的根管预备器械与冲洗剂难以达到完全清理根管的目的。Er：YAG激光联合根管冲洗剂使用,既可以采取更保守的根管预备,又能增强去除玷污层、开放牙本质小管和杀菌的能力,有利于根管封闭剂和根管内黏结剂的渗透而减少微渗漏;且在一定的激光参数范围内,其不会引起冲洗剂的根尖渗出;产热作用也极小,不会引起根尖周组织损伤。因此,Er：YAG激光的应用能使根管预备过程变得简单、高效、安全。本文综述了Er：YAG激光在根管治疗中的应用研究进展。     

��ͬʱ��Er��YAG�������䴦���������ճ��ǿ��Ӱ���о�

目的探讨不同时间Er：YAG激光照射处理对正常牙本质粘接的影响,得出牙本质粘接时最佳照射时间参数,以提高牙冠使用寿命。方法选择2012年5—10月在山西医科大学口腔医院就诊的15～30岁患者因正畸原因拔除的牙根发育完整、无修复体、无折裂的前磨牙60颗,随机分为A、B、C、D、E、F6组,每组10颗牙,经保留颌面牙本质处理后分别接受Er：YAG激光照射0、1、2、3、4、5s,与树脂粘接制作拉伸试件,测试粘接强度,并用扫描电镜观察剖面。结果 Er：YAG激光照射组（B～F组）树脂粘接强度明显大于未照射组（A组）;在激光照射组中,B～D组粘接强度递增,D组达峰值,但随着照射时间继续延长,E、F组粘接强度随之降低。扫描电镜观察显示,A组表面光滑、平整,与黏结剂嵌合程度差;B～E组牙本质表面清洁、粗糙、无热损伤痕迹;F组表面粗糙度最明显,有热损伤痕迹,部分区域甚至出现焦化或碳化的迹象。结论 Er∶YAG激光处理正常牙本质的最佳照射时间应该为3～4s。     

Er��YAG��������Gluma���������������С��Ч���о�

目的探讨Er:YAG激光与Gluma脱敏剂联合应用对牙本质小管的封闭作用。方法选取2010年3—6月于山西医科大学口腔医院口腔颌面外科因正畸拔除的24颗前磨牙,制成厚约2mm的牙本质片。根据其表面处理方式的不同随机分为4组:对照组、Er:YAG激光组、Gluma脱敏剂组、联合应用组(Er:YAG激光联合Gluma脱敏剂),每组6颗前磨牙。处理后,扫描电镜观察各组牙本质小管形态特征,并测量牙本质小管口的直径和相对面积。结果联合应用组中牙本质小管口的直径和相对面积均明显小于其他各组,且差异有统计学意义(P<0.05)。结论 Gluma和Er:YAG联合应用对牙本质小管的封闭作用优于单独应用Gluma脱敏剂或Er:YAG激光。     

Nd��YAG�����������ֲ�����ṹ���¶ȵ�Ӱ���о�

??Objective     To investigate the effect of irradiation with Nd??YAG laser on the surface microstructure and temperature change of dental implants in vitro??in order to provide the reference for clinical parameter setting and operation method. Methods    The titanium discs were irradiated by Nd??YAG laser with different parameter setting. The surface microstructure was observed by scanning electron microscope?? and the temperature elevation was measured by thermocouple. The time to reach a 10?? increase in temperature was recorded as well. Results    ??1??Local areas with surface melting on 0.2W ??20 mJ??10 Hz??and significant melting with crackson 1W setting ??100 mJ??10 Hz or 50 mJ??20 Hz?? were observed after Nd??YAG laser irradiation without cooling??while the surface of the titanium disk is still molten with water vapor cooling.??2??The temperature elevation of titanium discs were less than 10?? with low power setting or water cooling conditions of Nd??YAG laser irradiation for 30 seconds. It took 13.8??6.2 and 7.8 seconds??respectively??to reach a 10?? increase threshold in temperature after being irradiated with 0.5 W ??50 mJ??10 Hz??and 1W??100 mJ??10 Hz or 50 mJ??20 Hz??without cooling conditions. Conclusion    Direct and prolonged exposure to Nd:YAG laser leads to microstructure change of implant surface??and may produce a risk of thermal damage to surrounding tissue. The reasonable parameter setting??mobile radiation mode and cooling are suggested.     

Er��Cr��YSGG����������������벣������ˮ��͡�俹������ǿ��Ӱ����о�

目的评价Er,Cr:YSGG激光照射对牙本质与玻璃离子水门汀间抗剪切黏结强度的影响。方法于2008年7月至12月,在中国医科大学口腔医院收集15颗因正畸拔除的无龋坏、无隐裂的完整离体前磨牙。将标本牙的颊侧与舌侧牙本质表面分别用Er,Cr:YSGG激光照射处理(实验组)和涡轮手机处理(对照组),经FX-Ⅱ玻璃离子水门汀充填及冷热循环后进行剪切力实验,计算标本牙的抗剪切黏结强度,体视显微镜下观察牙体组织的剪切断面。结果剪切力实验结果显示:实验组牙本质与充填材料间的抗剪切黏结强度显著高于对照组(P<0.05)。体视显微镜观察:实验组牙体组织的剪切断面凹凸不平,充填物残留更多;对照组则较光滑、平坦。结论Er,Cr:YSGG激光照射会增强牙本质与玻璃离子水门汀间的抗剪切黏结强度。     

Nd�� YAG �������ƶ����������׻������ܴ���Ⱥ͸���ɥʧ�ĸ���Ч���о�

目的    评价脉冲Nd：YAG激光治疗慢性牙周炎患者牙周袋深度（PD）和附着丧失（AL）的效果。方法    选择2008年1—6月在福建医科大学附属协和医院就诊的45例慢性牙周炎患者,每例患者至少有4个以上≥6 mm的牙周袋并且分布在2个以上口腔区域内,在接受基础检查和龈上洁治术后,随机分成3组。A组（15例）：单纯接受龈下刮治和根面平整（SRP）治疗;B组（15例）：SRP+1次激光照射治疗（Nd： YAG激光,输出功率2 W,照射时间40 s）;C组（15例）：SRP+2次激光照射治疗（Nd： YAG激光,第1次照射输出功率2 W,照射时间40 s;第2次照射输出功率1 W,照射时间20s）。每组各选择40个位点。统计在基础检查,治疗2、4和12周时各组的PD和AL。结果    从第2周时,3组的PD均明显减小。而AL的改善在第4周时可以明显观察到,且C组的效果最为明显,并一直延续到12周。结论    SRP基础上辅助2次不同能量的激光治疗对慢性牙周炎PD和AL的改善效果均明显优于单独SRP使用。     

Er��Cr��YSGG����Բ�ͬ�����������븴����֬��΢����ճ��ǿ�ȵ�Ӱ��

目的比较老年牙本质和青年牙本质与复合树脂间粘接强度的差异,评价Er,Cr：YSGG激光对牙本质与复合树脂间粘接强度的影响。方法于2012年2—3月在中国医科大学口腔医学院收集老年人（A组）和青年人（B组）离体牙标本各10颗,每组随机分为2个亚组,即A1、A2组和B1、B2组。A1、B1组采用Er,Cr：YSGG激光预备,A2、B2组采用传统涡轮手机预备,自酸蚀粘接剂结合Z350复合树脂充填,37℃水浴24h后,制备成沙漏状试件并进行微拉伸粘接强度测试。体式显微镜下观察并记录断裂模式。结果微拉伸粘接强度测试结果,青年牙本质组明显高于老年牙本质组,差异有统计学意义（P〈0．05）;激光预备组略高于手机预备组,差异无统计学意义（P〉0．05）。各组断裂模式多为界面断裂,组间差异无统计学意义（P〉0．05）。结论老年牙本质由于增龄性变化导致粘接强度降低;Er,Cr：YSGG激光预备对牙本质与复合树脂间粘接强度无不利影响,可作为传统涡轮手机的替代方法。     

�������ʯ��ʯ��������������ʷ��������о���չ

??Nowadays??erbium??yttrium-aluminum-garnet??Er??YAG??laser has been used widely in dental hard tissue treatment??including caries prevention??caries removal??canal preparation and decontamination??periapical surgery and so on. In vitro studies have shown that Er??YAG laser irradiation can cause chemical and morphological changes in dentin. In order to identify the adaptability of Er??YAG laser to dental hard tissue??some researchers have utilized analysis methods of modern biological material investigations. They analyzed the dentin before and after Er??YAG laser irradiation??contrasted the change of dentin morphology??structure and chemical composition. The aim of this paper is to review the previous research methods and results, in order to provide reference for the future study design and clinical practice.     

Nd��YAG��������ȫ��ʴ��ϵͳ����ĥ�����ٴ���Ч�۲�

目的探讨Nd：YAG激光联合全酸蚀黏结系统治疗磨损牙的术后敏感情况及,临床疗效。方法选取2011年2—5月在中国医科大学口腔医学院牙体牙髓科门诊就诊、符合纳入标准的20例患者的Ⅲ级以下磨损牙（前磨牙或磨牙）40颗,每例患者有2颗同名牙有相似病损,按照随机数字表将同一患者的2颗患牙分为试验组和对照组。试验组使用Nd：YAG激光联合全酸蚀黏结剂Scotchbond处理后,用Z350复合树脂充填修复;对照组直接使用Scotchbond处理后,用Z350复合树脂充填修复,以改良美国公共卫生署（USPHS）标准评价修复后1年的随访结果。结果治疗后6个月随访,牙齿敏感情况试验组好于对照组,差异有统计学意义（P〈0．05）;1午后试验组成功率高于对照组,差异有统计学意义（P〈0．05）。结论Nd：YAG激光联合全酸蚀黏结剂处理磨损牙表面后进行复合树脂修复,可在一定程度上减轻术后敏感症状,增强黏结强度,改善修复治疗效果,对Ⅲ级以下磨损牙的修复有较大的意义。     

Nd��YAG���������������������

提要：牙周炎是指发生在牙周支持组织的慢性感染性疾病,可导致牙周组织的附着丧失和牙槽骨的进行性破坏。近些年来,国内外学者们致力于激光在慢性牙周炎治疗中的研究。本文就不同能量的激光在牙周炎治疗中的应用做一综述。     

Nd��YAG����������Ʒ������������׻����е�Ӧ��ǰ��

随着我国进入老龄化社会,如何提高老年人生活质量成为困扰我们的难题。慢性牙周炎是老年人普遍存在的口腔疾病,不仅影响咀嚼,还影响消化以及全身的营养摄入。由于老年人常合并多种全身疾病,各项机能指标、免疫能力下降,现有的牙周治疗技术如刮治术、手术、药物治疗等应用时会存在一些不足。考虑到老年人对复杂治疗的耐受能力,一般首选非手术治疗,目前Nd∶YAG激光已广泛运用于牙周治疗。本文将从老年牙周炎特点、牙周非手术治疗技术、Nd∶YAG激光在牙周治疗中的优越性等方面进行阐述,为Nd∶YAG激光在老年牙周炎治疗的应用提供理论依据。     

Er：YAG激光在龋病防治中的研究进展

龋病是影响人类口腔和全身健康的常见疾病,目前龋病的预防和治疗方法主要是应用氟化物及窝沟封闭和涡轮机机械去腐。铒钇铝石榴石(Er：YAG)激光是一种新型牙体硬组织激光,可以高效切割牙体硬组织,因其安全、无痛、微创而越来越受人们重视。本文就其在龋病预防和去腐备洞对牙髓的影响、微渗漏、粘接性等方面性能的研究进展作一综述。     

��ϵ����������Er��YAG�����ٴ�Ӧ���о�

??Objective    To compare the patients' feeling and postoperative effect of using the Er??YAG laser and conventional technique??and to investigate the applications of Er??YAG laser in labial frenectomy. Methods    Patients were collected from the Department of Oral and Maxillofacial Surgery of Yantai Stomatological Hospital??from April 2014 to March 2015. Twenty-eight patients requiring frenectomy were randomly assigned to have treatment either with conventional surgery or with Er??YAG laser techniques. Compare the postoperative reaction of two methods of treatment in patients??including pain??swelling??language??bleeding??chewing function and lip movement status. Results    From the pain VAS score of 3 hours??3 days??1 week and 1 month pain degree?? we found the laser group was significantly lower than the traditional surgery group??and the difference was statistically significant??P??0.05??. As for other reactions 3 hours??3 days??1 week and 1 month after the suegery??the laser group was also obviously lower than the traditional surgery group??and the difference was statistically significant??P??0.05??. Conclusion    Patients with abnormal labial frenum using the Er?? YAG laser will have a better feeling after the operation. The Er??YAG laser surgery can shorten the operation time and reduce the postoperative pain and adverse reactions.     

Er∶YAG和Nd∶YAG激光在牙冠延长微创手术中的应用

目的 探讨Er∶ YAG和Nd∶YAG激光在牙冠延长术中的应用效果.方法 选取需行牙冠延长术的32位患者的32颗患牙,随机分为2组,激光手术组采用Er∶ YAG和Nd∶YAG激光,不翻瓣进行牙冠延长术;传统牙冠延长术组采用传统牙周手术方法.比较2组手术时间、术后疼痛、术后感染、龈缘位置、龈沟出血指数及探诊深度.结果 激光手术组手术时间明显短于传统牙冠延长术组,术后疼痛指数明显低于传统牙冠延长术组.激光手术组在2周后龈缘位置即达到稳定,传统牙冠延长术组4周后达到稳定.2组均未发生术后感染.龈沟出血指数和探诊深度2组差异无统计学意义.结论 应用Er∶ YAG和Nd∶YAG激光进行牙冠延长手术具有手术时间短、术后反应小、较短时间获得稳定的龈缘位置等优点,是一种创伤小、疗效好的手术方法,值得临床推广应用.     

Er:YAG激光去除全瓷冠1例报告

<正>全瓷材料因其优异的美学性能、良好的生物相容性及机械性能成为口腔领域常用的修复材料。但在临床中,不完善的牙体治疗,修复体的破损、折裂,以及患者对修复体颜色、美观不满意等原因,常导致需要拆除全瓷修复体^[1-2]。传统钻磨去粘接法耗时耗力,在拆除过程中,往往会造成医源性的牙体组织再损伤,一方面破坏了牙体组织的结构,降低了牙体组织的抗力,减少了再粘接面积;另一方面造成全瓷修复体完全的破损,失去了再利用的可能性,最终可能会影响再治疗的效果^[2-4]。因此,全瓷修复体去粘接的问题亟待解决。     

Er: YAG激光在口腔医学中的应用

Er：YAG激光属于中红外线激光,是新一代水动力生物激光系统,拥有适合切除口腔软硬组织的特点,与传统治疗方法相比具有许多优点,可减轻治疗过程中的不适感和疼痛,患者更易接受。因铒激光在牙科治疗中的研究和应用的不断深入,本文对其工作原理及其在口腔治疗中的优势和应用进行综述。     

������ϴ�ڸ��������е�����

??Root canal debridement and infection control are two of the main steps in root canal therapy. Bacteria will be present as biofilm colonies inside the root canal??and it will be well within fins??intercanal anastomoses??apical ramification??apical furcation or lateral accessory canal. Meanwhile??during the cleaning and shaping process??smear layer can be produced??which can be used for the viable bacteria inside the complex anatomical structure to sustain growth and activity. In addition??due to the complexity of the root canal system??the conventional irrigation and disinfection technology is superficial??then the smear layer and Enterococcus faecalis biofilms are difficult to remove. In recent years??lasers??as a novel adjuncting irrigation tool??are used clinically??such as Er??YAG laser and Er??Cr??YSGG laser. As is reported??laser-activated irrigations can effectively remove the smear layer and the infection and obtain better disinfection rates. So in this a review??we made a summary of the effect of laser-activated irrigations on endodontics.