Er:YAG激光对儿童窝沟封闭疗效影响的临床观察

Clinical observation of the Er:YAG laser affected children's pit and fissure sealant

目的：将Er：YAG激光应用于年轻恒牙窝沟封闭术,比较封闭剂的总保留率。方法：选择6-9岁、双侧下颌第一磨牙窝沟形态复杂的儿童60例为研究对象,随机分为A、B两组,采用自身半口对照方法：A组儿童对照侧实验牙应用金刚砂车针行釉质成形术,酸蚀,涂布窝沟封闭剂,实验侧实验牙应用Er：YAG激光行釉质成形术,涂布窝沟封闭剂;B组儿童对照侧实验牙处理同A组,实验牙应用Er：YAG激光行釉质成形术,酸蚀,涂布窝沟封闭剂。术后让受试儿童对治疗评分,定期随访,观察封闭剂保留情况。结果：63.3%的受试儿童愿意主动选择激光治疗。3、6个月复诊时,两组封闭剂的总保留率没有统计学差异（P〉0.05）;12、18个月复诊时,封闭剂材料总保留率：激光＋酸蚀剂组〉传统车针组〉激光组,差异有统计学意义（P〈0.05）。结论：激光是更容易被儿童接受的治疗方式,Er：YAG激光应用于恒牙釉质窝沟封闭时需要配合使用酸蚀剂,增强封闭剂固位。

Objective：To compare the total reserved blocking rate,and discuss the Er：YAG laser is suitable for promotion in clinical treatment of children by applying Er：YAG laser on the enameloplasty sealant technique（EST）of young permanent teeth. Method：A total of 60 children aged from 6 to 9 with complex fissure shape on the first molar at both sides of the lower jaw were randomly divided into Group A and Group B so that the split-mouth design could be utilized. Group A：EST by high-speed handpiece and acid etching before applying fissure sealants on control side and Er：YAG laser enameloplasty before applying fissure sealants on control side. Group B：The method used on control side was the same as Group A. And for test side,Er：YAG laser enameloplasty was associated with acid etching before before applying fissure sealants. Children were asked to rate the treatment afterward. They also received regular follow-up visits so that the reserving status of sealants could be observed. Result：63.3 % of treated children chose laser treatment over other types of treatment. On return visits of the 3rd and 6th months,the total reserving rate from both groups didn＇t show statistic difference（P〈0.05）. On return visits of the 12 th and 18 th month,The total reserving rates were as below：Laser with acid etching high-speed handpiece with acid etching laser,showing statistic difference（P〈0.05）. Conclusion：Laser is more easily accepted by children than other types of treatment. Er：YAG laser should be associated with acid etching when applied on enameloplasty of permanent teeth to enhance sealants retention.