Er：YAG激光联合次氯酸钠对管间峡区的清理作用

Evaluation of root canal isthmus debridement efficacy of Er:YAG laser in combination with sodium hypochlorite

目的:评价Er:YAG激光与NaClO联合应用对根管及管间峡区内有机碎屑的清理效果,为探索新型根管及管间峡区清理技术提供实验依据。方法:挑选经过统一根管预备后含有管间峡区的前磨牙50颗,随机分为5组,分别采用以下方法进行处理:A组仅使用1.0%NaClO冲洗1 min,B、C、D组分别用0.5、1.0、2.0 W Er:YAG激光照射1 min,同时联合使用1.0%NaClO冲洗,E组不做任何处理。标本脱钙包埋后切片,行H-E染色后采集图像进行观察,测量根管及管间峡区内剩余有机碎屑的含量,分别计算根管及管间峡区的清洁度。采用SPSS 13.0软件包对数据进行统计学分析。结果:A、B、C、D 4组根管清洁度分别为95.24%、96.53%、97.63%和98.22%,管间峡区清洁度分别为16.50%、51.48%、52.56%和53.83%,B、C、D 3组根管及管间峡区清洁度均优于A组,差异显著(P<0.05)。B、C、D 3组间比较根管及管间峡区清洁度无显著差异(P>0.05)。结论:Er:YAG激光和NaClO冲洗液联合应用可获得较理想的根管及管间峡区清理效果,有望成为一种新型、有效的根管及管间峡区清理技术。

PURPOSE： To histologically evaluate the efficacy of sodium hypochlorite （NaCIO） in combination with Er： YAG （erbium-doped yttrium aluminium garnet） laser in dissolving necrotic tissue and cleaning root canals as well as canal isthmuses. METHODS： After scanned by cone-beam CT （CBCT）, 50 well-prepared premolars with root canal isthmuses were selected and randomly assigned into 5 groups. They were subsequently subjected to different regimens as followed： group A-irrigated with 1% NaC10 for 1 minute, group B- irradiated by Er：YAG laser at 0.5 W combined with 1% NaC10 irrigation for 1 minute, group C- irradiated by Er：YAG laser at 1.0 W combined with 1% NaC10 irrigation for 1 minute, group D- irradiated by Er：YAG laser at 2.0 W combined with 1% NaCIO irrigation for 1 minute,group E- negative control. After histological preparation and staining, the cross-sections were evaluated for percentage of tissue removal from root canals and isthmuses. The cleanliness values were calculated using SPSS 13.0 software package. RESULTS： The mean percentage of root canals in group A, B, C and D was 95.24%, 96.53%,97.63% and 98.22%, respectively, and the mean percentage of isthmuses was 16.50%, 51.48%, 52.56% and 53.83%, respectively. The mean percentage of root canal and isthmus cleanliness values were significantly higher in group B, C and D （P〈0.05） than that in group A. There was no significant differences of root canal and isthmus cleanliness among group B, C and D. CONCLUSIONS： Er：YAG laser combined with 1% NaC10 irrigation may be used effectively in root canal and root canal isthmus cleanliness as a new method.