铒激光荡洗活化对于根管内壁玷污层和根管硬度的影响

The effect of Er:yttrium aluminum garnet laser irrigation on the root canal smear layer and root canal microhardness

目的观察不同荡洗方式对根管内壁形态产生的影响。方法收集老年牙周炎患者(60岁以上)拔除的20颗单根前磨牙, 使用简单随机方法随机分为5组(每组4颗), A组:注射针头冲洗组;B组:超声荡洗组;C组:铒(Er)∶钇铝石榴石晶体(YAG)激光(15 Hz、15 mJ、0.20 W)荡洗组;D组:Er∶YAG激光(15 Hz、20 mJ、0.30 W)荡洗组;E组:Er∶YAG激光(15 Hz、20 mJ、0.35 W)荡洗组。观察根管内玷污层及根管硬度的变化。结果经不同根管荡洗方法处理后, A组、B组、C组、D组、E组去除牙本质玷污层评分分别为(4.67±0.27)分、(3.08±0.57)分、(2.83±0.43)分、(1.17±0.19)分、(2.87±0.50)分, 效果总体比较差异有统计学意义(F=35.946, P<0.01)。其中, B组、C组、D组、E组的玷污层去除效果均优于A组, 差异有统计学意义(均P<0.01), D组荡洗对玷污层去除效果优B组、C组和E组, 差异有统计学意义(均P<0.01);经不同根管荡洗方法处理后, A组、B组、C组、D组、E组根管壁牙本质显微硬度分别为(58.98±5.54)分、(55.19±5.71)分、(56.04±3.96)分、(66.65±3.23)分、(45.68±7.58)分, 差异有统计学意义(F=5.83, P<0.05), 其中, 激光D组的根管壁牙本质显微硬度高于激光C组、B组(均P<0.05)。结论激光根管荡洗优于传统荡洗方式, 0.30 W Er:YAG激光进行根管荡洗可最大化清除玷污层, 同时对根管硬度影响最小。

Objective To examine the effects of different endodontic irrigation methods on root canal morphology.MethodsWe collected 20 extracted single-root premolars from elderly patients(≥60 years)with periodontitis and randomly divided them into 5 groups.Group A:syringe irrigation;Group B:P5ultrasonic irrigation,Group C:0.20 WEr:yttrium aluminum garnet(YAG)laser irrigation;Group D:0.30WEr:YAG laser irrigation;and Group E;0.35WEr:YAGlaser irrigation.Changes in the smear layer in the root canal and the hardness of the root canal were assessed.ResultsAfter treatment with different root canal cleaning methods,the scores of smear layer removal for Groups A,B,C,D and E were(4.67±0.27),(3.08±0.57),(2.83±0.43),(1.17±0.19)and(2.87±0.50),respectively.There were statistically significant differences between them(F=35.946,P<0.01).Among them,Group B,C,D and E had better smear layer removal than Group A,and the differences were statistically significant(all P<o.01).Group D had better removal of the smear layer than Groups B,C and E,and the differences were statistically significant(P<o.o1);Values for dentin microhardness of Groups A,B,C,D and E were(58.98±5.54),(55.19±5.71),(56.04±3.96),(66.65±3.23)and(45.68±7.58),respectively,with statistically,significant differences(F=5.83,P<0.05),and for laser-based irrigation,the value for dentin microhardness of Group D was higher than those of groups C and B(all P<0.05).ConclusionsLaser-based root canal irrigation is better than traditional rrigation methods,with O.30 W Er;YAG laser achieving maximal removal of the smear layer and at the same time having the least impact on root canal hardness.