Aoki A, Miura M, Akiyama F, Nakagawa N, Tanaka J, Oda S, Watanabe H, Ishikawa I
Periodontology, Department of Hard Tissue Engineering, Graduate School, Tokyo Medical and Dental University, Japan.
J Periodontal Res. 2000 Oct;35(5):266-77. doi: 10.1034/j.1600-0765.2000.035005266.x.
The purpose of the present study was to evaluate the effectiveness of Er:YAG laser scaling and the morphological and histological changes of the laser-scaled root surface in comparison with the effectiveness and root surface changes produced by conventional ultrasonic scaling. Fifty-three periodontally involved human extracted teeth with a band of subgingival calculus were used. The teeth were divided randomly into 2 groups for laser scaling and ultrasonic scaling. Laser irradiation was performed at an energy output of 40 mJ/pulse and 10 pulses/s under water spray, with the probe tip contacted obliquely to the root surface. Ultrasonic scaling was performed at a clinically standard power setting. The time required for scaling, the scaled area and the temperature changes were determined using both methods of treatment. The features of the scaled surfaces were examined by histological and scanning electron microscope (s.e.m.) observations. The Er:YAG laser provided subgingival calculus removal on a level equivalent to that provided by the ultrasonic scaler, without major thermal elevation. Macroscopically, the laser-treated root surface was somewhat rougher than or similar to the ultrasonically scaled root. However, the efficiency of the laser scaling was lower than that of the ultrasonic scaling. In addition, histological examination revealed a thin deeply stained zone on the lased root surface, and s.e.m. analysis revealed a characteristic microroughness on the lased surface. The laser scaling provided a level of calculus removal that was similar to that provided by the ultrasonic scaling. However, the Er:YAG laser produced superficial, structural and thermal microchanges on the root cementum.
本研究的目的是评估铒激光龈下刮治的有效性，以及与传统超声龈下刮治相比，激光刮治后牙根表面的形态学和组织学变化。本研究使用了53颗带有龈下牙石带的牙周病患拔除牙。将牙齿随机分为两组，分别进行激光刮治和超声刮治。在喷水条件下，以40 mJ/脉冲的能量输出和10脉冲/秒的频率进行激光照射，探头尖端倾斜接触牙根表面。超声刮治在临床标准功率设置下进行。使用两种治疗方法测定刮治所需时间、刮治面积和温度变化。通过组织学和扫描电子显微镜（SEM）观察来检查刮治后表面的特征。铒激光在龈下牙石清除效果上与超声洁治器相当，且不会引起明显的温度升高。宏观上，激光处理后的牙根表面比超声刮治后的牙根表面略粗糙或相似。然而，激光刮治的效率低于超声刮治。此外，组织学检查显示激光处理后的牙根表面有一条薄的深色染色带，SEM分析显示激光处理后的表面有特征性的微粗糙度。激光刮治在牙石清除效果上与超声刮治相似。然而，铒激光会在牙根牙骨质上产生表面、结构和热方面的微观变化。
