Kesler G, Koren R, Kesler A, Hay N, Gal R
Dental Clinic Center, Petah Tikva, Israel.
J Clin Laser Med Surg. 1999 Jun;17(3):111-4. doi: 10.1089/clm.1999.17.111.
Evaluation of the efficiency of 15 F CO2 laser microprobe, in cases of periapical lesions. The elimination of the pathological reaction caused by certain species of bacteria by reduction of reinfection and stimulation of osteogenesis.
Until now, no suitable delivery fiber existed for CO2 laser endodontic radiation in the apical region where it is most difficult to eliminate the pulp tissue using conventional methods. To overcome this problem, Sharplan Lasers designed a microprobe that reaches closer to the apex, distributing the energy density to a smaller area of the root canal, thus favorably increasing the thermal effects.
The study was conducted on 900 teeth, corresponding to 1512 root canals, divided in two groups. Four hundred sixty-eight were new cases, carefully selected according to strict parameters such as wide periapical translucency over 1 mm, supported by digital x-ray, with a lesion of 3 mm and more. All root canals were mechanically prepared in the conventional method up to size 35, Physiological saline solution served as rinsing solution and the root canals were treated by 15 F CO2 laser microprobe for 60 pulses repeatedly. The temperature at the surrounding tissue of the root did not exceed 38 degrees C.
Filling of the canal was possible at the same appointment, without antibiotic treatment. Four hundred thirty-two of the cases, which were referred to us by other dentists after an unsuccessful treatment according to the classic therapy, were treated by the same laser therapy. Follow-up was performed by clinical examination, and a digital x-ray was taken, during and after treatment as well as after 3, 6, 9, and 12 months.
There is a 98% success rate in both study groups, according to objective criteria for successful treatment including reduction of apical translucency after 2-6 months, freedom from clinical complaints, and no need for periapical surgery.
评估15F CO2激光微探头在根尖周病变病例中的有效性。通过减少再感染和刺激骨生成来消除某些细菌种类引起的病理反应。
到目前为止，在根尖区域还没有适合用于CO2激光牙髓病治疗辐射的传输光纤，在该区域使用传统方法最难清除牙髓组织。为克服这一问题，Sharplan激光公司设计了一种微探头，它能更接近根尖，将能量密度分布到根管的更小区域，从而有利地增强热效应。
该研究针对900颗牙齿（对应1512个根管）进行，分为两组。468例为新病例，根据严格参数仔细挑选，如数字X线显示根尖周透射影超过1mm、病变达3mm及以上。所有根管均采用传统方法机械预备至35号，用生理盐水作为冲洗液，并用15F CO2激光微探头反复处理根管60次脉冲。牙根周围组织的温度不超过38摄氏度。
在同一次就诊时即可进行根管充填，无需抗生素治疗。另外432例病例是其他牙医按照经典疗法治疗失败后转诊给我们的，采用相同的激光疗法进行治疗。通过临床检查进行随访，在治疗期间、治疗后以及3、6、9和12个月后拍摄数字X线片。
根据成功治疗的客观标准，包括2 - 6个月后根尖透射影减小、无临床症状以及无需根尖手术，两个研究组的成功率均为98%。
