Kreisler Matthias, Al Haj Haitham, d'Hoedt Bernd
Department of Oral Surgery, Johannes Gutenberg-University Mainz, Germany.
Int J Prosthodont. 2002 Nov-Dec;15(6):582-7.
This study investigated temperature changes at the implant-bone interface during simulated implant surface decontamination with an Er:YAG laser.
Stepped cylinder implants with three different surfaces (titanium plasma sprayed, sandblasted and acid etched, and hydroxyapatite coated) were placed in bone blocks cut from freshly resected pig femurs. An artificial periimplant bone defect with a size of 6 mm2 provided access for laser irradiation in the coronal third of the implant. A 540-pm periimplantitis application tip was used at a distance of 0.5 mm from the implant surface. Pulse energy was varied between 60 and 120 mJ at 10 pps. The bone block was placed into a 37 degrees C water bath to simulate in vivo thermal conductivity and diffusitivity of heat. K-type thermocouples connected to a digital meter were used to register temperature changes at three levels of the periimplant bone.
The temperature at the implant-bone interface did not exceed 47 degrees C after 120 seconds of continuing laser irradiation. Temperature elevations were significantly higher at the hydroxyapatite-coated implants than in the two titanium surface groups (P < .001).
Decontamination of implant surfaces by means of the Er:YAG laser did not excessively heat the periimplant bone within the energy range investigated. This technique therefore seems clinically safe, at least when used with the surfaces studied.
本研究调查了在使用铒钇铝石榴石(Er:YAG)激光模拟种植体表面去污过程中种植体 - 骨界面的温度变化。
将具有三种不同表面(钛等离子喷涂、喷砂和酸蚀以及羟基磷灰石涂层)的阶梯圆柱状种植体植入从新鲜切除的猪股骨上切下的骨块中。在种植体冠方三分之一处制造一个6平方毫米大小的人工种植体周围骨缺损,以便进行激光照射。使用一个540微米的种植体周围炎治疗头,距离种植体表面0.5毫米。脉冲能量在60至120毫焦之间变化,频率为每秒10次。将骨块放入37摄氏度的水浴中,以模拟体内的热导率和热扩散率。使用连接到数字仪表的K型热电偶记录种植体周围骨三个层面的温度变化。
持续激光照射120秒后,种植体 - 骨界面的温度未超过47摄氏度。羟基磷灰石涂层种植体的温度升高明显高于两个钛表面组(P <.001)。
在研究的能量范围内,使用Er:YAG激光对种植体表面进行去污不会使种植体周围骨过度受热。因此,至少在与所研究的表面一起使用时,该技术在临床上似乎是安全的。