Hicks John, Winn David, Flaitz Catherine, Powell Lynn
Department of Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas 77030, USA.
Quintessence Int. 2004 Jan;35(1):15-20.
This in vivo pilot study investigated the role of argon laser irradiation and combined fluoride and argon laser treatment in accelerated natural caries development in sound enamel surfaces beneath plaque-retentive orthodontic bands.
Five patients (3 female, 2 male, ages 19 to 28 years) requiring tooth extraction prior to orthodontic treatment, participated in the study. Buccal surfaces were treated with either: (1) argon laser (250 mW for 10 seconds, ARGO-MOD); (2) topical fluoride (0.5% fluoride ion, Thera-Flur-N) followed by argon lasing; or (3) no treatment (control). Orthodontic bands with plaque-retentive slots on buccal surfaces were placed on the teeth slated for extraction (n = 14). Following a minimum of 5 weeks of intraoral exposure, the teeth were extracted for laboratory analysis. The teeth underwent serial longitudinal sectioning (12 sections per tooth). The sections were imbibed in water, and lesion depths were determined with each section, using polarized light microscopy. Comparisons were made among treatment groups (analysis of variance, Duncan's multiple range test for paired samples).
Mean lesion depths were: 261 +/- 24 microm for the no treatment control group (n = 84 sections); 147 +/- 18 microm for the argon laser group (n = 24 sections); and 99 +/- 12 microm for the fluoride and argon laser group (n = 60 sections). Both the argon laser (44%) and the fluoride and argon laser groups (62%) had significant lesion depth reductions compared to controls. The addition of fluoride treatment prior to argon lasing resulted in a 32% reduction in lesion depth compared to argon laser treatment alone.
Within this clinical pilot study, in vivo natural caries formation was affected significantly by a single exposure to low fluence argon laser irradiation. Topical fluoride treatment in combination with argon lasing provided an even greater degree of resistance against in vivo enamel caries development. A simple technique for reducing the caries susceptibility of enamel may be a clinical reality.
本体内初步研究调查了氩激光照射以及氟化物与氩激光联合治疗在正畸带环下方健康釉质表面加速自然龋发展过程中的作用，正畸带环会留存菌斑。
五名（3名女性，2名男性，年龄19至28岁）在正畸治疗前需要拔牙的患者参与了本研究。颊面接受以下处理：（1）氩激光（250毫瓦，照射10秒，ARGO - MOD）；（2）局部用氟（0.5%氟离子，Thera - Flur - N），随后进行氩激光照射；或（3）不做处理（对照组）。在预定拔除的牙齿（n = 14）上放置颊面带有菌斑留存槽的正畸带环。经过至少5周的口腔内暴露后，将牙齿拔除进行实验室分析。牙齿进行连续纵向切片（每颗牙齿12片）。切片在水中浸泡，使用偏光显微镜测定每片的病变深度。在各治疗组之间进行比较（方差分析，配对样本的邓肯多重极差检验）。
平均病变深度为：未处理对照组为261±24微米（n = 84片）；氩激光组为147±18微米（n = 24片）；氟化物与氩激光联合治疗组为99±12微米（n = 60片）。与对照组相比，氩激光组（减少44%）和氟化物与氩激光联合治疗组（减少62%）的病变深度均显著降低。与单独氩激光治疗相比，在氩激光照射前加用氟化物治疗使病变深度降低了32%。
在本临床初步研究中，单次低能量氩激光照射显著影响了体内自然龋的形成。局部用氟治疗与氩激光照射相结合对体内釉质龋发展提供了更高程度的抵抗力。一种降低釉质龋易感性的简单技术可能成为临床现实。
