Apel C, Meister J, Götz H, Duschner H, Gutknecht N
Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Aachen University, Pauwelsstrasse 30, DE-52074 Aachen, Germany.
Caries Res. 2005 Jan-Feb;39(1):65-70. doi: 10.1159/000081659.
Numerous studies have confirmed the potential of erbium laser irradiation for increasing the acid resistance of dental enamel. The objective of the present paper was to investigate the effect of subablative erbium laser irradiation on the structure and acid resistance of dental enamel by means of confocal laser scanning microscopy (CLSM). To this end, 12 samples of human dental enamel were irradiated with subablative energy densities (Phi) of an Er:YAG (lambda = 2.94 microm, Phi = 6 J/cm(2)) and an Er:YSGG laser (lambda = 2.79 microm, Phi = 8 J/cm(2)). The enamel surfaces of 6 samples were polished prior to irradiation. The remaining 6 samples were left intact (without polishing procedures) and, in the further course of the study, they were subjected to 1-week in situ demineralisation. All irradiated test surfaces were assigned a control surface on the same sample. The changes following laser irradiation and the in situ wearing time were assessed qualitatively using a confocal laser scanning microscope. The irradiation of dental enamel with subablative erbium laser irradiation produces fine cracks in the enamel surface. These cracks act as starting points for acid attack and favour deep demineralisation. These changes reduce or eliminate the positive effect of subablative erbium laser irradiation observed in connection with caries-preventive use. The clinical use of subablative erbium laser irradiation to prevent caries would appear not to make sense under the conditions studied.
众多研究已证实铒激光照射在提高牙釉质耐酸性方面的潜力。本文的目的是通过共聚焦激光扫描显微镜（CLSM）研究亚消融性铒激光照射对牙釉质结构和耐酸性的影响。为此，用亚消融能量密度（Φ）的铒钇铝石榴石激光（波长λ = 2.94微米，Φ = 6焦/平方厘米）和铒钇钪镓石榴石激光（波长λ = 2.79微米，Φ = 8焦/平方厘米）对12个人类牙釉质样本进行照射。6个样本的牙釉质表面在照射前进行了抛光。其余6个样本保持原样（未进行抛光处理），在研究的后续过程中，它们经历了1周的原位脱矿。所有照射过的测试表面在同一样本上都有一个对照表面。使用共聚焦激光扫描显微镜对激光照射和原位磨损时间后的变化进行定性评估。亚消融性铒激光照射牙釉质会在牙釉质表面产生细微裂纹。这些裂纹成为酸侵蚀的起始点，有利于深层脱矿。这些变化减少或消除了在龋齿预防应用中观察到的亚消融性铒激光照射的积极效果。在所研究的条件下，亚消融性铒激光照射预防龋齿的临床应用似乎没有意义。
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