Moghare Abed A, Tawakkoli M, Dehchenari M A, Gutknecht N, Mir M
Dental School, Isfahan Medical University, Isfahan, Tehran, Iran.
Lasers Med Sci. 2007 Mar;22(1):25-9. doi: 10.1007/s10103-006-0413-y. Epub 2006 Nov 18.
Scaling and root planing are one of the most commonly used procedures for the treatment of periodontal diseases. Removal of calculus using conventional hand instruments is incomplete and rather time-consuming. In search for more efficient and less difficult instrumentation, investigators have proposed lasers as alternatives or adjuncts for scaling and root planing. The aim of the present study was to compare the effectiveness of subgingival scaling and root planing with erbium: yttrium, aluminium, garnet (Er:YAG) laser and hand instrumentation in vitro. The mesial and distal surfaces of 15 periodontal loosed extracted teeth were treated randomly either by hand instrumentation or by Er:YAG laser irradiation. After choosing the "very long pulse mode" (pulse duration of about 700 micros), the output energy of 160 mJ with 920-microm beam diameter (RO7 Perio tip, Fidelis, Fotona, Slovenia) and frequency of 12 Hz were selected, both according to the best results of past studies. In addition, air water spray was used during the procedures. The morphology of the root surface was evaluated by three observers with a scanning electron microscopy in magnifications of 50x and 400x. The result of this setting showed that the rate of remained roughness on treated root surfaces in two groups of hand instruments and Er:YAG laser had a meaningful difference: The surface roughness in Er:YAG laser group was more than in hand instruments group. The present study could demonstrate the in vitro capability of the Er:YAG laser for scaling and root planing in periodontitis, although the effectiveness of this setting did not reach that achieved by hand instrumentation. It could be concluded that lower frequency and long pulse duration maybe more suitable for the micro-morphology of root surface after treatment. This theory is going to be tested with the same laser instrument in the next study.
龈下刮治术和根面平整术是治疗牙周疾病最常用的方法之一。使用传统手动器械去除牙石并不彻底且相当耗时。为了寻找更高效且操作难度较小的器械，研究人员提出将激光作为龈下刮治术和根面平整术的替代或辅助手段。本研究的目的是在体外比较铒：钇铝石榴石（Er:YAG）激光与手动器械进行龈下刮治术和根面平整术的效果。对15颗牙周松动的拔除牙齿的近中面和远中面随机采用手动器械或Er:YAG激光照射进行治疗。根据以往研究的最佳结果，选择“超长脉冲模式”（脉冲持续时间约700微秒）后，选用输出能量为160 mJ、光束直径为920微米的（RO7牙周治疗头，Fidelis，Fotona，斯洛文尼亚）以及频率为12 Hz。此外，操作过程中使用了空气水喷雾。由三名观察者使用扫描电子显微镜在50倍和400倍放大倍数下评估根面形态。该设置的结果表明，手动器械组和Er:YAG激光组处理后的根面残留粗糙度率存在显著差异：Er:YAG激光组的表面粗糙度高于手动器械组。本研究能够证明Er:YAG激光在体外对牙周炎进行龈下刮治术和根面平整术的能力，尽管该设置的效果未达到手动器械的效果。可以得出结论，较低频率和长脉冲持续时间可能更适合治疗后根面的微观形态。这一理论将在后续研究中使用同一激光器械进行验证。
