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钕钇铝石榴石激光牙髓切断术治疗人类乳牙的临床、影像学和组织病理学评估

Clinical, radiographic, and histopathologic evaluation of Nd:YAG laser pulpotomy on human primary teeth.

作者信息

Odabaş Mesut Enes, Bodur Haluk, Bariş Emre, Demir Cem

机构信息

Department of Pediatric Dentistry, Faculty of Dentistry, University of Gazi, Ankara, Turkey.

出版信息

J Endod. 2007 Apr;33(4):415-21. doi: 10.1016/j.joen.2006.12.013.

Abstract

The purpose of this study was to compare clinical, radiographic, and histopathologic effects of Nd:YAG laser pulpotomy to formocresol pulpotomy on human primary teeth. Patients with at least two vital primary molar teeth that required pulpotomy, because of pulpal exposure to caries, were selected for this study. After hemorrhage control, complete hemostasis into the canal orifice was achieved by exposure to Nd:YAG laser (1064 nm) and an He-Ne laser (the aiming beam of the Nd:YAG laser) in noncontact mode at 2 W, 20 Hz, 100 mJ, or was achieved by applying 1:5 dilution of formocresol. Forty-two teeth in two groups were to be followed up clinically and radiographic at 1, 3, 6, 9, and 12 months. Eighteen teeth planned for serial extractions were selected for histopathologic study. The teeth were extracted at 7 and 60 days. The teeth in the laser group had a clinical success rate of 85.71% and a radiographic success rate 71.42% at 12 months. The teeth in the formocresol group had a clinical and radiographic success rate of 90.47% at 12 months. There were no statistically significant differences between laser and formocresol group with regard to both clinical and radiographic success rates. There was a statistically significant difference between 7- and 60-day laser groups with regard to inflammatory cell response criteria. Dentin bridge was absent in all samples. No stained bacteria were observed in any of these samples. In conclusion, Nd:YAG laser may be considered as an alternative to formocresol for pulpotomies in primary teeth.

摘要

本研究旨在比较钕钇铝石榴石(Nd:YAG)激光牙髓切断术与甲醛甲酚牙髓切断术对人类乳牙的临床、影像学和组织病理学影响。本研究选取了至少有两颗因龋坏导致牙髓暴露而需要进行牙髓切断术的活髓乳牙患者。在控制出血后,通过以非接触模式将Nd:YAG激光(1064纳米)和氦氖激光(Nd:YAG激光的瞄准光束)以2瓦、20赫兹、100毫焦的功率照射根管口来实现完全止血,或者通过应用1:5稀释的甲醛甲酚来实现止血。两组中的42颗牙齿在1、3、6、9和12个月时进行临床和影像学随访。选取计划进行系列拔牙的18颗牙齿进行组织病理学研究。这些牙齿在7天和60天时拔除。激光组牙齿在12个月时的临床成功率为85.71%,影像学成功率为71.42%。甲醛甲酚组牙齿在12个月时的临床和影像学成功率为90.47%。激光组和甲醛甲酚组在临床和影像学成功率方面均无统计学显著差异。在炎症细胞反应标准方面,7天和60天的激光组之间存在统计学显著差异。所有样本中均未发现牙本质桥。在任何这些样本中均未观察到染色细菌。总之,Nd:YAG激光可被视为乳牙牙髓切断术中甲醛甲酚的替代方法。

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