Dommisch Henrik, Peus Katja, Kneist Susanne, Krause Felix, Braun Andreas, Hedderich Jürgen, Jepsen Søren, Eberhard Jörg
Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany.
Eur J Oral Sci. 2008 Apr;116(2):170-6. doi: 10.1111/j.1600-0722.2008.00521.x.
The aim of this randomized clinical study was to compare the efficacy of a fluorescence-controlled erbium-loaded yttrium aluminum garnet (Er:YAG) laser with conventional bur treatment for caries therapy in adults. Twenty-six patients with 102 carious lesions were treated using either the Er:YAG laser, at threshold levels of 7, 8, 9, and 10 [U], or rotary burs. Both techniques were applied to each lesion at separate locations. After treatment, dentine samples were obtained using a carbide bur. The viable counts of Streptococcus mutans (SM) and lactobacilli (LB) [expressed as colony-forming units (log10 CFUs)], treatment time, pain, vibration, and sound intensity were determined. The median numbers of CFUs for SM and LB were not statistically different between laser and bur treatment at threshold levels 7 and 8 [U]. At threshold levels 9 and 10 [U], the median number of CFUs for LB [1.11 (range: 0.00-2.04)] were significantly higher following laser treatment than following bur treatment [0.30 (range: 0.00-0.60)]. The results indicate that treatment with a fluorescence-controlled Er:YAG laser at threshold levels of 7 and 8 removed caries to a level similar to that achieved using conventional bur treatment, with clinically irrelevant amounts of remaining bacteria. Although more time consuming, laser treatment provided higher patient comfort than bur treatment.
这项随机临床研究的目的是比较荧光控制的掺铒钇铝石榴石（Er:YAG）激光与传统牙钻治疗成人龋齿的疗效。26名患有102处龋损的患者分别接受了阈值为7、8、9和10 [U] 的Er:YAG激光治疗或旋转牙钻治疗。两种技术分别应用于每个龋损的不同部位。治疗后，使用硬质合金牙钻获取牙本质样本。测定变形链球菌（SM）和乳酸菌（LB）的活菌计数[以菌落形成单位（log10 CFUs）表示]、治疗时间、疼痛、振动和声强。在阈值7和8 [U] 时，激光治疗和牙钻治疗的SM和LB的CFUs中位数无统计学差异。在阈值9和10 [U] 时，激光治疗后LB的CFUs中位数[1.11（范围：0.00 - 2.04）]显著高于牙钻治疗后的[0.30（范围：0.00 - 0.60）]。结果表明，阈值为7和8的荧光控制Er:YAG激光治疗龋损的程度与传统牙钻治疗相似，残留细菌量在临床上无关紧要。虽然激光治疗耗时更长，但与牙钻治疗相比，患者舒适度更高。
