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铒铬:钇钪镓石榴石激光治疗对乳牙根管壁清洁度的影响。

Impact of Er,Cr:YSGG laser therapy on the cleanliness of the root canal walls of primary teeth.

作者信息

Soares Flavio, Varella Claudio H, Pileggi Roberta, Adewumi Abi, Guelmann Marcio

机构信息

Department of Pediatric Dentistry, University of Florida, Gainesville, Florida 32610-0436, USA.

出版信息

J Endod. 2008 Apr;34(4):474-7. doi: 10.1016/j.joen.2008.02.006.

Abstract

Root canal therapy might be required for primary teeth displaying signs of pulpal inflammation or necrosis. Cleaning and shaping followed by obturation of the canal space with a resorbable paste have been widely performed with remarkable clinical success. However, lengthy endodontic procedures might be contraindicated when treating certain pediatric patients. The aim of this study was to compare the cleanliness of the root canal walls of primary teeth and the time required for the completion of the cleaning and shaping procedures performed by the Er,Cr:YSGG laser, manual or rotary instrumentation techniques. Thirty-five extracted, single-rooted, primary teeth were divided into 4 groups: I, canals were instrumented with Profile .04 rotary instruments to a master apical file size #35; II, the laser was used (parameters: 1.50 W, 20 pps, 30% water and 50% air) with a Z3 laser tip (0.32-mm diameter); III, canals were instrumented with stainless steel K-files; and IV, no instrumentation was performed (control). The teeth were split in 2 halves and prepared for scanning electron microscopy analysis. Images from the coronal, middle, and apical thirds of the roots were analyzed independently by 2 calibrated, blinded evaluators. Statistical analysis revealed significant differences among the groups (Kruskal-Wallis, P = .0001). The techniques were not capable of providing completely clean canals. Treatment with Er,Cr:YSGG laser provided similar cleanliness when compared with rotary instrumentation technique and was superior to manual instrumentation. The laser technique required less time for completion of the cleaning and shaping procedures when compared with both rotary or hand instrumentation.

摘要

对于出现牙髓炎症或坏死迹象的乳牙,可能需要进行根管治疗。根管清理、塑形,随后用可吸收糊剂充填根管空间,这种治疗方法已被广泛应用,并取得了显著的临床效果。然而,在治疗某些儿科患者时,冗长的牙髓治疗程序可能是禁忌的。本研究的目的是比较乳牙根管壁的清洁程度,以及使用铒铬:钇钪镓石榴石(Er,Cr:YSGG)激光、手动或旋转器械技术完成根管清理和塑形程序所需的时间。35颗拔除的单根乳牙被分为4组:I组,使用Profile.04旋转器械将根管预备至主尖锉35号;II组,使用Z3激光头(直径0.32毫米)的Er,Cr:YSGG激光(参数:1.50瓦,20脉冲每秒,30%水和50%空气);III组,使用不锈钢K锉进行根管预备;IV组,不进行器械操作(对照组)。将牙齿纵劈为两半,准备进行扫描电子显微镜分析。由2名经过校准且不知情的评估人员独立分析牙根冠方、中部和根尖三分之一处的图像。统计分析显示各组之间存在显著差异(Kruskal-Wallis检验,P = 0.0001)。这些技术均无法使根管完全清洁。与旋转器械技术相比,Er,Cr:YSGG激光治疗后的清洁程度相似,且优于手动器械技术。与旋转或手动器械技术相比,激光技术完成根管清理和塑形程序所需的时间更少。

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