Staninec Michal, Meshkin Neda, Manesh Saman K, Ritchie R O, Fried Daniel
Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA 94143, USA.
Dent Mater. 2009 Apr;25(4):520-5. doi: 10.1016/j.dental.2008.10.004. Epub 2008 Dec 4.
Cracking of tooth structure is a frequent mechanism of clinical failure necessitating treatment. Some laser conditions, particularly those without sufficient water cooling, may cause surface cracking of dentin. Surface cracks may serve as initiation sites for the onset of catastrophic fracture under mechanical stress, resulting in failure of the dentin. In this study, the hypothesis that laser initiated cracks result in lower bending strength of dentin was tested. Dentin beam specimens were prepared from human molar teeth, 1.1 mm x 1.1 mm x approximately 9 mm, and divided into groups C (control), W (wet), D (dry) of 12 beams each. In groups W and D, the middle of each beam on one surface (buccal) was irradiated with either a Er-YAG or Q-switched Er-YSGG laser and measured under a microscope, noting the dimensions in the irradiated area and immediately adjacent to irradiated area. Each beam was placed in a mechanical testing machine in a four-point bend jig and tested with a monotonically increasing load at a displacement rate of 1mm/min until failure. The bending strengths for groups C, W (Er-YAG laser) and D (Q-switched Er-YSGG laser) were, respectively, 141.6, 114.0, and 90.9 MPa. A one-way ANOVA determined a significant difference between groups C and D, p<0.001.
The Q-switched Er-YSGG laser without water caused cracks in the surface that significantly decreased the bending strength of dentin.
牙齿结构的裂纹是导致临床治疗失败的常见机制。一些激光条件,尤其是那些没有足够水冷的条件,可能会导致牙本质表面开裂。表面裂纹可能成为机械应力下灾难性骨折发生的起始点,从而导致牙本质失效。在本研究中,对激光引发的裂纹会导致牙本质弯曲强度降低这一假设进行了测试。从人类磨牙制备牙本质梁标本,尺寸为1.1毫米×1.1毫米×约9毫米,并分为C组(对照组)、W组(湿组)、D组(干组),每组各12根梁。在W组和D组中,每根梁一个表面(颊面)的中部用Er-YAG或调Q Er-YSGG激光照射,并在显微镜下测量,记录照射区域及其紧邻区域的尺寸。将每根梁置于四点弯曲夹具中的机械试验机上,以1毫米/分钟的位移速率施加单调增加的载荷直至破坏。C组、W组(Er-YAG激光)和D组(调Q Er-YSGG激光)的弯曲强度分别为141.6、114.0和90.9兆帕。单向方差分析确定C组和D组之间存在显著差异,p<0.001。
无水的调Q Er-YSGG激光会导致表面出现裂纹,显著降低牙本质的弯曲强度。