Department of Periodontology, Faculty of Dentistry, Selçuk University, Konya 42079, Turkey.
Lasers Med Sci. 2010 May;25(3):345-53. doi: 10.1007/s10103-009-0643-x. Epub 2009 Feb 14.
The purpose of this study was to investigate the efficiency of hand instrumentation and laser irradiation on calculus removal from the root surfaces, in vitro. Thirty-two human teeth, extracted for periodontal reasons, were used in this study. Root surfaces of single-rooted teeth were treated by different methods including (1) conventional hand instruments; (2) hand instruments and tetracycline-hydrochloride (Tet-HCl); (3) erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser irradiation, setting I (short pulse); (4) Er,Cr:YSGG laser irradiation, setting II (long pulse). Three premolar teeth, extracted for orthodontic reasons, served as control. The morphology of the root surfaces was evaluated by light and scanning electron microscopy. Energy dispersive X-ray (EDX) analysis was performed to compare the mineral content of root surfaces treated with hand instrumentation and lasing procedures. The results of this study demonstrated that all treatments were efficient in calculus removal from the root surfaces. Thermal changes, including melting and carbonization, were not observed in either lasing procedure. The surface was rougher in the laser groups than in the groups treated with hand instruments. Moreover, roughness was greater in the long-pulse laser setting than in the short-pulse setting. While increased calcium (Ca) and decreased phosphate (P) (weight concentration percent) were observed in all treatments when compared with the control, laser procedures resulted in a more similar mineral content than in the groups treated with hand instruments. Based on these findings, laser procedures, when used in appropriate settings, are capable of performing scaling and root planing in the treatment of periodontitis. It may be concluded that short pulse laser may be more suitable for the micro-morphology of the root surface. However, additional in vitro and clinical studies are necessary to clarify the success of laser in periodontal therapy.
本研究旨在探讨手动器械和激光照射对离体根面牙石去除效率的影响。本研究共使用 32 颗因牙周病而拔除的人牙。单根牙的根面分别采用以下方法处理：（1）传统手动器械；（2）手动器械和盐酸四环素（Tet-HCl）；（3）铒铬：钇钪镓石榴石（Er,Cr:YSGG）激光照射，I 档（短脉冲）；（4）Er,Cr:YSGG 激光照射，II 档（长脉冲）。3 颗因正畸而拔除的前磨牙作为对照。用光镜和扫描电镜观察根面形态。采用能谱分析（EDX）比较手动器械和激光处理后根面的矿物质含量。本研究结果表明，所有处理方法均能有效去除根面牙石。两种激光处理均未观察到热变化，包括熔融和碳化。激光组的表面粗糙度高于手动器械组。此外，长脉冲激光设置的粗糙度大于短脉冲设置。与对照组相比，所有治疗组的钙（Ca）含量增加，磷酸盐（P）含量减少（重量浓度百分比），但激光组的矿物质含量与手动器械组更相似。基于这些发现，在适当的设置下，激光程序可以在牙周炎的治疗中进行洁治和根面平整。可以得出结论，短脉冲激光可能更适合根面的微观形态。然而，需要更多的体外和临床研究来阐明激光在牙周治疗中的成功。
