Akyol Utkan, Güngörmüş Metin
Ataturk University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Erzurum, Turkey.
Photomed Laser Surg. 2010 Aug;28(4):477-82. doi: 10.1089/pho.2008.2479.
The aim of this study was to compare bone healing in experimental diabetics after ostectomies obtained by Er:YAG laser and bur drilling.
STUDY DESIGN/MATERIAL AND METHODS: Twenty-eight Wistar rats weighing 250-300 g were used for this study. Diabetes was chemically induced with streptozotocin administered as a single intraperitoneal injection. Fourteen nondiabetic (normal) and 14 diabetic rats were included in the analysis. Left femur distal epiphysis of nondiabetic and diabetic rats was perforated with a surgical bone drill. Another defect with similar dimensions was created by an Er:YAG laser on the left femur of diabetic rats. An Er:YAG laser of 2940-nm wavelength with an energy density of 1.5 W was used. The rats were assigned to three experimental groups: normal bur group (control), diabetic bur group, and diabetic Er:YAG group. The rats were killed at 10 and 20 days to compare the bone healing of each group.
At 10 days of healing, the sum of histologic scores was higher in the normal bur group than in the diabetic bur and diabetic Er:YAG groups. In the present study, union, spongiosa, and bone marrow were evaluated, respectively, and there were no significant differences among the groups regarding the union and bone marrow (p > 0.05). Spongiosa bone formation was higher in the normal bur group than in the diabetic bur and diabetic Er:YAG groups (p = 0.011). There were no significant differences among the groups as to union, spongiosa, bone marrow, and sum of histologic scores (p > 0.05) at 20 days of healing.
Histologically, no difference was found between the Er:YAG and bur cavities in diabetic rats regarding bone healing. With these histological and experimental results, we believe that the 2940-nm Er:YAG laser (1.5 W) can be used confidently in the ablation of bones in diabetic cases.
本研究旨在比较实验性糖尿病大鼠经铒激光和牙钻截骨术后的骨愈合情况。
研究设计/材料与方法：本研究选用28只体重250 - 300克的Wistar大鼠。通过单次腹腔注射链脲佐菌素化学诱导糖尿病。分析纳入14只非糖尿病（正常）大鼠和14只糖尿病大鼠。用手术骨钻在非糖尿病和糖尿病大鼠的左股骨远端骨骺打孔。在糖尿病大鼠的左股骨上用波长2940纳米、能量密度1.5瓦的铒激光制造另一个尺寸相似的缺损。将大鼠分为三个实验组：正常牙钻组（对照组）、糖尿病牙钻组和糖尿病铒激光组。在第10天和第20天处死大鼠以比较各组的骨愈合情况。
愈合10天时，正常牙钻组的组织学评分总和高于糖尿病牙钻组和糖尿病铒激光组。在本研究中，分别评估了骨愈合、松质骨和骨髓情况，各组在骨愈合和骨髓方面无显著差异（p > 0.05）。正常牙钻组的松质骨形成高于糖尿病牙钻组和糖尿病铒激光组（p = 0.011）。愈合20天时，各组在骨愈合、松质骨、骨髓和组织学评分总和方面无显著差异（p > 0.05）。
组织学上，糖尿病大鼠中铒激光和牙钻造成的骨缺损在骨愈合方面无差异。基于这些组织学和实验结果，我们认为2940纳米铒激光（1.5瓦）可放心用于糖尿病患者的骨切除。
