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影响光固化设备牙髓腔温度升高的参数:固化灯和牙髓血流量。

Parameters influencing increase in pulp chamber temperature with light-curing devices: curing lights and pulpal flow rates.

机构信息

Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul, Korea.

出版信息

Oper Dent. 2010 May-Jun;35(3):353-61. doi: 10.2341/09-234-L.

Abstract

UNLABELLED

This laboratory study examined the effects of curing lights with different light intensities and changing flow rate on the increase in pulpal temperature during the light curing process and the rate of the subsequent decrease in temperature after the termination of light curing. The tip of a temperature sensor was positioned on the pulpal dentinal wall of the buccal side of the maxillary premolar. Metal tubes were inserted in the palatal and buccal root of the tooth, one for water inflow and the other for water outflow. The tubes were connected to a pump to control the flow rate. The water flow rate was set to 4.2 microl/minute, 28 microl/minute or 70 microl/minute. At each flow rate, the unprepared tooth was light cured from the buccal side 1 mm from the buccalsurface, using four different curing lights. The temperature data were recorded and stored on a computer every second for three minutes. The curing lights that were used were: Astralis 10 (QTH(high), Ivoclar Vivadent), Bluephase 16i (LED(conv), Ivoclar Vivadent) and two experimental LED-curing lights (LED(exp2000), LED(exp3000), Ivoclar Vivadent). The power densities were 1200 mW/cm2, 1600 mW/cm2, 2000 mW/cm2 and 3000 mW/cm2, respectively. The curing lights, LED(conv), LED(exp2000) and LED(exp3000) were activated for 60 seconds, and the QTH(high) was activated for 30 sec- onds. The maximum intrapulpal temperature (TM) and rate of temperature change at 30 seconds after turning off the light (S(30LO)) were analyzed by two-way ANOVA with a post-hoc Tukey test (p < 0.05). The influencing factors were the flow rates and curing lights.

RESULTS

The T(MAX) ranged from 41.0 degrees C to 53.5 degrees C. There was a difference between the curing lights (p < 0.05), with LED(exp3000) > LED(exp2000) > LED(conv) > QTH(high). There was no difference in T(MAX) between the different flow rates (p > 0.05). Both the curing lights and flow rates affected the SE(30LO) (p < 0.05). The S(30LO) was LED(exp3000) < LED(exp2000) > LEDon, , QTH(high) (p < 0.05). The S(30LO) at 70 microl/minutes was higher than at 4.2 pd/minutes and 28 microl/minutes (p < 0.05).

CLINICAL IMPLICATION

Because the increase in temperature is directly related to the light intensity and exposure time, curing devices with high power density (> 1200 mW/cm2) should only be activated for a short period of time (< 15 seconds) even in teeth without cavity preparation. The flow rate had only a negligible effect on the temperature increase.

摘要

本实验室研究旨在探讨不同光强和变化的水流速率对光固化过程中牙髓温度升高以及光固化结束后温度下降速率的影响。将温度传感器的探头置于上颌前磨牙颊侧牙髓牙本质壁上。将金属管插入牙齿的腭侧和颊侧根管中,一个用于进水,另一个用于出水。通过水泵来控制水流速率。将水流速率设置为 4.2 微升/分钟、28 微升/分钟或 70 微升/分钟。在每种水流速率下,使用四种不同的固化灯,从颊侧距颊面 1 毫米处对未预备的牙齿进行光固化。每隔一秒记录一次温度数据,并在计算机上存储三分钟。使用的固化灯为:Astralis 10(QTH(高),Ivoclar Vivadent)、Bluephase 16i(LED(普通),Ivoclar Vivadent)和两种实验性 LED 固化灯(LED(exp2000)、LED(exp3000),Ivoclar Vivadent)。光密度分别为 1200 mW/cm2、1600 mW/cm2、2000 mW/cm2 和 3000 mW/cm2。LED(普通)、LED(exp2000)和 LED(exp3000)的激活时间为 60 秒,QTH(高)的激活时间为 30 秒。在关闭光源后 30 秒时的最大牙髓温度(TM)和温度变化率(S(30LO))通过双因素方差分析和事后 Tukey 检验进行分析(p < 0.05)。影响因素为水流速率和固化灯。

结果

T(MAX)范围为 41.0 摄氏度至 53.5 摄氏度。不同固化灯之间存在差异(p < 0.05),LED(exp3000)> LED(exp2000)> LED(普通)> QTH(高)。不同水流速率之间的 T(MAX)无差异(p > 0.05)。固化灯和水流速率均影响 S(30LO)(p < 0.05)。S(30LO)为 LED(exp3000)< LED(exp2000)> LED(普通)> QTH(高)(p < 0.05)。70 微升/分钟的 S(30LO)高于 4.2 微升/分钟和 28 微升/分钟(p < 0.05)。

临床意义

由于温度升高与光强度和暴露时间直接相关,因此即使在没有窝洞预备的牙齿中,高功率密度(> 1200 mW/cm2)的固化设备也应仅短时间(< 15 秒)激活。水流速率对温度升高的影响可以忽略不计。

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