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二氧化碳激光照射对拔牙窝愈合过程的影响。

Influence of carbon dioxide laser irradiation on the healing process of extraction sockets.

机构信息

Department of Oral Rehabilitation, Fukuoka Dental College, Japan.

出版信息

Acta Odontol Scand. 2011 Jan;69(1):33-40. doi: 10.3109/00016357.2010.517556. Epub 2010 Sep 23.

Abstract

OBJECTIVE

To clarify the healing-promoting effects of carbon dioxide laser irradiation in high and low reactive-level laser therapies (HLLT and LLLT, respectively) on extraction sockets after tooth extraction.

MATERIAL AND METHODS

Forty-two 5-week-old male Wistar rats were divided into laser irradiation and non-irradiation (control) groups and compared. The laser-irradiation group underwent HLLT immediately after tooth extraction and then LLLT 1 day post-extraction. Tissue was excised 6 h and 3, 7, or 21 days after extraction and histopathologically investigated. The alveolar crest height was measured osteomorphometrically 21 days post-extraction, and granulation tissue in the extraction socket surface layer was immunohistologically investigated using anti-α-smooth muscle actin (anti-α-SMA) antibody 3 and 7 days post-extraction.

RESULTS

Many osteoclasts appeared and active bone resorption was noted in the irradiation group 3 days after extraction compared to the controls. On Day 7, new bone formation started around the extraction socket in the control group, but from the superficial to over the middle layer of the socket in the irradiation group. On Day 21, a concavity existed in the alveolar crest region in the controls, whereas this region was flat, with no concavity, in the irradiation group. On osteomorphometry, the alveolar crest height was significantly higher in the irradiation (0.7791 ± 0.0122) than the control (0.6516 ± 0.0181) group (P < 0.05). On immunostaining, many α-SMA-positive cells were noted in the control group, but very few in the irradiation group.

CONCLUSION

Laser-irradiated extraction wound healing showed characteristics different from those of the normal healing process, suggesting a favorable healing-promoting effect.

摘要

目的

阐明二氧化碳激光照射在拔牙后牙槽窝的高反应性和低反应性激光治疗(HLLT 和 LLLT)中的促进愈合作用。

材料与方法

将 42 只 5 周龄雄性 Wistar 大鼠分为激光照射组和非照射(对照)组,并进行比较。激光照射组在拔牙后立即进行 HLLT,然后在拔牙后 1 天进行 LLLT。在拔牙后 6 小时和 3、7 或 21 天取出组织,并进行组织病理学检查。在拔牙后 21 天进行骨形态计量学测量牙槽嵴高度,并在拔牙后 3 天和 7 天使用抗α-平滑肌肌动蛋白(抗-α-SMA)抗体对牙槽窝表面层的肉芽组织进行免疫组织化学研究。

结果

与对照组相比,照射组在拔牙后 3 天出现了许多破骨细胞,并出现了活跃的骨吸收。在第 7 天,对照组开始在牙槽窝周围形成新骨,但在照射组则从牙槽窝表面层到中层开始。在第 21 天,对照组的牙槽嵴区域存在凹陷,而照射组的该区域则是平坦的,没有凹陷。在骨形态计量学上,照射组的牙槽嵴高度(0.7791 ± 0.0122)明显高于对照组(0.6516 ± 0.0181)(P < 0.05)。在免疫染色方面,对照组中有许多α-SMA 阳性细胞,但照射组中很少。

结论

激光照射的拔牙伤口愈合表现出与正常愈合过程不同的特征,提示有促进愈合的作用。

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