Dostalova Tatjana, Jelinkova Helena, Sulc Jan, Nemec Michal, Jelinek Michal, Fibrich Martin, Michalik Pavel, Miyagi Mitsunobu, Seydlova Michaela
Charles University, Department of Paediatric Stomatology, Prague, Czech Republic.
Photomed Laser Surg. 2011 Jul;29(7):477-84. doi: 10.1089/pho.2010.2870. Epub 2011 Feb 20.
The aim of this study was to prepare a simple and reliable method for ceramic bracket debonding, ensuring minimal changes in the enamel structure and an acceptable temperature rise in the pulp.
Ceramic bracket debonding is based on the principle of degrading the strength of adhesive resin between the tooth and ceramic bracket. The search for a safe and efficient method of adhesive resin removal following debonding has resulted in the introduction of a wide range of instruments and procedures, among which proper use of laser irradiation can be promising.
The debonding of two types of ceramic brackets utilized a diode-pumped Thulium:Ytterbium-Aluminium-Perovskite (Tm:YAP) microchip laser generating irradiation at a wavelength of 1998 nm (spot size 3 mm; focused by lens), with two power settings (1-2 W). Loss of enamel and residual resin on teeth, as well as rise in temperature inside the tooth were subsequently investigated in detail.
A 1W power of irradiation during a 60-sec period resulted in a temperature rise from 3 to 4°C in the approximate root location. This power is also suitable for debracketing from the point of view of damage to enamel lying below the bracket. Only a slight damage to the enamel was registered by SEM compared to conventional bracket removal.
Use of a Tm:YAP laser (wavelength 1998 nm, power 1 W, irradiance 14 W/cm(2), interacting time 60 sec) which is at the same time compact and small enough to be used in the dental practice, together with moderate cooling, could be an efficient tool for debracketing.
本研究旨在制备一种简单可靠的陶瓷托槽脱粘方法，确保牙釉质结构变化最小，牙髓温度升高可接受。
陶瓷托槽脱粘基于降低牙齿与陶瓷托槽之间粘结树脂强度的原理。为寻找脱粘后安全有效的粘结树脂去除方法，人们引入了多种器械和程序，其中正确使用激光照射可能很有前景。
两种类型陶瓷托槽的脱粘使用二极管泵浦铥镱铝钛矿（Tm:YAP）微芯片激光，其产生波长为1998nm的照射（光斑尺寸3mm；由透镜聚焦），有两种功率设置（1 - 2W）。随后详细研究了牙齿上牙釉质的损失、残留树脂以及牙齿内部的温度升高情况。
在60秒照射期间，1W功率导致牙根大致位置的温度从3°C升高到4°C。从对托槽下方牙釉质的损伤角度来看，该功率也适用于脱槽。与传统托槽去除相比，扫描电子显微镜（SEM）显示牙釉质仅有轻微损伤。
使用Tm:YAP激光（波长1998nm，功率1W，辐照度14W/cm²，作用时间60秒），其紧凑小巧足以在牙科实践中使用，同时适度冷却，可能是一种有效的脱槽工具。
