Ishikawa Isao, Okamoto Tomohiro, Morita Seigo, Shiramizu Fumika, Fuma Yoshihiro, Ichinose Shizuko, Okano Teruo, Ando Tomohiro
Institute of Advanced Biomedical Engineering and Science, Tokyo, Japan .
Photomed Laser Surg. 2011 May;29(5):333-8. doi: 10.1089/pho.2010.2856. Epub 2011 Apr 15.
Bleeding control is a major concern during dental surgery. A novel photocoagulation method using an irradiating blue-violet light emitting diode (LED) was investigated.
Some dental light-curving units can emit blue-violet wavelengths around 380-515 nm with two peaks (410 nm and 470 nm). These wavelengths can cover the maximum absorption spectra of hemoglobin (430 nm).
Blue-violet LED 380-515 nm, 750 mW/cm(2), 10 sec (7.5 J/cm(2)) was used. Irradiation was performed for 10 sec or an additional 10 sec for 10 cases of tooth extraction at a distance of 1 cm from the socket. Bleeding was stopped by conventional roll pressure in another five cases as a control. Bleeding time for both procedures was measured. A Mann-Whitney U test was used for statistical analysis. In vitro transmission electron microscope (TEM) studies were performed to clarify the mechanism of hemostasis by blue-violet LED irradiation.
Irradiation with the blue-violet LED yielded immediate hemostasis of the socket. Five cases showed coagulation within the first 10 sec, and another five cases required an additional 10 sec to fully control the bleeding. In contrast, the conventional method required 2-5 min (median 180 sec) to obtain hemostasis. The difference between the time required to stop the bleeding in the two methods was found to be statistically significant (p = 0.0014). A week later, the LED-irradiated sockets were healed uneventfully with epithelial covering. TEM showed the formation of a thin amorphous layer and an adjacent agglutination of platelets and other cellular elements under the layer at the interface of the irradiated blood.
Blue-violet LED irradiation of bleeding sockets caused immediate clot formation and hemostasis. This procedure was safe and reliable and showed no adverse effects.
出血控制是牙科手术中的一个主要问题。研究了一种使用发射蓝紫光的发光二极管(LED)的新型光凝方法。
一些牙科光固化装置可以发射波长在380 - 515nm左右的蓝紫光,有两个峰值(410nm和470nm)。这些波长可以覆盖血红蛋白的最大吸收光谱(430nm)。
使用波长为380 - 515nm、功率为750mW/cm²、照射时间为10秒(7.5J/cm²)的蓝紫光LED。对10例拔牙病例,在距牙槽窝1cm处照射10秒或额外照射10秒。另外5例作为对照,采用传统的压迫止血法。测量两种方法的止血时间。采用曼 - 惠特尼U检验进行统计分析。进行体外透射电子显微镜(TEM)研究以阐明蓝紫光LED照射止血的机制。
蓝紫光LED照射使牙槽窝立即止血。5例在最初10秒内出现凝血,另外5例需要额外照射10秒才能完全控制出血。相比之下,传统方法需要2 - 5分钟(中位数180秒)才能止血。两种方法止血所需时间的差异具有统计学意义(p = 0.0014)。一周后,LED照射的牙槽窝顺利愈合,有上皮覆盖。TEM显示在照射血液的界面处,在层下形成了一层薄的无定形层以及相邻的血小板和其他细胞成分的凝集。
对出血的牙槽窝进行蓝紫光LED照射可立即形成血凝块并止血。该方法安全可靠,无不良反应。