Chan Kenneth H, Tom Henry, Darling Cynthia L, Fried Daniel
University of California, San Francisco, San Francisco, California, 94143-0758.
Lasers Surg Med. 2014 Nov;46(9):672-8. doi: 10.1002/lsm.22285. Epub 2014 Aug 21.
Since optical coherence tomography (OCT) is well suited for measuring small dimensional changes on tooth surfaces, OCT has great potential for monitoring tooth erosion. Previous studies have shown that enamel areas ablated by a carbon dioxide laser manifested lower rates of erosion compared to the non-ablated areas. The purpose of this study was to develop a model to monitor erosion in vitro that could potentially be used in vivo.
Thirteen bovine enamel blocks were used in this in vitro study. Each 10 mm × 2 mm block was partitioned into five regions, the central region was unprotected, the adjacent windows were irradiated by a CO2 laser operating at 9.3 µm with a fluence of 2.4 J/cm(2) , and the outermost windows were coated with acid resistant varnish. The samples were exposed to a pH cycling regimen that caused both erosion and subsurface demineralization for 2, 4 and 6 days. The surfaces were scanned using a time-domain polarization sensitive optical coherence tomography (PS-OCT) system and the degree of surface loss (erosion) and the integrated reflectivity with lesion depth was calculated for each window.
There was a large and significant reduction in the depth of surface loss (erosion) and the severity of demineralization in the areas irradiated by the laser.
Irradiation of the enamel surface with a pulsed carbon dioxide laser at sub-ablative intensities results in significant inhibition of erosion and demineralization under the acid challenge employed in this study. In addition, these results suggest that it may be feasible to modify regions of the enamel surface using the laser to serve as reference marks to monitor the rate of erosion in vivo.
由于光学相干断层扫描(OCT)非常适合测量牙齿表面的微小尺寸变化,因此OCT在监测牙齿侵蚀方面具有巨大潜力。先前的研究表明,与未消融区域相比,二氧化碳激光消融的牙釉质区域表现出较低的侵蚀率。本研究的目的是建立一个体外监测侵蚀的模型,该模型有可能用于体内。
本体外研究使用了13个牛牙釉质块。每个10毫米×2毫米的块被分成五个区域,中央区域未受保护,相邻窗口用波长为9.3微米、能量密度为2.4焦/平方厘米的二氧化碳激光照射,最外层窗口涂有耐酸清漆。将样品暴露于pH循环方案中,该方案会导致侵蚀和表面下脱矿质,持续2、4和6天。使用时域偏振敏感光学相干断层扫描(PS-OCT)系统扫描表面,并计算每个窗口的表面损失(侵蚀)程度以及与病变深度相关的积分反射率。
激光照射区域的表面损失(侵蚀)深度和脱矿质严重程度大幅显著降低。
在本研究采用的酸刺激下,用亚消融强度的脉冲二氧化碳激光照射牙釉质表面可显著抑制侵蚀和脱矿质。此外,这些结果表明,使用激光修饰牙釉质表面区域作为参考标记来监测体内侵蚀率可能是可行的。