Romanos Georgios E, Belikov Andrey V, Skrypnik Alexei V, Feldchtein Felix I, Smirnov Michael Z, Altshuler Gregory B
Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, 11794-8700.
Department of Periodontology, Stony Brook University, School of Dental Medicine, Stony Brook, New York, 11794-8700.
Lasers Surg Med. 2015 Jul;47(5):411-20. doi: 10.1002/lsm.22360. Epub 2015 Apr 28.
Uncovering implants with lasers, while bloodless, has been associated with a risk of implant and bone overheating. The present study evaluated the effect of using a new generation of high-power diode lasers on the temperature of a dental implant and the surrounding tissues using an in vitro model.
STUDY DESIGN/MATERIALS AND METHODS: The implant temperature was measured at three locations using micro thermocouples. Collateral thermal damage of uncovered soft tissues was evaluated using NTBC stain. Implant temperature rise during and collateral thermal soft-tissue damage following implant uncovering with and without tissue air-cooling was studied using both the classic operational mode and the new thermo-optically powered (TOP) technology.
For the classic surgical mode using a cork-initiated tip and constant laser power set at 3.4 W, the maximum temperature rise in the coronal and apical parts of the implant was 23.2 ± 4.1°С and 9.5 ± 1.8°С, respectively, while 1.5 ± 0.5 mm of collateral thermal damage of the soft tissue surrounding the implant model occurred. Using the TOP surgical tip with constant laser power reduced implant overheating by 30%; collateral thermal soft-tissue damage was 0.8 ± 0.2 mm. Using the TOP surgical mode with a tip temperature setting of 800°C and air-cooling reduced the implant temperature rise by more than 300%, and only 0.2 ± 0.1 mm of collateral thermal soft-tissue damage occurred, typical for optimized CO2 laser surgery. Furthermore, use of the new generation diode technology (TOP surgical mode) appeared to reduce the time required for implant uncovering by a factor of two, compared to the standard surgical mode.
Use of the new generation diode technology (TOP surgical mode) may significantly reduce overheating of dental implants during uncovering and seems to be safer for the adjacent soft and hard tissues. Use of such diode lasers with air-cooling can radically reduce the rise in implant temperatures (by more than three times), potentially making this technology safe and effective for implant uncovering.
使用激光暴露种植体，虽无出血，但存在种植体和骨组织过热的风险。本研究采用体外模型评估新一代高功率二极管激光对牙种植体及周围组织温度的影响。
研究设计/材料与方法：使用微型热电偶在三个位置测量种植体温度。使用NTBC染色评估未覆盖软组织的间接热损伤。采用经典操作模式和新型热光动力（TOP）技术，研究有无组织风冷情况下种植体暴露过程中种植体温度升高情况以及种植体暴露后软组织的间接热损伤情况。
对于使用软木启动尖端且恒定激光功率设置为3.4W的经典手术模式，种植体冠部和根尖部的最大温度升高分别为23.2±4.1℃和9.5±1.8℃，同时种植体模型周围软组织出现1.5±0.5mm的间接热损伤。使用恒定激光功率的TOP手术尖端可使种植体过热降低30%；间接热软组织损伤为0.8±0.2mm。采用尖端温度设置为800℃并进行风冷的TOP手术模式，可使种植体温度升高降低超过300%，仅出现0.2±0.1mm的间接热软组织损伤，这是优化二氧化碳激光手术的典型损伤情况。此外，与标准手术模式相比，使用新一代二极管技术（TOP手术模式）似乎可将种植体暴露所需时间缩短一半。
使用新一代二极管技术（TOP手术模式）可显著降低种植体暴露过程中的过热情况，对相邻的软硬组织似乎更安全。使用此类带风冷的二极管激光可从根本上降低种植体温度升高（超过三倍），这可能使该技术在种植体暴露方面安全有效。
