Issar Rashmi, Mazumdar Dibyendu, Ranjan Shashi, Krishna Naveen Kumar, Kole Ravindra, Singh Priyankar, Lakiang Deirimika, Jayam Chiranjeevi
Reader, Department of Conservative Dentistry & Endodontics, Buddha Institute of Dental Sciences and Hospital , Patna, Bihar, India .
Professor, Department of Conservative Dentistry & Endodontics, R. Ahmed Dental College and Hospital , Kolkata, West Bengal, India .
J Clin Diagn Res. 2016 May;10(5):ZC01-5. doi: 10.7860/JCDR/2016/19739.7705. Epub 2016 May 1.
Etching of enamel and dentin surfaces increases the surface area of the substrate for better bonding of the tooth colored restorative materials. Acid etching is the most commonly used method. Recently, hard tissue lasers have been used for this purpose.
The aim of the present study was to evaluate and compare the etching pattern of Er,Cr:YSGG and conventional etching on extracted human enamel and dentin specimens.
Total 40 extracted non-diseased teeth were selected, 20 anterior and 20 posterior teeth each for enamel and dentin specimens respectively. The sectioned samples were polished by 400 grit Silicon Carbide (SiC) paper to a thickness of 1.0 ± 0.5 mm. The enamel and dentin specimens were grouped as: GrE1 & GrD1 as control specimens, GrE2 & GrD2 were acid etched and GrE3 & GrD3 were lased. Acid etching was done using Conditioner 36 (37 % phosphoric acid) according to manufacturer instructions. Laser etching was done using Er,Cr:YSGG (Erbium, Chromium : Ytrium Scandium Gallium Garnet) at power settings of 3W, air 70% and water 20%. After surface treatment with assigned agents the specimens were analyzed under ESEM (Environmental Scanning Electron Microscope) at X1000 and X5000 magnification.
Chi Square and Student "t" statistical analysis was used to compare smear layer removal and etching patterns between GrE2-GrE3. GrD2 and GrD3 were compared for smear layer removal and diameter of dentinal tubule opening using the same statistical analysis. Chi-square test for removal of smear layer in any of the treated surfaces i.e., GrE2-E3 and GrD2-D3 did not differ significantly (p>0.05). While GrE2 showed predominantly type I etching pattern (Chi-square=2.78, 0.05
0.10) and GrE3 showed type III etching (Chi-square=4.50, p<0.05). The tubule diameters were measured using GSA (Gesellschaft fur Softwareentwicklung und Analytik, Germany) image analyzer and the 't' value of student 't' test was 18.10 which was a highly significant result (p<.001). GrD2 had a mean dentinal tubule diameter of 2.78μm and GrD3 of 1.09μm.
The present study revealed type I etching pattern after acid etching, while type III etching pattern in enamel after laser etching. The lased dentin showed preferential removal of intertubular dentin while acid etching had more effect on the peritubular dentin. No significant differences was observed in removal of smear layer between the acid etched and lased groups. Although diameter of the exposed dentinal tubules was lesser after lased treatment in comparison to acid etching, further long term in vivo studies are needed with different parameters to establish the usage of Er,Cr:YSGG as a sole etching agent.
对牙釉质和牙本质表面进行酸蚀可增加基底的表面积,以便更好地粘结牙齿修复材料。酸蚀是最常用的方法。最近,硬组织激光也被用于此目的。
本研究的目的是评估和比较铒铬:钇钪镓石榴石(Er,Cr:YSGG)激光蚀刻与传统酸蚀对拔除的人牙釉质和牙本质标本的蚀刻模式。
共选取40颗拔除的无病变牙齿,分别为20颗前牙和20颗后牙,用于制备牙釉质和牙本质标本。将切片样本用400目碳化硅(SiC)砂纸打磨至厚度为1.0±0.5毫米。牙釉质和牙本质标本分为:GrE1和GrD1为对照标本,GrE2和GrD2进行酸蚀,GrE3和GrD3进行激光蚀刻。根据制造商说明,使用Conditioner 36(37%磷酸)进行酸蚀。使用铒铬:钇钪镓石榴石(Er,Cr:YSGG)激光在功率设置为3W、空气70%和水20%的条件下进行激光蚀刻。在用指定试剂进行表面处理后,将标本在环境扫描电子显微镜(ESEM)下以1000倍和5000倍放大倍数进行分析。
采用卡方检验和学生t检验比较GrE2 - GrE3之间的玷污层去除情况和蚀刻模式。使用相同的统计分析方法比较GrD2和GrD3的玷污层去除情况和牙本质小管开口直径。在任何处理过的表面(即GrE2 - E3和GrD2 - D3)去除玷污层的卡方检验结果无显著差异(p>0.05)。虽然GrE2主要显示I型蚀刻模式(卡方=2.78,0.05 < p > 0.10),而GrE3显示III型蚀刻(卡方=4.50,p < 0.05)。使用德国Gesellschaft fur Softwareentwicklung und Analytik(GSA)图像分析仪测量小管直径,学生t检验的t值为18.10,这是一个高度显著的结果(p <.001)。GrD2的牙本质小管平均直径为2.78μm,GrD3为1.09μm。
本研究显示酸蚀后为I型蚀刻模式,而激光蚀刻后牙釉质为III型蚀刻模式。激光蚀刻的牙本质显示管间牙本质被优先去除,而酸蚀对管周牙本质的影响更大。酸蚀组和激光蚀刻组在去除玷污层方面未观察到显著差异。尽管与酸蚀相比,激光蚀刻处理后暴露的牙本质小管直径较小,但需要进一步进行不同参数的长期体内研究,以确定铒铬:钇钪镓石榴石(Er,Cr:YSGG)作为单一蚀刻剂的用途。