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激光在根管消毒与清洁中的应用:综述

The Use of Lasers in Disinfection and Cleanliness of Root Canals: a Review.

作者信息

Jurič Ivona Bago, Anić Ivica

机构信息

Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia.

出版信息

Acta Stomatol Croat. 2014 Mar;48(1):6-15. doi: 10.15644/asc48/1/1.

Abstract

The outcome of root canal treatment is based on efficient disinfection of the root canal system and prevention of reinfection. Current chemomechanical cleaning methods do not always achieve these goals, and insufficient root canal disinfection is the main reason for endodontic failure. Due to high energy content and specific characteristics of laser light, laser treatment has been proposed for cleaning and disinfecting the root canal system. This paper reviews the literature covering the effect of Er:YAG, Er,Cr:YSGG, Nd:YAG and diode laser on the root canal wall in the removal of smear layer and against intracanal bacteria. Recently, the use of laser energy to induce cavitation and acoustic streaming of intracanal irrigants has been investigated. Based on recent literature, it can be concluded that lasers have bactericidal effects. However, they still cannot replace sodium hypochlorite and should be considered as an adjunct to the current chemical root canal disinfection protocols. Certain lasers can help in removing the smear layer and debris and can modify the morphology of the root canal wall. Unfortunately, there have not been enough randomized clinical studies evaluating endodontic treatment outcome following the use of laser.

摘要

根管治疗的效果取决于根管系统的有效消毒以及防止再感染。当前的化学机械清理方法并不总能实现这些目标,而根管消毒不充分是牙髓治疗失败的主要原因。由于激光具有高能量含量和特定特性,已有人提出用激光治疗来清理和消毒根管系统。本文综述了有关钇铝石榴石掺铒(Er:YAG)、掺铒铬钇钪石榴石(Er,Cr:YSGG)、掺钕钇铝石榴石(Nd:YAG)和二极管激光对根管壁上玷污层的去除以及对根管内细菌作用效果的文献。最近,人们研究了利用激光能量引发根管冲洗液的空化作用和声流效应。根据最近的文献,可以得出激光具有杀菌作用的结论。然而,它们仍不能替代次氯酸钠,应被视为当前化学根管消毒方案的辅助手段。某些激光有助于去除玷污层和碎屑,并能改变根管壁的形态。遗憾的是,目前尚无足够的随机临床研究来评估使用激光后的牙髓治疗效果。

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