Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, J.R. Moore Building, Oxford Road, Manchester, M13 9PL, UK.
College of Dentistry, Asmarya University, Zliten, Libya.
Clin Oral Investig. 2019 May;23(5):2279-2285. doi: 10.1007/s00784-018-2654-0. Epub 2018 Oct 6.
The aim of this study was to see the effect of Er:YAG laser irradiation in dentine and compare this with its effect in enamel. The mechanism of crack propagation in dentine was emphasised and its clinical implications were discussed.
Coronal sections of sound enamel and dentine were machined to 50-μm thickness using a FEI-Helios Plasma (FIB). The specimen was irradiated for 30 s with 2.94-μm Er:YAG laser radiation in a moist environment, using a sapphire dental probe tip, with the tip positioned 2 mm away from the sample surface. One of the sections was analysed as a control and not irradiated. Samples were analysed using the Zeiss Xradia 810 Ultra, which allows high spatial resolution, nanoscale 3D imaging using X-ray computed tomography (CT).
Dentine: In the peritubular dentine, micro-cracks ran parallel to the tubules whereas in the inter-tubular region, the cracks ran orthogonal to the dentinal tubules. These cracks extended to a mean depth of approximately 10 μm below the surface. On the dentine surface, there was preferential ablation of the less mineralised intertubular dentine, and this resulted in an irregular topography associated with tubules. Enamel: The irradiated enamel surface showed a characteristic 'rough' morphology suggesting some preferential ablation along certain microstructure directions. There appears to be very little subsurface damage, with the prismatic structure remaining intact.
A possible mechanism is that laser radiation is transmitted down the dentinal tubules causing micro-cracks to form in the dentinal tubule walls that tend to be limited to this region.
Crack might be a source of fracture as it represents a weak point and subsequently might lead to a failure in restorative dentistry.
本研究旨在观察铒激光在牙本质中的照射效果,并与牙釉质的照射效果进行比较。强调了牙本质中裂纹扩展的机制,并讨论了其临床意义。
使用 FEI-Helios Plasma(FIB)将健康牙釉质和牙本质的冠状切片加工至 50-μm 厚度。将标本在潮湿环境中用蓝宝石牙科探头照射 30 秒,探头距离样品表面 2mm。其中一个切片作为对照不进行照射。使用 Zeiss Xradia 810 Ultra 进行分析,该仪器允许使用 X 射线计算机断层扫描(CT)进行高空间分辨率、纳米级 3D 成像。
牙本质:在管周牙本质中,微裂纹与牙本质小管平行,而在管间区域,裂纹与牙本质小管垂直。这些裂纹扩展到表面以下约 10μm 的平均深度。在牙本质表面,优先去除矿化程度较低的管间牙本质,导致与小管相关的不规则形貌。牙釉质:照射后的牙釉质表面呈现出特征性的“粗糙”形貌,表明在某些微结构方向上存在一些优先去除。表面似乎几乎没有亚表面损伤,棱柱结构保持完整。
一种可能的机制是激光辐射沿牙本质小管传输,导致牙本质小管壁形成微裂纹,这些微裂纹往往局限在该区域。
裂纹可能是导致牙体折裂的原因之一,因为它是一个薄弱点,随后可能导致修复牙科学中的失败。