Er:YAG 和 Er,Cr:YSGG 用于去除陶瓷和金属正畸托槽的热效应：实验分析。
Thermal effect of Er:YAG and Er,Cr:YSGG used for debonding ceramic and metal orthodontic brackets: An experimental analysis.
机构信息
Department of Facial Abnormalities, Division of Maxillofacial Orthopaedics and Orthodontics, Wroclaw Medical University, Poland.
Department of Building Physics and Computer Design Methods, Wroclaw University of Science and Technology, Poland.
出版信息
Adv Clin Exp Med. 2020 May;29(5):557-563. doi: 10.17219/acem/118844.
BACKGROUND
In orthodontics, erbium (Er:YAG) lasers can be used for bracket debonding.
OBJECTIVES
To assess the changes in temperature of pulp and enamel during laser debonding of brackets.
MATERIAL AND METHODS
A total of 13 brackets (n = 13; 2 metal and 11 ceramic brackets) were bonded to 13 caries-free premolars extracted for orthodontic reasons. Brackets were irradiated with 2 lasers. Laser No. 1 was an erbium-chromium (Er,Cr:YSGG) laser (Waterlase Express; Biolase, Irvine, USA) with a wavelength of 2,780 nm at a power of 2.78-2.85 W, energy of 185-190 mJ, fluence of 10 ns, frequency of 25 Hz, pulse duration of 300 μs, tip diameter of 0.6 mm, air/fluid cooling of 3.5 mL/s, and time of irradiation of 5-25 s. Laser No. 2 was an Er:YAG laser (LiteTouch; Light Instruments Ltd., Yokneam, Israel) with a wavelength of 2,940 nm at a power of 4 W, energy of 200 mJ, fluence of 10 ns, frequency of 20 Hz, pulse duration of 300 μs, tip diameter of 0.8 mm, air/fluid cooling of 3.5 mL/s, and time of irradiation of 5-15 s. Two thermographic cameras (FLIR Zenmuse XT and FLIR P65; FLIR Systems, Wilsonville, USA) and type K thermocouple (Zhangzhou Weihua Electronic Co., Fujian, China) were used for precise temperature measurement on the surface of the teeth and inside them.
RESULTS
When laser No. 1 was in use, the mean difference between the inner and outer temperature of the examined teeth (1.4°C) was higher than when the laser No. 2 was in use (0.6°C) (p = 0.0974). The study found that the temperature inside the tooth did not increase, and it even decreased during treatment with Er:YAG laser using water cooling, provided that appropriate proportion of water and air was used. For laser No. 1, confidence interval (CI) was between 0.7 and 2.2 and for laser No. 2 it was between 0.500 and 1.23. Only experiment for ceramic brackets was described.
CONCLUSIONS
These findings confirm that the use of Er:YAG family lasers for orthodontic bracket debonding in an in vitro study is safe and effective.
背景
在口腔正畸学中，铒（Er:YAG）激光可用于托槽的去除。
目的
评估激光去除托槽过程中牙髓和牙釉质温度的变化。
材料和方法
将 13 个（n=13；2 个金属托槽和 11 个陶瓷托槽）托槽黏结到 13 颗因正畸需要拔除的无龋前磨牙上。用 2 种激光照射托槽。激光 1 是一种铒铬（Er,Cr:YSGG）激光（Waterlase Express；Biolase，尔湾，美国），波长为 2780nm，功率为 2.78-2.85W，能量为 185-190mJ，脉冲宽度为 10ns，频率为 25Hz，脉冲持续时间为 300μs，尖端直径为 0.6mm，空气/水流冷却速度为 3.5mL/s，照射时间为 5-25s。激光 2 是一种 Er:YAG 激光（LiteTouch；Light Instruments Ltd.，Yokneam，以色列），波长为 2940nm，功率为 4W，能量为 200mJ，脉冲宽度为 10ns，频率为 20Hz，脉冲持续时间为 300μs，尖端直径为 0.8mm，空气/水流冷却速度为 3.5mL/s，照射时间为 5-15s。使用两个热成像相机（FLIR Zenmuse XT 和 FLIR P65；FLIR Systems，威尔逊维尔，美国）和 K 型热电偶（Zhangzhou Weihua Electronic Co.，福建，中国）精确测量牙齿表面和内部的温度。
结果
当使用激光 1 时，被检查牙齿的内外温差（1.4°C）平均值高于使用激光 2 时的温差（0.6°C）（p=0.0974）。研究发现，在使用水冷 Er:YAG 激光进行治疗时，牙齿内部温度不会升高，甚至会降低，只要使用适当比例的水和空气。对于激光 1，置信区间（CI）在 0.7 到 2.2 之间，对于激光 2，CI 在 0.500 到 1.23 之间。仅描述了陶瓷托槽的实验。
结论
这些发现证实，在体外研究中，使用 Er:YAG 激光家族进行正畸托槽去除是安全有效的。
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