Jezeršek Matija, Lukač Nejc, Lukač Matjaž, Tenyi Ana, Olivi Giovanni, Fidler Aleš
Faculty of Mechanical Engineering, Laboratory for Laser Techniques, University of Ljubljana, Ljubljana, Slovenia.
Department of Complex Matter, Jozef Stefan Institute, Ljubljana, Slovenia.
Photobiomodul Photomed Laser Surg. 2020 Oct;38(10):625-631. doi: 10.1089/photob.2019.4776. Epub 2020 Jun 16.
To measure distribution of pressures along the depth of the root canal during erbium-doped yttrium aluminum garnet (Er:YAG) laser-activated irrigation (LAI) with different modalities and fiber tip (FT) geometries. A new LAI modality based on the delivery of synchronized pairs of Er:YAG laser pulses to generate enhanced irrigant streaming and shock wave emission was recently introduced. However, the influence of FT geometry on efficacy and comparison with single pulse modality is not yet presented. Pressures within a simulated root canal were simultaneously measured at 5 depths during LAI. Seven FT geometries (conical and cylindrical) and two modalities [Super Short Pulse (SSP) and dual pulse AutoSWEEPS] were compared. Under the same conditions, average pressures using SSP at 20 mJ of laser energy ranged from 111 Pa for a conical 600 μm FT to 225 Pa for a flat 400 μm FT. The measured pressures for the SSP and the AutoSWEEPS at 20 mJ laser energy were 223 and 308 Pa at the most coronal level and 119 and 126 Pa at the apical constriction, respectively. Measured pressures and irrigant penetration depths at different root canal levels were found to be linearly correlated ( = 0.82; < 0.01). The generated pressures get progressively reduced from the coronal toward the apical third of the root canal. A strong dependence on the FT design and laser modality was observed. Within the limitations of the study, the AutoSWEEPS modality is more effective than standard SSP in generating pressures within the root canal, without increasing the risk of extrusion.
为了测量在掺铒钇铝石榴石（Er:YAG）激光激活冲洗（LAI）过程中，不同模式和光纤尖端（FT）几何形状下根管深度上的压力分布。最近引入了一种基于同步发射Er:YAG激光脉冲对以产生增强冲洗液流动和冲击波发射的新型LAI模式。然而，FT几何形状对疗效的影响以及与单脉冲模式的比较尚未见报道。在LAI过程中，同时在模拟根管的5个深度测量压力。比较了7种FT几何形状（圆锥形和圆柱形）和两种模式[超短脉冲（SSP）和双脉冲AutoSWEEPS]。在相同条件下，使用20 mJ激光能量的SSP时，平均压力范围从圆锥形600μm FT的111 Pa到扁平400μm FT的225 Pa。在20 mJ激光能量下，SSP和AutoSWEEPS在最冠方水平的测量压力分别为223和308 Pa，在根尖狭窄处分别为119和126 Pa。发现在不同根管水平的测量压力和冲洗液渗透深度呈线性相关（r = 0.82；P < 0.01）。产生的压力从根管的冠方到根尖三分之一逐渐降低。观察到对FT设计和激光模式有很强的依赖性。在本研究的局限性内，AutoSWEEPS模式在根管内产生压力方面比标准SSP更有效，且不会增加挤出风险。
