Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus, San Francisco, CA, 94143, USA.
Division of Pediatric Dentistry, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, 707 Parnassus, San Francisco, CA, 94143, USA.
Clin Oral Investig. 2021 Apr;25(4):2055-2068. doi: 10.1007/s00784-020-03515-x. Epub 2020 Aug 15.
The objective of this randomized, single-blind, split-mouth controlled, clinical trial was to evaluate whether the use of a short-pulsed 9.3-μm CO laser increases the caries resistance of occlusal pit and fissures in addition to fluoride therapy over 12 months.
A total of 60 participants, average age 13.1 years, were enrolled. At baseline, second molars were randomized into test and control, and assessed by ICDAS, SOPROLIFE, and DIAGNOdent. An independent investigator irradiated test molars with a CO laser (wavelength 9.3 μm, pulse duration 4 μs, pulse repetition rate 43 Hz, beam diameter 250 μm, average fluence 3.9 J/cm, 20 laser pulses per spot). Test molars received laser and fluoride treatment, control teeth fluoride alone. Fluoride varnish was applied at baseline and at 6 months. After 6 and 12 months, teeth were again assessed.
A total of 57 participants completed the 6-month and 51 the 12-month recall. Laser-treated surfaces showed very slight ICDAS improvements over time with ICDAS change - 1 in 11% and 8%, no changes (ICDAS change 0) in 68% and 67%, and slightly worsened (ICDAS change 1) in 19% and 24% at 6- and 12-month recalls, respectively, and worsened by two scores in 2% at both recall time points. Control teeth showed significantly higher ICDAS increases, with 47% and 25% showing ICDAS change 0, ICDAS change 1 in 49% and 55%, and ICDAS change 2 in 4% and 20% at 6- and 12-month recalls, respectively. Differences in ICDAS changes between the groups were statistically significant (P = 0.0002 and P < 0.0001; Wilcoxon's signed-rank test, exact). A total of 22% of the participants developed ICDAS 3 scores on the control teeth.
Microsecond short-pulsed 9.3-μm CO laser irradiation markedly inhibits caries progression in pits and fissures in comparison with fluoride varnish alone.
The 9.3-μm CO laser irradiation of pits and fissures enhances caries resistance.
ClinicalTrials.gov identifier: NCT02357979.
本随机、单盲、劈裂口对照临床试验的目的是评估在氟化物治疗的基础上，使用短脉冲 9.3μm CO 激光是否能提高窝沟龋的抗龋能力，随访时间为 12 个月。
共纳入 60 名平均年龄为 13.1 岁的参与者。基线时，第二磨牙随机分为试验组和对照组，采用 ICDAS、SOPROLIFE 和 DIAGNOdent 进行评估。一位独立的研究者用 CO 激光（波长 9.3μm、脉冲持续时间 4μs、脉冲重复率 43Hz、光束直径 250μm、平均能量密度 3.9J/cm、每个光斑 20 个激光脉冲）照射试验组磨牙。试验组磨牙接受 CO 激光和氟化物治疗，对照组磨牙仅接受氟化物治疗。氟化物涂料在基线时和 6 个月时应用。6 个月和 12 个月后再次评估牙齿。
共有 57 名参与者完成了 6 个月和 51 名参与者完成了 12 个月的随访。激光治疗组的 ICDAS 评分随时间呈轻度改善，6 个月和 12 个月时的改善分别为 11%和 8%，无变化（ICDAS 评分 0）分别为 68%和 67%，轻度恶化（ICDAS 评分 1）分别为 19%和 24%，2%的牙齿在两次随访时恶化两个等级。对照组的 ICDAS 评分增加明显较高，6 个月和 12 个月时分别有 47%和 25%的牙齿 ICDAS 评分 0，49%和 55%的牙齿 ICDAS 评分 1，4%和 20%的牙齿 ICDAS 评分 2。两组间 ICDAS 评分变化差异具有统计学意义（P=0.0002 和 P<0.0001；Wilcoxon 符号秩检验，确切）。对照组有 22%的牙齿出现 ICDAS3 评分。
与单独使用氟化物涂料相比，微秒短脉冲 9.3μm CO 激光照射能显著抑制窝沟龋的进展。
9.3μm CO 激光照射窝沟可增强抗龋能力。
ClinicalTrials.gov 标识符：NCT02357979。
