Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
Lasers Med Sci. 2021 Oct;36(8):1701-1708. doi: 10.1007/s10103-021-03313-1. Epub 2021 Apr 30.
The use of zirconia for implants and abutments has become more prevalent in implant dentistry as an alternative to the commonly used titanium implants, and peri-implant disease can still affect them. The erbium, chromium-doped:yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser has emerged as a promising treatment modality. The purposes of this in vitro study were to (1) determine the effects of the laser on the surface roughness of zirconia discs; (2) determine the extent of removal of a single species biofilm, E. coli, on the zirconia discs after applying the laser; (3) determine the amount of cell adhesion and proliferation utilizing fibroblasts on zirconia discs after treatment with the laser. All treatments will be compared with the commonly used ultrasonic instrumentation and hand scalers. For the first aim, gross examination revealed noticeable surface damage on the discs when using ultrasonic and scalers but not for the laser group. For surface roughness, the mean roughness was Pa= 0.623±0.185 μm, 0.762±0.421 μm, 0.740±0.214 μm, and 0.724±0.168 μm for control discs, and discs treated with either the Er,Cr:YSGG laser, ultrasonic instrumentation, and hand scalers respectively. There was no statistical significance among the groups (p=0.628). For bacteria decontamination, there was a statistical significance among the groups (p< 0.0001). Statistical significance was seen between the control group and each of the three treatment groups, favoring the treatment groups (p< 0.0001). Statistical significance was seen when comparing ultrasonic instrumentation and hand scalers (p= 0.000) as well as when comparing the Er,Cr:YSGG laser to hand scalers (p= 0.007), favoring both the ultrasonic instrumentation and Er,Cr:YSGG laser. No significance between the Er,Cr:YSGG laser group and the ultrasonic instrumentation group was noted (p =0.374). When comparing the cell attachment following treatment in each of the three groups and also without treatment (control), there was a statistical significance among the groups (p<0.0001) in terms of total cell count, favoring the control and the laser groups. Further evaluations with SEM showed differences in cell morphology indicating more adherent cells on Er,Cr:YSGG laser-treated surfaces. In conclusion, gross examination of the discs show clear surface changes when using ultrasonic instrumentation and hand scalers compared to the Er,Cr:YSGG laser group. The Er,Cr:YSGG laser was able to effectively ablate bacteria from zirconia disc. Fibroblast attachment on the surfaces of the zirconia discs shows more adherence when treated with Er,Cr:YSGG laser.
使用氧化锆作为种植体和基台在种植牙领域越来越普遍，作为常用钛种植体的替代品，种植体周围病仍然会影响它们。掺铒、铬：钇-钪-镓石榴石（Er,Cr:YSGG）激光已成为一种有前途的治疗方式。本体外研究的目的是：（1）确定激光对氧化锆片表面粗糙度的影响；（2）确定激光处理后氧化锆片上单一物种生物膜（大肠杆菌）的去除程度；（3）确定激光处理后利用成纤维细胞在氧化锆片上的细胞黏附和增殖程度。所有处理方法都将与常用的超声仪器和手动锉刀进行比较。对于第一个目的，肉眼观察发现，使用超声和锉刀时，圆盘表面有明显的损伤，但激光组没有。对于表面粗糙度，平均粗糙度分别为 Pa=0.623±0.185 μm、0.762±0.421 μm、0.740±0.214 μm 和 0.724±0.168 μm，分别为对照盘和用 Er,Cr:YSGG 激光、超声仪器和手动锉刀处理的盘。组间无统计学意义（p=0.628）。对于细菌消毒，组间有统计学意义（p<0.0001）。对照组与三个治疗组中的每一组均有统计学意义，治疗组有利（p<0.0001）。超声仪器和手动锉刀之间有统计学意义（p=0.000），Er,Cr:YSGG 激光与手动锉刀之间也有统计学意义（p=0.007），这两种方法都优于超声仪器和 Er,Cr:YSGG 激光。Er,Cr:YSGG 激光组与超声仪器组之间无显著性差异（p=0.374）。在比较三组中每一组和未处理组（对照组）的细胞附着后，组间有统计学意义（p<0.0001），总细胞计数有利于对照组和激光组。进一步的 SEM 评估显示细胞形态存在差异，表明 Er,Cr:YSGG 激光处理表面的细胞更具黏附性。总之，与 Er,Cr:YSGG 激光组相比，使用超声仪器和手动锉刀时，圆盘的肉眼检查显示出明显的表面变化。Er,Cr:YSGG 激光能够有效地从氧化锆盘上清除细菌。Er,Cr:YSGG 激光处理后，成纤维细胞在氧化锆片表面的黏附性更强。
