Labunet Anca, Tonea Andrada, Kui Andreea, Sava Sorina
Dental Materials and Ergonomics Discipline, Iuliu Hațieganu University of Medicine and Pharmacy, 400089 Cluj Napoca, Romania.
Prosthetic Dentistry Discipline, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj Napoca, Romania.
Materials (Basel). 2022 Mar 8;15(6):1988. doi: 10.3390/ma15061988.
In dental practice, different situations require etching the enamel layer. Acid etching, the present golden standard, may be replaced by other methods, such as laser etching. The main focus of our scoping review is to assess the existent literature regarding the effectiveness of different types of lasers, to identify the main aspects studied so far, and to understand where new search strategies are needed.
The search was conducted in several databases focusing on the laser etching of human definitive enamel. We included English language articles published between January 2000 and December 2021.
The 34 articles reviewed showed that hard lasers, Er:YAG, Er,Cr:YAG, may represent an alternative etching method on enamel surfaces. They create a fractured, irregular surface and open dentin tubules, highly suitable for adhesion but with a lower risk of cavity formation. Nd:YAG, CO, and Diode lasers do not help in creating sufficient shear bond strength. There is, however, evidence suggesting that microcracks in the enamel layer may appear after thermomechanical ablation using laser energy.
While the use of acid etching is still successfully used for enamel conditioning, some researchers have emphasized the role played by saliva in the enamel-remineralization process a few days after the procedure. In this context, laser energy can be used, especially for bonding ceramic brackets in the case of orthodontic treatments. However, as thermomechanical ablation can generate microcracks, further research is required in order to establish clear findings concerning the use of laser energy on enamel etching.
在牙科实践中，不同情况需要对牙釉质层进行酸蚀处理。酸蚀作为目前的金标准，可能会被其他方法所取代，比如激光蚀刻。我们的范围综述的主要重点是评估关于不同类型激光有效性的现有文献，确定目前已研究的主要方面，并了解哪些方面需要新的搜索策略。
在多个专注于人类恒牙釉质激光蚀刻的数据库中进行检索。我们纳入了2000年1月至2021年12月期间发表的英文文章。
所综述的34篇文章表明，硬激光，如铒钇铝石榴石（Er:YAG）、铒铬钇铝石榴石（Er,Cr:YAG），可能是牙釉质表面蚀刻的一种替代方法。它们会形成破碎、不规则的表面并打开牙本质小管，非常适合粘结，但形成龋洞的风险较低。钕钇铝石榴石（Nd:YAG）、二氧化碳（CO）和二极管激光在产生足够的剪切粘结强度方面并无帮助。然而，有证据表明，使用激光能量进行热机械消融后，牙釉质层可能会出现微裂纹。
虽然酸蚀仍成功用于牙釉质预处理，但一些研究人员强调了唾液在酸蚀处理几天后牙釉质再矿化过程中所起的作用。在这种情况下，可以使用激光能量，特别是在正畸治疗中粘结陶瓷托槽时。然而，由于热机械消融会产生微裂纹，需要进一步研究以明确激光能量用于牙釉质蚀刻的相关结果。
