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比较评价 Nd:YAG 激光(1064nm)和 980nm 半导体激光对正畸托槽周围釉质的影响:一项体外研究。

Comparative Evaluation of Influence of Nd:YAG Laser (1064 nm) and 980 nm Diode Laser on Enamel around Orthodontic Brackets: An In Vitro Study.

机构信息

Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy, 9 Revolutiei 1989 Avenue, 300070 Timisoara, Romania.

Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 9 Revolutiei 1989 Avenue, 300070 Timisoara, Romania.

出版信息

Medicina (Kaunas). 2022 May 1;58(5):633. doi: 10.3390/medicina58050633.

Abstract

(1) Background: The prevention of demineralizing lesions at the enamel structure level continues to represent a challenge in daily dental practice. When bacteria influence the pH level, this will decrease below the threshold for remineralization and the dissociation of hydroxyapatite will occur with a high percentage of phosphate and calcium loss. These elements continue to be studied by many authors in order to obtain a working protocol that will lead to their stabilization at the level of the enamel structure, thus preventing the demineralization process. The aim of this study is to evaluate and compare the influence of two types of laser wavelengths on the surface morphology and mineral components of the enamel through an examination with scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDX). (2) Methods: Thirty permanent human incisors extracted for periodontal reasons from patients aged 25−40 years old were selected for this study. Metallic brackets (SS Standard 022 Slot, OC Orthodontics, McMinnville, OR, 97128, USA) were bonded onto each tooth. The buccal surface was randomly assigned three sections: Section A—negative control (no treatment), section B—treated with 980 nm Gallium−Aluminum−Arsenide diode laser (a 300 µm optic fiber was used with 0.8 W output power, energy density of 5.33 J/mm2, in continuous mode, for 30 s, oriented perpendicularly to the enamel surface in contact mode) (KaVo GENTLEray 980 Diode Laser, Kaltenbach & Voigt GmbH, Biberach, Germany), and section C—treated with Nd:YAG laser (a 300 µm fiber was carried out at a 1 mm distance from the enamel surface with 0.75 W power, 75 mJ pulse energy, pulse repetition rate of 10 Hz, 5 J/mm2 fluency, average exposure time of 30 s, and water cooling assisted) (LIGHTWALKER AT S, M021-5AF/1 S, Fotona d.o.o, Ljubljana, Slovenia). The elements evaluated in this study were calcium (Ca), phosphate (P), oxygen (O), and carbon (C). A one-way analysis of variance, paired t-tests, and independent t-tests were carried out to evaluate the results using the SPSS 19 IBM Statistical package software for Microsoft. (3) Results: The evaluation of the data indicated that both wavelengths produced an increase in Ca wt% (for diode laser the mean of Ca wt% before irradiation was 21.06, while that after treatment reached 28.24; and for Nd:YAG laser, the mean of Ca wt% before irradiation was 21.31, while that after treatment reached 33.88); as well, the 980 nm diode laser decreased P wt% (from 17.20 before irradiation to 16.92 after irradiation) and the Nd:YAG laser increased P wt% (from 17.46 before irradiation to 18.28 after irradiation). These results showed a statistically significant difference at the p < 0.05 level. (4) Conclusions: It can be concluded that the best improvement of enamel chemical composition was obtained with Nd:YAG irradiation.

摘要

(1) 背景:在日常牙科实践中,预防釉质结构水平的脱矿化仍然是一个挑战。当细菌影响 pH 值时,pH 值将下降到再矿化的阈值以下,羟磷灰石将发生解离,导致磷酸盐和钙大量流失。许多作者一直在研究这些元素,以获得一个将其稳定在釉质结构水平的工作方案,从而防止脱矿化过程。本研究旨在通过扫描电子显微镜(SEM)和能量色散 X 射线光谱(EDX)评估和比较两种类型的激光波长对釉质表面形态和矿物质成分的影响。

(2) 方法:从 25-40 岁牙周病患者中选择 30 颗永久人切牙进行本研究。将金属托槽(SS Standard 022 Slot,OC Orthodontics,McMinnville,OR,97128,USA)粘接到每颗牙齿上。颊面随机分为三个部分:A 区——阴性对照(未处理)、B 区——用 980nm 砷化镓铝二极管激光处理(使用 300µm 光纤,输出功率为 0.8W,能量密度为 5.33J/mm2,连续模式 30s,垂直于釉质表面,接触模式)(KaVo GENTLEray 980 二极管激光,Kaltenbach & Voigt GmbH,Biberach,Germany)、C 区——用 Nd:YAG 激光处理(将 300µm 光纤以 1mm 的距离从釉质表面引出,功率为 0.75W,脉冲能量为 75mJ,脉冲重复率为 10Hz,5J/mm2 曝光率,平均曝光时间为 30s,水冷辅助)(LIGHTWALKER AT S,M021-5AF/1 S,Fotona d.o.o,Ljubljana,Slovenia)。本研究评估的元素为钙(Ca)、磷(P)、氧(O)和碳(C)。使用 SPSS 19 IBM 统计软件包对数据进行单向方差分析、配对 t 检验和独立 t 检验。

(3) 结果:数据分析表明,两种波长都能增加 Ca wt%(对于二极管激光,照射前 Ca wt%的平均值为 21.06,而照射后的平均值为 28.24;对于 Nd:YAG 激光,照射前 Ca wt%的平均值为 21.31,而照射后的平均值为 33.88);此外,980nm 二极管激光降低了 P wt%(从照射前的 17.20 降低到照射后的 16.92),Nd:YAG 激光增加了 P wt%(从照射前的 17.46 增加到照射后的 18.28)。这些结果在 p<0.05 水平上显示出统计学意义。

(4) 结论:可以得出结论,Nd:YAG 照射对釉质化学成分的改善效果最好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d607/9145095/542bf6d591b1/medicina-58-00633-g001.jpg

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