Sharma Nikhil, Sisodia Suruchi, Jain Arvind, Bhargava Triveni, Kumar Pratiksha, Rana Kuldeep Singh
Department of Conservative Dentistry and Endodontics, Modern Dental College and Research Centre, Indore, IND.
Department of Conservative Dentistry and Endodontics, Government College of Dentistry, Indore, IND.
Cureus. 2023 Jan 31;15(1):e34432. doi: 10.7759/cureus.34432. eCollection 2023 Jan.
Dentistry is undergoing a gentle revolution that will consign drill and fill to history. In order to increase the acceptance of dental treatment, efforts are directed toward changing traditional painful dentistry into a new concept of painless dentistry. It is common practice to utilize burs for caries removal and cavity preparation. Chemomechanical caries removal is a painless procedure that uses a chemical substance to eradicate diseased dentine. With the Food and Drug Administration (FDA) approval of Erbium-doped yttrium-aluminum-garnet (Er: YAG) laser systems for caries removal and cavity preparation, the discipline of laser operational dentistry was born out of a desire to find a way to remove the decay without causing any pain or stress to the surrounding healthy tissue.
This in vitro research aimed to assess the relative advantages of chemomechanical and laser caries extraction techniques in comparison to the more traditional bur technique. The efficacy of each method was evaluated by microscopic examination of samples treated with each experimental method. We also evaluated the efficiency of each method by recording the time required for caries excavation.
The methods used for caries excavation were bur excavation, chemo-mechanical method, and laser method. Histological slices were produced after all the samples had been treated with the experimental techniques, and they were studied using a binocular light transmission microscope. The samples were then scored as '0' for absence and '1' for the presence of demineralized dentine. These scores and the time recorded for each method were subjected to statistical analysis.
This study found no statistically significant difference in the effectiveness of the different approaches to removing caries; however, bur excavation was the quickest and chemo-mechanical was the slowest, with the latter not being useful in cases with low caries activity. The laser method of caries removal doesn't remove caries existing in the undercut areas of the cavity thus making the use of bur mandatory.
With more practice and experience, the chemo-mechanical and laser methods can be used in a more efficient way to render painless operative procedures to patients.
牙科正在经历一场温和的革命,这将把钻孔补牙送进历史。为了提高牙科治疗的接受度,人们致力于将传统的痛苦牙科转变为无痛牙科的新概念。使用牙钻进行龋齿去除和窝洞预备是常见的做法。化学机械去龋是一种无痛程序,它使用化学物质根除病变牙本质。随着美国食品药品监督管理局(FDA)批准掺铒钇铝石榴石(Er:YAG)激光系统用于龋齿去除和窝洞预备,激光手术牙科学科应运而生,其目的是找到一种在不损伤周围健康组织的情况下去除龋坏的方法。
本体外研究旨在评估化学机械去龋和激光去龋技术相对于更传统的牙钻技术的相对优势。通过对每种实验方法处理的样本进行显微镜检查来评估每种方法的疗效。我们还通过记录龋齿挖掘所需的时间来评估每种方法的效率。
用于龋齿挖掘的方法有牙钻挖掘、化学机械法和激光法。在用实验技术处理所有样本后制作组织切片,并使用双目透光显微镜进行研究。然后将样本中无脱矿牙本质记为“0”分,有脱矿牙本质记为“1”分。对这些分数以及每种方法记录的时间进行统计分析。
本研究发现不同龋齿去除方法的有效性在统计学上没有显著差异;然而,牙钻挖掘最快,化学机械法最慢,后者在龋齿活动度低的情况下不太适用。激光去龋方法无法去除窝洞倒凹区域存在的龋齿,因此牙钻的使用必不可少。
随着更多的实践和经验积累,可以更有效地使用化学机械法和激光法为患者提供无痛手术操作。