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牙髓再生治疗中用于根管消毒的 Nd:YAP 激光的效果:一项初步研究。

Effects of an Nd:YAP laser used for root canal disinfection in pulp regenerative therapy: a pilot study.

机构信息

Department of Periodontology, Changzhou Hospital of Stomatology, 213003 Changzhou, Jiangsu, China.

Department of Pediatric Dentistry, Changzhou Hospital of Stomatology, 213003 Changzhou, Jiangsu, China.

出版信息

J Clin Pediatr Dent. 2023 Mar;47(2):23-29. doi: 10.22514/jocpd.2023.008. Epub 2023 Mar 3.

Abstract

This study aimed to compare the disinfection effects between a triple antibiotic paste and neodymium-doped yttrium aluminum perovskite (Nd:YAP) laser in pulp regenerative therapy and evaluate corresponding therapeutic effects based on apical radiographs and cone-beam computed tomography (CBCT). Sixty-six immature permanent teeth in 66 patients diagnosed with acute or chronic apical periodontitis were analyzed. All teeth were given pulp regenerative therapy. The patients were categorized into a control (triple antibiotic paste) and an experimental (Nd:YAP laser) group. Teeth in the experimental group were disinfected using an Nd:YAP laser, while those in the control group were disinfected using a triple antibiotic paste. Clinical and radiological examinations were performed every 3-6 months after treatment and followed up for 24 months. Statistical analysis was performed after clinical examination and showed that after one week of treatment, symptoms persisted in two teeth in the control group and two teeth in the experimental group. Two weeks later, the clinical symptoms disappeared in all teeth ( 0.05). After 24 months of follow-up, the clinical symptoms recurred in two teeth in the control group and one tooth in the experimental group. On radiographic examination, 31 and 27 teeth showed continued root development, and three and two teeth showed no obvious root development in the control and experimental groups, respectively. The pulp sensibility test was positive in four teeth in both groups, with no significant difference between the two groups ( 0.05). The results of this study suggest that endodontic irradiation with an Nd:YAP laser could be an effective alternative to triple antibiotic paste during disinfection of pulp regenerative therapy. Treatment outcomes were assessed using apical radiographs and CBCT, and no negative prognostic effects of the Nd:YAP laser on pulp regenerative therapy were found.

摘要

本研究旨在比较三抗糊剂和掺钕钇铝石榴石(Nd:YAP)激光在牙髓再生治疗中的消毒效果,并基于根尖射线照片和锥形束计算机断层扫描(CBCT)评估相应的治疗效果。分析了 66 名患有急性或慢性根尖周炎的患者的 66 颗未成熟恒牙。所有牙齿均接受牙髓再生治疗。患者分为对照组(三抗糊剂)和实验组(Nd:YAP 激光)。实验组用 Nd:YAP 激光消毒,对照组用三抗糊剂消毒。治疗后每 3-6 个月进行临床和影像学检查,并随访 24 个月。临床检查后进行统计学分析,结果显示治疗后一周,对照组有 2 颗牙、实验组有 2 颗牙症状持续存在。两周后,所有牙齿的临床症状均消失( 0.05)。24 个月随访时,对照组有 2 颗牙、实验组有 1 颗牙出现临床症状复发。影像学检查显示,对照组有 31 颗牙和 27 颗牙继续根发育,实验组分别有 3 颗牙和 2 颗牙无明显根发育。两组均有 4 颗牙牙髓感觉测试阳性,两组间无显著差异( 0.05)。本研究结果表明,Nd:YAP 激光根管内照射在牙髓再生治疗的消毒过程中可能是三抗糊剂的有效替代方法。采用根尖射线照片和 CBCT 评估治疗效果,未发现 Nd:YAP 激光对牙髓再生治疗有不良预后影响。

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