铒：钇铝石榴石激光照射对感染磨牙位点牙槽嵴保存效果的影响：一项随机对照试验。
Influence of Er:YAG laser irradiation on the outcomes of alveolar ridge preservation at the infected molar sites: a randomized controlled trial.
机构信息
College & Hospital of Stomatology, Key Lab. of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, 230032, China.
Department of Dental Implantology, College & Hospital of Stomatology, Anhui Medical University, Hefei, 230032, China.
出版信息
BMC Oral Health. 2023 May 23;23(1):317. doi: 10.1186/s12903-023-02996-y.
BACKGROUND
The purpose of this study was to investigate the socket healing outcome after alveolar ridge preservation at infected molar sites using an erbium-doped yttrium aluminium garnet (Er:YAG) laser.
METHODS
Eighteen patients who needed molar extraction and exhibited signs of infection were included and allocated into either the laser group or the control group. Er:YAG laser irradiation for degranulation and disinfection was performed with alveolar ridge preservation (ARP) in the laser group. Traditional debridement with a curette was performed in the control group. Two months after ARP, bone tissue samples were harvested at the time of implant placement for histological analysis. Assessment of dimension changes in alveolar bone was conducted by superimposing two cone-beam computed tomography (CBCT) scans taken at baseline and two months after extraction.
RESULTS
Histologically, after two months of healing, Er:YAG laser treatment resulted in more newly formed bone (laser: 17.75 ± 8.75, control: 12.52 ± 4.99, p = 0.232). Moreover, greater osteocalcin (OCN) positive expression and lower runt-related transcription factor 2 (RUNX-2) positive expression were detected in the laser group. However, no statistically significant difference was observed between the two groups. The difference in the vertical resorption of the buccal bone plate was statistically significant between groups (laser: -0.31 ± 0.26 mm, control: -0.97 ± 0.32 mm, p < 0.05). Major changes in ridge width were observed at 1 mm below the bone crest. However, the differences between groups were not significant (laser: -0.36 ± 0.31 mm, control: -1.14 ± 1.24 mm, p = 0.171).
CONCLUSIONS
ARP with Er:YAG laser irradiation seemed to improve bone healing by regulating osteogenesis-related factor expression in the early stage at infected sites.
TRIAL REGISTRATION
The trial was registered on the Chinese Clinical Trial Registry Platform ( https://www.chictr.org.cn/ ) (registration number: ChiCTR2300068671; registration date: 27/02/2023).
背景
本研究旨在探讨使用铒激光（Er:YAG）对感染磨牙部位进行牙槽嵴保存后的愈合结果。
方法
纳入 18 名需要磨牙拔除且有感染迹象的患者，并将其分为激光组和对照组。激光组采用 Er:YAG 激光进行脱颗粒和消毒，以进行牙槽嵴保存（ARP）。对照组采用传统的刮匙清创术。ARP 两个月后，在植入物放置时采集骨组织样本进行组织学分析。通过叠加基线和拔牙后两个月的两次锥形束计算机断层扫描（CBCT）扫描来评估牙槽骨的尺寸变化。
结果
组织学上，愈合两个月后，Er:YAG 激光治疗导致更多的新骨形成（激光组：17.75±8.75，对照组：12.52±4.99，p=0.232）。此外，激光组中骨钙素（OCN）阳性表达更高， runt 相关转录因子 2（RUNX-2）阳性表达更低。然而，两组之间没有统计学上的显著差异。两组间颊侧骨板垂直吸收的差异具有统计学意义（激光组：-0.31±0.26mm，对照组：-0.97±0.32mm，p<0.05）。在距骨嵴 1mm 以下观察到牙槽嵴宽度的主要变化。然而，两组之间的差异没有统计学意义（激光组：-0.36±0.31mm，对照组：-1.14±1.24mm，p=0.171）。
结论
在感染部位，ARP 联合 Er:YAG 激光照射似乎通过调节成骨相关因子的表达来改善早期骨愈合。
试验注册
该试验在中国临床试验注册平台（https://www.chictr.org.cn/）（注册号：ChiCTR2300068671；注册日期：2023 年 2 月 27 日）进行了注册。
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