Aoki Akira, Mizutani Koji, Taniguchi Yoichi, Lin Taichen, Ohsugi Yujin, Mikami Risako, Katagiri Sayaka, Meinzer Walter, Iwata Takanori
Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
Taniguchi Dental Clinic, Kita 7-17, 18-chome, Nango-dori, Shiroishi-ku, Sapporo, Hokkaido, Japan.
Jpn Dent Sci Rev. 2024 Dec;60:1-14. doi: 10.1016/j.jdsr.2023.11.002. Epub 2023 Dec 9.
Lasers have numerous advantageous tissue interactions such as ablation or vaporization, hemostasis, bacterial killing, as well as biological effects, which induce various beneficial therapeutic effects and biological responses in the tissues. Thus, lasers are considered an effective and suitable device for treating a variety of inflammatory and infectious conditions of periodontal disease. Among various laser systems, the Er:YAG laser, which can be effectively and safely used in both soft and hard tissues with minimal thermal side effects, has been attracting much attention in periodontal therapy. This laser can effectively and precisely debride the diseased root surface including calculus removal, ablate diseased connective tissues within the bone defects, and stimulate the irradiated surrounding periodontal tissues during surgery, resulting in favorable wound healing as well as regeneration of periodontal tissues. The safe and effective performance of Er:YAG laser-assisted periodontal surgery has been reported with comparable and occasionally superior clinical outcomes compared to conventional surgery. This article explains the characteristics of the Er:YAG laser and introduces its applications in periodontal surgery including conventional flap surgery, regenerative surgery, and flapless surgery, based on scientific evidence from currently available basic and clinical studies as well as cases reports.
激光具有多种有利的组织相互作用,如消融或汽化、止血、杀菌以及生物效应,这些效应能在组织中引发各种有益的治疗效果和生物反应。因此,激光被认为是治疗牙周疾病各种炎症和感染状况的有效且合适的设备。在各种激光系统中,掺铒钇铝石榴石(Er:YAG)激光能够在软组织和硬组织中有效且安全地使用,热副作用极小,在牙周治疗中备受关注。这种激光在手术过程中能够有效且精确地清理患病的牙根表面,包括去除牙结石,消融骨缺损内患病的结缔组织,并刺激周围受照射的牙周组织,从而实现良好的伤口愈合以及牙周组织的再生。与传统手术相比,掺铒钇铝石榴石激光辅助牙周手术的安全有效性能已得到报道,其临床结果相当,有时甚至更优。本文基于当前可用的基础和临床研究以及病例报告的科学证据,阐述了掺铒钇铝石榴石激光的特性,并介绍了其在牙周手术中的应用,包括传统翻瓣手术、再生手术和不翻瓣手术。