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使用不同功率输出的干式与湿式铒铬:钇钪镓石榴石激光去除二硅酸锂贴面的效率

Efficiency of dry versus wet Er,Cr:YSGG laser debonding of lithium disilicate veneers using different power outputs.

作者信息

Raafat Soha, Zohdy Maged, Eldemellawy Mohamed, Ghali Rami, Taha Doaa

机构信息

Assistant Lecturer, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.

Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.

出版信息

J Prosthet Dent. 2025 Jan;133(1):193.e1-193.e8. doi: 10.1016/j.prosdent.2024.09.008. Epub 2024 Sep 30.

Abstract

STATEMENT OF PROBLEM

Since water is the chromophore for the erbium, chromium-yttrium scandium gallium garnet (Er,Cr:YSGG) laser, the laser energy reaching the restoration decreases as part of it is absorbed by water. Theoretically, reducing the water or implementing dry debonding could reduce the energy consumed by water, increasing laser efficiency. Studies on whether it is suitable for removing veneers without using coolant are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the debonding time, intrapulpal temperature, and translucency of veneers during wet versus dry debonding with an Er,Cr:YSGG laser using different power outputs.

MATERIAL AND METHODS

Sixty-three maxillary central incisors were flattened labially to receive ceramic specimens. After cementation, ceramic specimens were irradiated with an Er,Cr:YSGG laser for debonding with different power outputs and water percentages (N=70): subgroup A1, 4 W and 1% water; A20, 4 W and 20% water; A40, 4 W and 40% water; B1, 5 W and 1% water; B20, 5 W and 20% water; B40, 5 W and 40% water; C1, 6 W and 1% water; C20, 6 W and 20% water; C40, 6 W and 40% water, and a control group of unbonded ceramic specimens. During debonding, the temperature rise and debonding time were evaluated, followed by the evaluation of the translucency and surface topography of the debonded specimens. Two-way analysis of variance (ANOVA) and the Dunnett test were used to analyze the data (α=.05).

RESULTS

The mean intrapulpal temperature rise varied significantly among groups B and C (P<.001), with the highest mean temperature rise found in subgroup B1 (4.00 ±0.00 ºC) and the lowest mean temperature rise in subgroup C20 (1.20 ±0.45 ºC). For the debonding time, the mean values of time required for debonding varied significantly among different groups (P<.001), with the longest time recorded in subgroup A1 (333.4 ±74.8 s) and the shortest time recorded in subgroup C20 (17.0 ±6.0 s). Only subgroups C1 (18.89 ±0.2) and C40 (18.60 ±0.2) showed a significantly lower translucency than the control group (19.44 ±0.06) (P<.001).

CONCLUSIONS

Dry Er,Cr:YSGG laser debonding resulted in increased intrapulpal temperature when using high power outputs, but without exceeding the critical threshold of dental pulp temperature. Dry debonding also limited the transmission of laser energy, affecting the debonding efficiency. A power output of 5 W and 20% water can be considered efficient and safe laser parameters for debonding lithium disilicate veneers if their reuse is intended.

摘要

问题陈述

由于水是铒铬钇钪镓石榴石(Er,Cr:YSGG)激光的发色团,到达修复体的激光能量会随着其中一部分被水吸收而降低。从理论上讲,减少水分或采用干式脱粘可以减少水消耗的能量,提高激光效率。目前缺乏关于不使用冷却液是否适合去除贴面的研究。

目的

本体外研究的目的是评估使用不同功率输出的Er,Cr:YSGG激光进行湿式与干式脱粘时贴面的脱粘时间、牙髓内温度以及透明度。

材料与方法

六十三颗上颌中切牙唇面磨平以粘贴陶瓷试件。粘贴后,用Er,Cr:YSGG激光对陶瓷试件进行不同功率输出和水百分比的照射以进行脱粘(N = 70):A1组,4W和1%水;A20组,4W和20%水;A40组,4W和40%水;B1组,5W和1%水;B20组,5W和20%水;B40组,5W和40%水;C1组,6W和1%水;C20组,6W和20%水;C40组,6W和40%水,以及一组未粘结的陶瓷试件作为对照组。在脱粘过程中,评估温度升高和脱粘时间,随后评估脱粘试件的透明度和表面形貌。采用双向方差分析(ANOVA)和Dunnett检验分析数据(α = 0.05)。

结果

B组和C组之间牙髓平均温度升高差异显著(P <.001),B1亚组的平均温度升高最高(4.00 ± 0.00 ºC),C20亚组的平均温度升高最低(1.20 ± 0.45 ºC)。对于脱粘时间,不同组之间脱粘所需时间的平均值差异显著(P <.001),A1亚组记录的时间最长(333.4 ± 74.8秒),C20亚组记录的时间最短(17.0 ± 6.0秒)。只有C1亚组(18.89 ± 0.2)和C40亚组(18.60 ± 0.2)的透明度显著低于对照组(19.44 ± 0.06)(P <.001)。

结论

当使用高功率输出时,干式Er,Cr:YSGG激光脱粘会导致牙髓内温度升高,但未超过牙髓温度的临界阈值。干式脱粘还限制了激光能量的传输,影响脱粘效率。如果打算重新使用二硅酸锂贴面,5W功率输出和20%水可被视为高效且安全的激光脱粘参数。

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