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铒激光在不同陶瓷修复体脱粘中的应用:一项体外研究。

Er:YAG Laser Applications for Debonding Different Ceramic Restorations: An In Vitro Study.

作者信息

Luca Ruxandra Elena, Giumancă-Borozan Anișoara, Hulka Iosif, Munteanu Ioana-Roxana, Todea Carmen Darinca, Miron Mariana Ioana

机构信息

University Clinic of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.

Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, Revolutiei 1989 Avenue No. 9, 300070 Timisoara, Romania.

出版信息

Medicina (Kaunas). 2025 Jun 30;61(7):1189. doi: 10.3390/medicina61071189.

Abstract

: Conventional methods for removing cemented fixed prosthetic restorations (FPRs) are unreliable and lead to unsatisfactory outcomes. At their best, they allow the tooth to be saved at the expense of a laborious process that also wears down rotating tools and handpieces and occasionally results in abutment fractures. Restorations are nearly never reusable in any of these situations. Erbium-doped yttrium-aluminum-garnet (Er:YAG) and erbium-chromium yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers casafely and effectively remove FPRs, according to scientific studiesre. This study sets out to examine the impact of Er:YAG laser radiation on the debonding of different ceramic restorations, comparing the behavior of various ceramic prosthetic restoration types under laser radiation action and evaluating the integrity of prosthetic restorations and dental surfaces exposed to laser radiation. : The study included a total of 16 removed teeth, each prepared on opposite surfaces as abutments.y. Based on the previously defined groups, four types of ceramic restorations were included in the study: feldspathic (F), lithium disilicates (LD), layered zirconia (LZ), and monolithic zirconia (MZ). The thickness of the prosthetic restorations was measured at three points, and two different materials were used for cementation. The Er:YAG Fotona StarWalker MaQX laser was used to debond the ceramic FPR at a distance of 10 mm using an R14 sapphire tip with 275 mJ, 20 Hz, 5.5 W, with air cooling (setting 1 of 9) and water. After debonding, the debonded surface was visualized under electron microscopy. : A total of 23 ceramic FPRs were debonded, of which 12 were intact and the others fractured into two or three pieces. The electron microscopy images showed that debonding took place without causing any harm to the tooth structure. The various restoration types had the following success rates: 100% for the LZ and F groups, 87% for the LD group, and 0% for the MZ group. In terms of cement type, debonding ceramic FPRs cemented with RELYX was successful 75% of the time, compared to Variolink DC's 69% success rate. : In summary, the majority of ceramic prosthetic restorations can be successfully and conservatively debonded with Er:YAG radiation.

摘要

传统的去除粘结固定修复体(FPRs)的方法不可靠,且效果不理想。即便在最佳情况下,这些方法虽能保住牙齿,但过程繁琐,还会磨损旋转工具和机头,偶尔还会导致基牙骨折。在上述任何一种情况下,修复体几乎都无法再使用。根据科学研究,掺铒钇铝石榴石(Er:YAG)激光和掺铒铬钇钪镓石榴石(Er,Cr:YSGG)激光能够安全有效地去除FPRs。本研究旨在探讨Er:YAG激光辐射对不同陶瓷修复体脱粘的影响,比较各种陶瓷修复体类型在激光辐射作用下的表现,并评估暴露于激光辐射下的修复体和牙齿表面的完整性。

该研究共纳入16颗拔除的牙齿,每颗牙齿相对的两个表面均制备为基牙。根据先前定义的组别,研究纳入了四种类型的陶瓷修复体:长石质(F)、二硅酸锂(LD)、分层氧化锆(LZ)和整体式氧化锆(MZ)。在三个点测量修复体的厚度,并使用两种不同的材料进行粘结。使用Er:YAG Fotona StarWalker MaQX激光,通过R14蓝宝石尖端,在距离10毫米处,以275毫焦、20赫兹、5.5瓦的参数,采用空气冷却(9种设置中的设置1)和水冷却的方式,使陶瓷FPRs脱粘。脱粘后,在电子显微镜下观察脱粘表面。

总共23个陶瓷FPRs被脱粘,其中12个完整,其他的则断裂成两到三块。电子显微镜图像显示,脱粘过程未对牙齿结构造成任何损害。各种修复体类型的成功率如下:LZ组和F组为100%,LD组为87%,MZ组为0%。就粘结剂类型而言,用RELYX粘结的陶瓷FPRs脱粘成功率为75%,而Variolink DC的成功率为69%。

总之,大多数陶瓷修复体可以通过Er:YAG辐射成功且保守地脱粘。

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