Moritz A, Gutknecht N, Schoop U, Goharkhay K, Ebrahim D, Wernisch J, Sperr W
Department of Conservative Dentistry, School of Dentistry, University of Vienna, Austria.
J Clin Laser Med Surg. 1996 Feb;14(1):27-32. doi: 10.1089/clm.1996.14.27.
Various methods are used for treatment of hypersensitive dental necks. They all aim to seal exposed dentinal tubules, which are open toward the oral cavity and transmit stimuli to the sensitive nerve endings of the tooth pulp. The main sealing materials are fluoride preparations, strontium chloride, and hydroxyapatite. However, these materials must be applied periodically to achieve permanent freedom from pain. Since the introduction of laser technology into dentistry, efforts have been made to treat dentine hypersensitivity with the laser. An in vitro study revealed that CO2 laser irradiation results in almost complete closure of the dentinal tubules in the dental neck region. In the present in vivo study, the efficacy of laser treatment was examined in 72 patients with dentine hypersensitivity and 72 control patients over a period of 12 weeks. When success was defined as complete freedom from pain, the success rate in the laser group was 94.5%; when marked pain relief was included in the definition of treatment success, 98.6% of the patients were treated successfully. Treatment of the control group with conventional dental neck fluoridation resulted in no marked improvement. Laser Doppler measurements of pulpal blood flow immediately before and after treatment revealed no effects of laser irradiation on pulpal blood flow. Dentine samples were obtained from the dental necks 6 weeks after laser treatment and examined with atomic absorption spectroscopy (AAS). Tin was present in the samples, which suggests that the combined laser treatment and fluoridation result in permanent integration of fluoride in the dentine surface.
治疗牙颈部过敏有多种方法。它们都旨在封闭暴露的牙本质小管,这些小管向口腔开放,并将刺激传递至牙髓的敏感神经末梢。主要的封闭材料有氟化物制剂、氯化锶和羟基磷灰石。然而,这些材料必须定期应用才能实现永久无痛。自从激光技术引入牙科以来,人们一直致力于用激光治疗牙本质过敏。一项体外研究表明,二氧化碳激光照射可使牙颈部区域的牙本质小管几乎完全封闭。在本体内研究中,对72例牙本质过敏患者和72例对照患者进行了为期12周的激光治疗效果检查。当将成功定义为完全无痛时,激光组的成功率为94.5%;当治疗成功的定义包括显著缓解疼痛时,98.6%的患者治疗成功。用传统的牙颈部氟化法治疗对照组,效果无明显改善。治疗前后立即用激光多普勒测量牙髓血流,结果显示激光照射对牙髓血流无影响。激光治疗6周后从牙颈部获取牙本质样本,并用原子吸收光谱法(AAS)进行检测。样本中存在锡,这表明激光治疗与氟化相结合可使氟永久整合到牙本质表面。