Pelagalli J, Gimbel C B, Hansen R T, Swett A, Winn D W
Center for Advanced Laser Dentistry, Independence, Ohio 44131, USA.
J Clin Laser Med Surg. 1997;15(3):109-15. doi: 10.1089/clm.1997.15.109.
We determined that the Er:YAG pulsed 2.94 micron radiation was successful in the removal of caries, cavity preparation, and etching prior to acid etching.
The laser group was compared to a control group in which the high-speed drill was employed. Parameters measured included histological evaluation of the pulp, scanning electron microscopy of the surface morphology of the tooth, dye penetration studies, bond strength measurements, and rating of the laser's ability to remove caries and form the preparation.
We collectively evaluated 60 patients with 106 teeth in both the laser and control groups over a 1-year period. Teeth were treated in vivo and then extracted immediately, at 2 days, 1 month, and up to 1-year to assess pulpal healing, surface morphology, and the quality of the preparation, restoration, and pain.
The dental laser was shown to be equal or better than the drill in the tested procedures of caries removal, cavity preparation, and etching prior to acid etching. The scanning electron microscopy revealed no microfracturing, open dentinal tubules, and effective etching with the laser having a mean of 2.7 with an optimum rating of 3. The histological testing confirmed that the pulp was not compromised using the laser with scores of theta for hemorrhage, 0.47 for hyperemia, and 0.12 for inflammation on a scale of 0 to 3 where 0 is no effect.
The FDA has recently cleared the Er:YAG to remove all classes of caries, form the cavity preparation, and modify the enamel and dentin prior to acid etching. In this Phase I study conducted as part of the clinical trials, there were no complications and no tooth was compromised. Patients were consistently treated without anesthesia with the same or better results than the drill as confirmed by scanning electron microscopy and histological studies.
我们确定铒激光脉冲2.94微米辐射在龋病去除、窝洞预备以及酸蚀前的蚀刻方面是成功的。
将激光组与使用高速牙钻的对照组进行比较。测量的参数包括牙髓的组织学评估、牙齿表面形态的扫描电子显微镜检查、染料渗透研究、粘结强度测量以及激光去除龋病和形成预备体能力的评级。
在1年的时间里，我们对激光组和对照组的60例患者共106颗牙齿进行了综合评估。牙齿在体内进行治疗，然后在即刻、2天、1个月以及长达1年时拔除，以评估牙髓愈合、表面形态以及预备体、修复体的质量和疼痛情况。
在龋病去除、窝洞预备以及酸蚀前的蚀刻这些测试操作中，牙科激光显示出与牙钻相当或更好的效果。扫描电子显微镜检查显示没有微裂纹、开放的牙本质小管，并且激光蚀刻有效，平均评分为2.7，最佳评分为3。组织学测试证实使用激光时牙髓未受损害，出血评分为θ，充血评分为0.47，炎症评分为0.12，评分范围为0至3，其中0表示无影响。
美国食品药品监督管理局（FDA）最近已批准铒激光用于去除所有类型的龋病、形成窝洞预备体以及在酸蚀前对釉质和牙本质进行改性。在作为临床试验一部分进行的这项I期研究中，没有出现并发症，也没有牙齿受到损害。扫描电子显微镜检查和组织学研究证实，患者在无麻醉的情况下接受治疗，效果与牙钻相同或更好。
