Glockner K, Rumpler J, Ebeleseder K, Städtler P
Clinical Department of Conservative Dentistry, School of Dentistry, Karl-Franzens University, Graz, Austria.
J Clin Laser Med Surg. 1998 Jun;16(3):153-7. doi: 10.1089/clm.1998.16.153.
The authors explored whether the preparation with the Er:YAG laser showed a difference in increase of intrapulpal temperature in comparison to the conventional burr.
The effect of preparation with the Er:YAG laser on the temperature in the pulp is probably the biggest problem in using the laser for preparation of dental hard tissue.
The effect on the temperature in the pulp was studied on extracted human incisors and canines in vitro in palatinal class I cavities. The temperature during preparation with the Er:YAG laser was compared to that recorded during conventional tactile preparation with a diamond burr. The study was designed so that the pulpal cavity and the measuring probe were kept at a constant temperature of 37 degrees C from the root upward while the crown, which was thermally isolated, was exposed to preparation and cooling agents.
During preparation with the laser, there was a temperature drop after a few seconds from 37 degrees C to 25 degrees C to 30 degrees C due to cooling with water and air. Even with trepanation, there was only an increase in temperature in the pulp when the temperature measuring probe was hit directly by the laser beam. With conventional preparation in comparison, even before trepanation there was a rise in temperature to more than 60 degrees C.
The reduction in pain with clinical use of the Er:YAG laser for class V cavities has already been mentioned in publications and could, in addition to the nontactile preparation, be due to the lesser increase in intrapulpal temperature during the laser preparation in comparison to the conventional burr.
作者探讨了与传统牙钻相比,铒激光预备在牙髓腔内温度升高方面是否存在差异。
铒激光预备对牙髓温度的影响可能是将激光用于牙硬组织预备时最大的问题。
在体外对拔除的人切牙和尖牙腭侧I类洞进行研究,观察其对牙髓温度的影响。将铒激光预备过程中的温度与使用金刚石牙钻进行传统触觉预备时记录的温度进行比较。该研究设计为从牙根向上使牙髓腔和测量探头保持在37摄氏度的恒定温度,而热隔离的牙冠则暴露于预备和冷却剂中。
在激光预备过程中,由于水和空气冷却,几秒钟内温度从37摄氏度降至25摄氏度至30摄氏度。即使是环形钻开髓,只有当温度测量探头直接受到激光束照射时,牙髓温度才会升高。相比之下,传统预备即使在环形钻开髓之前温度就会升至60摄氏度以上。
出版物中已经提到临床使用铒激光预备V类洞时疼痛减轻,除了非接触式预备外,这可能还归因于与传统牙钻相比,激光预备过程中牙髓腔内温度升高较少。