Nd：YAG激光去除根管内充填材料效果的研究

›› 2016, Vol. 36 ›› Issue (4): 314-317.

Nd：YAG激光去除根管内充填材料效果的研究

陈幸哲¹,朱庆萍¹,孙超²,吴大明¹,周广超³,袁玲⁴,张宏超⁴

1. 江苏省口腔医院
2. 南京医科大学口腔医学研究所，南京医科大学附属口腔医院
3. 南京医科大学口腔医学研究所
4. 南京理工大学

收稿日期:2015-11-12 修回日期:2015-12-20 出版日期:2016-04-28 发布日期:2016-04-24
通讯作者: 朱庆萍 E-mail:zhuqpp@163.com
基金资助:
江苏省科学技术厅自然科学基金资助项目

Removal of filling materials from root canals using Nd:YAG laser irradiation

Received:2015-11-12 Revised:2015-12-20 Online:2016-04-28 Published:2016-04-24

摘要/Abstract

摘要： 目的通过测定根管内充填材料的清除率和根管外壁温度的变化，评价不同功率Nd:YAG激光去除根管内充填材料的效果。方法选取临床拔除的40颗单根管离体上颌中切牙，常规镍钛锉根管预备、热牙胶充填根管后，随机均分为A、B、C实验组和D 对照组，分别采用1.0，1.5，2.0 W的Nd:YAG激光及Protaper D3再治疗锉去除根管内充填材料，同时测量根管外壁的温度变化。各样本在处理前后分别采用mimics软件将口腔颌面锥形束CT（CBCT）的扫描数据进行处理，计算出实验前根管内充填材料体积、处理后剩余充填材料体积及根管充填材料清除率。结果 A、B、C、D四组根管充填材料清除率分别为80.49%、89.82%、78.09%、21.09%，除A组与C组比较无统计学差异外，其他组间两两比较均有统计学差异（P＜0.05);A、B、C、D四组根管外壁温度升高均值分别为5.28、6.48、7.73、0.80 ℃，A、B、C组均与D组有统计学差异（P＜0.05)。结论 Nd:YAG激光能够有效去除根管内充填材料，参数设置为频率20 Hz,功率1.5 W,SP模式的Nd:YAG激光根管充填材料清除率高，根管外壁温度较再治疗锉明显升高，但在牙周可耐受范围以内。

关键词: Nd：YAG激光, Protaper再治疗锉, 根管再治疗

Abstract: Objective To evaluate the effect of different power of Nd:YAG laser on the removal of root canal filling materials by measuring the removal percentage of root canal filling materials and the change of the temperature on the root surface. Methods 40 maxillary central incisors were prepared by ProTaper rotary files and filled by SybronEndo filling system. After that, 40 teeth were randomly divided into four groups of 10 each, namely experimental groups A, B, C and control group D. Root canal filling materials of four groups were removed by 1.0, 1.5, 2.0 W Nd:YAG laser and ProTaper D3 respectively, and temperature changes on the root surface were also measured at the same time. The Mimics software was used to process the data of CBCT before and after treatment. The removal percentage of root canal filling materials was calculated. Results The average removal percentage of filling materials in group A, B, C and D was 80.49%, 89.82%, 78.09%, 21.09%, respectively. There was significant difference within groups (P＜0.05), except for group A and C. Average temperature increase of group A, B, C and D were 5.28, 6.48, 7.73, 0.80 ℃, respectively, with significant differences between experimental groups and control group (P＜0.05). Conclusion Nd:YAG laser can effectively remove the root canal filling materials, the parameter of 20 Hz, 1.5 W, SP Nd:YAG laser (group B) has a high removal percentage, and the temperature increase on the root surface is within the tolerance range of periodontium.

Key words: Nd：YAG laser, ProTaper universal retreatment systems, root canal retreatment

中图分类号:

R781.05

陈幸哲朱庆萍孙超吴大明周广超袁玲张宏超. Nd：YAG激光去除根管内充填材料效果的研究[J]. , 2016, 36(4): 314-317.

参考文献

[1]钟东青，熊世江.根管再治疗研究进展[J].中国实用口腔科杂志,2014,7(5):315-318
[2]李凤霞,谭红,叶玲.不同器械去除根管充填材料的研究进展[J].国际口腔医学杂志,2010,37(4):457-459
[3]Simsek N,Keles A,Ahmetoglu F,et al.Comparison of different retreatment techniques and root canal sealers: a scanning electron microscopic study[J].Braz Oral Res,2014,28(1):1-7
[4]Alves FR,Ribeiro TO,Moreno JO,et al.Comparison of the efficacy of nickel-titanium rotary systems with or without the retreatment instruments in the removal of gutta-percha in the apical third[J].BMC Oral Health,2014,14(9):1099-1104
[5]Fruchi LDC,Ordinola-Zapata R,Cavenago BC,et al.Efficacy of reciprocating instruments for removing filling material in curved canals obturated with a single-cone technique: a micro–computed tomographic analysis[J].J Endod,2014,40(7):1000-1004
[6]李红文,耿发云,耿晓瑞,等.CT扫描评价不同器械根管再治疗的效果[J].牙体牙髓牙周病学杂志,2013,23(6):399-402
[7]Mollo A,Botti G,Goldoni NP,et al.Efficacy of two Ni-Ti systems and hand files for removing gutta-percha from root canals[J].Int Endod J,2012,45(1):1-6
[8] 樊明文.牙体牙髓病学[M]. 4版.北京：人民卫生出版社,2012:354
[9]黎远皋,王霄,谢克贤,等.Nd: YAG激光根管内照射时牙根表面温度的变化[J].华西口腔医学杂志,2014,32(5):480-483
[10]Asnaashari M,Safavi N.Disinfection of contaminated canals by different laser wavelengths,while performing root canal therapy[J].J Lasers Med Sci,2013,4(1):8-16
[11]Moura-Netto C,Guglielmi CA,Mello-Moura AC,et al.Nd:YAG laser irradiation effect on apical intracanal dentin - a microleakage and SEM evaluation[J].Braz Dent J,2011,22(5):377-381
[12]Takashina M,Ebihara A,Sunakawa M.The possibility of dowel removal by pulsed Nd:YAG laser irradiation[J].Lasers Surg Med,2002,31(4):268-274
[13]Vidu?i? D,Juki? S,Karlovi? Z,et al.Removal of gutta-percha from root canals using an Nd:YAG laser[J].Int Endod J,2003,36:670-673
[14]Anjo T,Ebihara AA,Takashina M,et al.Removal of two types of root canal filling material using pulsed Nd:YAG laser irradiation[J].Photomed Laser Surg,2004,22(6):470-476
[15]Eriksson AR,Albrektsson T.Temperature threshold levels for heat-induced bone t1 injury: a vitalmicroscopic study in the rabbit[J].J Prosthet Dent,1983,50(1):101-107
[16]Sauk JJ,Norris K,Foster RA,et al.Expression of heat stress proteins by human periodontal ligament cells[J].J Oral Pathol,1988,17(9/10):496-499
[17]Rios MA.Efficacy of 2 reciprocating systems compared with a rotary retreatment system for gutta-percha removal[J].J Endod,2014,40(4):543-546
[18]Voet KC,Wu MK,Wesselink PR,et al.Removal of gutta-percha from root canals using the self-adjusting file[J].J Endod,2012,38(7):1004-1006
[19]Ma J,Al-Ashaw AJ,Shen Y,et al.Efficacy of protaper universal rotary retreatment system for gutta-percha removal from oval root canals:a micro–computed tomography study[J].J Endod,2012,38(11):1516-1520
[20]Strakas D,Franzen R,Kallis A,et al.A comparative study of temperature elevation on human teeth root surfaces during Nd:YAG laser irradiation in root canals[J].Lasers Med Sci,2013,28(6):1441-1444
[21]Folwaczny M,Mehl A,Jordan C,et al.Antibacterial effects of pulsed Nd:YAG laser radiation at different energy settings in root canals[J].J Endod,2002,28(1):24-29
[22]贺慧霞,刘鲁川,安建平,等.脉冲Nd：YAG激光根管内照射剂量与杀菌效应的关系[J].牙体牙髓牙周病学杂志,2003,13(5):276-279
[23]He H,Yu J,Song Y,et al.Thermal and morphological effects of the pulsed Nd:YAG laser on root canal surfaces[J].Photomed Laser Surg,2009,27(2):235-240
[24]Ali,Keles,Hakan,Arslan,Aliye,Kamalak,et al.Removal of filling materials from oval-shaped canals using laser irradiation: a micro–computed tomographic study[J].J Endod,2015,41(2):219-224