铒激光对不同长度与弯曲度根管玷污层的清理效果研究

doi:10.13591/j.cnki.kqyx.2023.05.007

Abstract

Abstract:

Objective To compare the cleaning effect of three kinds of Er:YAG laser power parameters on smear layer and damage on root canals with different length and curvature. Methods One root of 144 extracted permanent teeth with single root canal were divided into short group and long group according to different root length, and each group was divided into 3 subgroups according to different root canal curvature: straight, moderate and severe. Each subgroup was divided into 4 groups according to different root canal cleaning methods: ultrasonic group, 0.3 W PIPS group, 0.6 W PIPS group, 0.9 W PIPS group (n=6). After the final irrigation, the root were split longitudinally into two parts and observed under a scanning electron microscope ( ×1 000). The laser's cleaning ability was evaluated according to the smear layer score and damage. Results The cleaning effect of the experimental groups (Er: YAG laser) was significantly better than that of the control group (ultrasonic) (P<0.05). ①At the coronal section of short root, while the power was set at 0.3 W, most of the dental tubules were opened; at 0.6 W, moderate and severe curvature groups' cleaning efficiency were significant improved; at 0.9 W, the cleaning efficiency had no difference with 0.6 W. However, micro-cracks were found on the dentin wall. At the apical section, the cleaning efficiency were improved by the increase of laser power, but it was worse than the coronal section (P<0.05). ②For the long root, most of the straight and moderate groups' dentin tubules at coronal section were opened at 0.3 W while the cleaning efficiency at the apical section was worse than that at coronal section. At 0.9 W, the cleaning efficiency of straight and moderate groups were improved (P<0.05), but the coronal micro-cracks appeared again without significant improvement of smear layer removal ability in the severe curvature group. Conclusion 0.3 W can be an appropriate power for short straight root while for the short moderate root, the power needs to reach 0.9 W. 0.9 W is fit for long straight and moderate root, but neither short nor long severe curvature root can achieve a good cleaning effect at 0.9 W.

Key words: Er:YAG laser, smear layer, root canal irrigation, curved canal

CLC Number:

R319.9

QU Chaojie,GUO Wei. The effect of smear layer removal after cleaning root canals in different length and curvature with Er: YAG laser irrigation[J]. Stomatology, 2023, 43(5): 427-433.

Figures/Tables 11

Fig.1

Tab.1

Fig.2

Fig.3

Fig.4

Fig.5

Fig.6

Tab.2

Fig.7

Fig.8

Tab.3

References 25

[1]	周学东. 牙体牙髓病学[M]. 5版. 北京: 人民卫生出版社, 2020: 116-197.
[2]	Teja KV, Janani K, Alqahtani AA, et al. Herbal agents versus ethylene diamine Tetra acetic acid on removal of the smear layer-A systematic review of in vitro studies[J]. Int J Environ Res Public Health, 2022, 19(11):6870. doi: 10.3390/ijerph19116870
[3]	Căpută PE, Retsas A, Kuijk L, et al. Ultrasonic irrigant activation during root canal treatment: A systematic review[J]. J Endod, 2019, 45(1):31-44.e13. doi: S0099-2399(18)30625-3 pmid: 30558797
[4]	Lukač N, Jezeršek M. Amplification of pressure waves in laser-assisted endodontics with synchronized delivery of Er: YAG laser pulses[J]. Lasers Med Sci, 2018, 33(4):823-833. doi: 10.1007/s10103-017-2435-z
[5]	DiVito E, Peters OA, Olivi G. Effectiveness of the erbium: YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation[J]. Lasers Med Sci, 2012, 27(2):273-280. doi: 10.1007/s10103-010-0858-x
[6]	Akcay M, Arslan H, Mese M, et al. Effect of photon-initiated photoacoustic streaming, passive ultrasonic, and sonic irrigation techniques on dentinal tubule penetration of irrigation solution: A confocal microscopic study[J]. Clin Oral Investig, 2017, 21(7):2205-2212. doi: 10.1007/s00784-016-2013-y
[7]	Meire MA, Havelaerts S, de Moor RJ. Influence of lasing parameters on the cleaning efficacy of laser-activated irrigation with pulsed erbium lasers[J]. Lasers Med Sci, 2016, 31(4):653-658. doi: 10.1007/s10103-016-1892-0
[8]	王惠芸. 我国人牙的测量和统计[J]. 中华口腔科杂志, 1959, 7(3):149-155.
[9]	Ahmed HMA, Ibrahim N, Mohamad NS, et al. Application of a new system for classifying root and canal anatomy in studies involving micro-computed tomography and cone beam computed tomography: Explanation and elaboration[J]. Int Endod J, 2021, 54(7):1056-1082. doi: 10.1111/iej.v54.7
[10]	Sousa-Neto MD, Silva-Sousa YC, Mazzi-Chaves JF, et al. Root canal preparation using micro-computed tomography analysis: A literature review[J]. Braz Oral Res, 2018, 32(suppl 1):e66.
[11]	Haupt F, Meinel M, Gunawardana A, et al. Effectiveness of different activated irrigation techniques on debris and smear layer removal from curved root canals: A SEM evaluation[J]. Aust Endod J, 2020, 46(1):40-46. doi: 10.1111/aej.12342 pmid: 30907051
[12]	Schneider SW. A comparison of canal preparations in straight and curved root canals[J]. Oral Surg Oral Med Oral Pathol, 1971, 32(2):271-275. doi: 10.1016/0030-4220(71)90230-1
[13]	Peters OA, Barbakow F. Effects of irrigation on debris and smear layer on canal walls prepared by two rotary techniques: A scanning electron microscopic study[J]. J Endod, 2000, 26(1):6-10. doi: 10.1097/00004770-200001000-00002
[14]	Alamoudi RA. The smear layer in endodontic: To keep or remove-an updated overview[J]. Saudi Endod J, 2019, 9: 71-81.
[15]	Shi L, Wan J, Yang YF, et al. Evolution of the combined effect of different irrigation solutions and activation techniques on the removal of smear layer and dentin microhardness in oval-shaped root canal—An in-vitro study[J]. Biomol Biomed, 2023, 23(1):126-136. doi: 10.17305/bjbms.2022.7440 pmid: 35880401
[16]	Vianna ME, Gomes BPFA, Berber VB, et al. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2004, 97(1):79-84. doi: 10.1016/S1079-2104(03)00360-3
[17]	谭青松, 彭彬, 边专, 等. 不同浓度次氯酸钠根管超声冲洗的实验研究[J]. 口腔医学研究, 2007, 23(4):388-390.
[18]	Kurzmann C, Meire MA, Lettner S, et al. The efficacy of ultrasonic and PIPS (photon-induced acoustic streaming) irrigation to remove artificially placed dentine debris plugs out of an artificial and natural root model[J]. Lasers Med Sci, 2020, 35(3):719-728. doi: 10.1007/s10103-019-02912-3
[19]	何新宇, 彭丽莉, 王众, 等. 光子引导的光声流效应在根管治疗术中的研究进展[J]. 牙体牙髓牙周病学杂志, 2018, 28(11):673-676, 679.
[20]	Luca R, Todea C, Balabuc C, et al. Alternative techniques in root canal debridement[C]// SPIE Proceedings", "Fifth International Conference on Lasers in Medicine: Biotechnologies Integrated in Daily Medicine. Timisoara, Romania. SPIE, 2014: 89250 F1-89250F7.
[21]	Hoteit M, Nammour S, Zeinoun T. Evaluation ofenamel topography after debonding orthodontic ceramic brackets by different Er, Cr: YSGG and Er: YAG lasers settings[J]. Dent J (Basel), 2020, 8(1):6.
[22]	林欣欣. 采用铒激光荡洗技术清理根管玷污层的体外研究[D]. 北京: 北京协和医学院, 2019.
[23]	苏征, 白雨豪, 侯晓玫. 不同技术对弯曲根管根尖气锁去除效果的锥形束CT研究[J]. 北京大学学报(医学版), 2017, 49(1):76-80.
[24]	何蓉, 刘学军, 周宇琨. 光子引导的光声流效应在根管荡洗中应用的系统评价[J]. 国际口腔医学杂志, 2021, 48(6):644-655.
[25]	苏征, 侯本祥, 方厂云, 等. S形根管经往复运动单支锉系统预备后的形态对冲洗效果的影响[J]. 中南大学学报(医学版), 2014, 39(11):1181-1185.

分组	冲洗方法	参数
对照组	超声	6档
0.3 W组	Er: YAG激光	20 mJ,15 Hz,0.3 W
0.6 W组	Er: YAG激光	40 mJ,15 Hz,0.6 W
0.9 W组	Er: YAG激光	60 mJ,15 Hz,0.9 W

组别	轻度弯曲		中度弯曲		重度弯曲
组别	冠	根	冠	根	冠	根
超声组	3.00±0.63^*	4.00±0.00^*	4.00±0.63^*	4.83±0.41^*	5.00±0.00^*	5.00±0.00^*
0.3 W Er:YAG	1.33±0.52^AB	2.33±0.52^AB	2.17±0.41^①	3.17±0.41^B②	2.17±0.41^①	4.00±0.00^①②
0.6 W Er:YAG	1.17±0.41	2.67±0.52^②	1.33±0.52	2.83±0.41^②	1.33±0.52	3.00±0.00^②
0.9 W Er:YAG	1.00±0.00	2.00±0.00	1.67±0.52	2.17±0.41	1.67±0.52	2.33±0.52

组别	轻度弯曲		中度弯曲		重度弯曲
组别	冠	根	冠	根	冠	根
超声组	4.00±0.63^*	4.83±0.41^*	4.83±0.41^*	5.00±0.00^*	5.00±0.00^*	5.00±0.00
0.3 W Er:YAG	1.67±0.51^A	3.83±0.41^B①②	1.33±0.52^A	3.33±0.52^A②	3.00±0.00^①②	5.00±0.00
0.6 W Er:YAG	1.67±0.52	3.00±0.00^A②	1.67±0.52	2.83±0.41^A	2.33±1.03^②	4.67±0.52
0.9 W Er:YAG	1.00±0.00	2.33±0.52^A	1.17±0.41	2.33±0.52^A	1.33±0.52	4.50±0.55

The effect of smear layer removal after cleaning root canals in different length and curvature with Er: YAG laser irrigation

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 11

References 25

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	LYU Ying,XU Rui,ZHANG Qinqin,SHI Banruo,WU Qiaochu,WEI Xin. Effects of irrigants on mixed biofilm of Enterococcus faecalis and Candida albicans in standard root canal models [J]. Stomatology, 2023, 43(5): 434-438.
[2]	WANG Ruyu, PAN Yahui, NIE Rongrong, MENG Xiangfeng. Studies on the effect of ultrasound on properties and bonding strength of dentin smear layer [J]. Stomatology, 2023, 43(1): 52-56.
[3]	XIAO Min, LIU Jin, FAN Xiaomin, WU Haoze, WANG Jueyu, WANG Kejing, LI Na, JIANG Wenkai, MEI Xiaohan. The effect of sonic activated device used for different time on intracanal smear layer removal: An SEM analysis [J]. Stomatology, 2023, 43(1): 46-51.
[4]	FENG Fan, LIU Xiaqing, LI Yadan, LIU Henan, QIAO Yuxuan, LI Ying. Research progress of Er: YAG laser pretreatment methods of post space [J]. Stomatology, 2022, 42(5): 467-470.
[5]	ZHANG Xudong, YANG Xuelian, LIU Xiaqing, MA Yufeng. Advances in research on the application of Er:YAG laser in oral hard tissues [J]. Stomatology, 2022, 42(4): 381-384.
[6]	. Effects of smear layer by different burs on the bonding strength of dentin and self-adhesive resin cement [J]. , 2019, 39(5): 423-426.
[7]	. Efficacy observation of Nd:YAG and Er:YAG laser for the treatment of severe periodontitis [J]. , 2018, 38(6): 514-517.
[8]	. Antimicrobial effect of Nd:YAG laser and Er:YAG laser on enterococcus faecalis in root canals [J]. , 2018, 38(5): 417-421.
[9]	. The clinical research of the rotary nickeltitanium instruments and the ultrasonic root canal irrigation which were applied to the single-visit root canal therapy of the chronic apical periodontitis [J]. , 2018, 38(2): 162-165.
[10]	. Effect of Er:YAG laser on the treatment of peri-implantitis: A short-term clinical efficacy evaluation [J]. , 2018, 38(12): 1118-1121.
[11]	. Application and research progress of laser on peri-implantitis [J]. , 2017, 37(2): 170-175.
[12]	. Clinical observation of 6 cases of gingival pigmentation treated with Er:YAG laser [J]. , 2017, 37(11): 1007-1010.
[13]	. The effect of Er: YAG laser preparation and xtra power mode of curing light on the microleakage of the composite resin [J]. , 2016, 36(5): 403-406.
[14]	. In vitro study of the effects of Er:YAG laser irradiation on the shear bond strength of dentin-ceramic interface [J]. , 2016, 36(4): 341-344.
[15]	. Scanning electron microscopic study on the cleaning ability of different kinds of ultrasonic irrigants and rinsing time after root canal preparation [J]. , 2016, 36(1): 44-49.