Histological changes induced by CO2 laser microprobe specially designed for root canal sterilization: in vivo study.
Histological changes induced by CO2 laser microprobe specially designed for root canal sterilization: in vivo study.
复制标题
专为根管灭菌设计的 CO2 激光微探针引起的组织学变化：体内研究。
DOI：
10.1089/clm.1998.16.263
复制
发表时间：
1998
期刊：
影响因子：
--
通讯作者：
R. Gal
中科院分区：
文献类型：
--
作者：
G. Kesler;R. Koren;A. Kesler;N. Hay;R. Gal
客观化
到目前为止，在传统方法最难去除牙髓组织的根尖区，还没有合适的输送纤维用于CO2激光根管照射。为了克服这个问题，我们设计了一种更接近根尖的微探头，将能量密度分布到根管的较小区域，从而有利地增加了热效应。
方法
一个耦合在特殊手机上的CO2激光微探头被固定在Sharplan 15-F CO2激光器的传输光纤上。这项研究是对30颗因牙周问题而要拔除的上颌或下颌、中部、侧牙或前磨牙的重要牙齿进行的。20例患者在常规根管预备后，用这种新型光纤传输的脉冲CO2激光进行了实验治疗。激光治疗时根面三点测温均不超过38℃，10颗患牙为对照组，仅按常规方法进行根管预备。
结果
激光治疗的牙齿的组织学检查显示，根管周围剩余的牙髓组织凝固性坏死和空泡化。所有接受15-F CO2激光治疗的患者乳牙本质和次级牙本质均正常。革兰氏染色和细菌学检查显示完全无菌。这些结果证明了这种特殊的微探头在根管消毒中的独特能力，而不会对周围组织造成热损伤。
结论
在关闭根管前使用这种特殊的微探头将经典根管预备与CO2激光照射相结合，可以极大地改变根管充填的质量。
OBJECTIVE
Until now, no suitable delivery fiber has existed for CO2 laser endodontic radiation in the apical region, where it is most difficult to eliminate the pulp tissue using conventional methods. To overcome this problem, we have designed a microprobe that reaches closer to the apex, distributing the energy density to a smaller area of the root canal and thus favorably increasing the thermal effects.
METHODS
A CO2 laser microprobe coupled onto a special hand piece was attached to the delivery fiber of a Sharplan 15-F CO2 laser. The study was conducted on 30 vital maxillary or mandibulary, central, lateral, or premolar teeth destined for extraction due to periodontal problems. Twenty were experimentally treated with pulsed CO2 laser delivered by this newly developed fiber after conventional root canal preparation. Temperature measured at three points on the root surface during laser treatment did not exceed 38 degrees C. Ten teeth represented the control group, in which only root canal preparation was performed in the conventional method.
RESULTS
Histological examination of the laser-treated teeth showed coagulation necrosis and vacuolization of the remaining pulp tissue in the root canal periphery. Primary and secondary dentin appeared normal in all cases treated with 15-F CO2 laser. Gram stain and bacteriologic examination revealed complete sterilization. These results demonstrate the unique capabilities of this special microprobe in sterilization of the root canal, with no thermal damage to the surrounding tissue.
CONCLUSIONS
The combination of classical root canal preparation with CO2 laser irradiation using this special microprobe before closing the canal can drastically change the quality of root canal fillings.