半导体激光与ND:YAP激光在牙齿美白中的应用效果分析-东南大学学报医学版

半导体激光与ND:YAP激光在牙齿美白中的应用效果分析

单位：1. 南京大学附属口腔医院, 南京市口腔医院牙体牙髓病科, 江苏南京 210008;
2. 南京大学附属口腔医院, 南京市口腔医院牙周病科, 江苏南京 210008

分类号：R781

出版年·卷·期（页码）：2018·37·第一期（125-129）

摘要：

目的：通过扫描电镜观察冷光美白，半导体激光美白，ND：YAP激光美白术后牙釉质表面微结构变化情况。方法：选取因正畸拔除的新鲜前磨牙，随机分为正常组，冷光美白组，半导体激光组和ND：YAP激光组。冷光组以35%过氧化氢美白凝胶涂布牙面，冷光照射15 min，共3次；半导体激光组用35%过氧化氢涂布牙面，1.5 W，20 Hz，1/2波形照射15 s，重复3~4次；ND：YAP激光组用35%过氧化氢涂布牙面，5 W，30 Hz，G模式照射牙面15 s，重复3~4次。记录各组美白前后色阶变化情况并分别置于扫描电镜下观察。结果：三实验组美白术后色阶变化无显著统计学差异（P > 0.05）。正常牙釉质表面光滑无凹陷；半导体激光组釉质表面见不规则裂缝及再矿化结晶；ND：YAP激光美白组牙本质小管被侵蚀呈熔融状态，局部有弹坑样深凹陷形成；冷光美白组牙齿表面有不同程度大小的微孔凹陷，呈蚀刻样改变。结论：三种美白技术都可以达到显著的美白效果，半导体激光和ND：YAP激光操作时间较短，对牙釉质表面的损伤较冷光美白小，同时半导体激光对美白剂的高效处理方式，对牙釉质表面微结构损伤最小。

Objective: Observe the microstructure of tooth enamel after cold light whitening, semiconductor laser whitening and ND: YAP laser whitening under scanning electron microscopy (sem). Methods: Orthodontic extraction fresh premolar teeth were chosen and divided into normal group, cold light group, semiconductor laser group, ND: YAP laser group. The cold light group was coated with 35% hydrogen peroxide enamel and then radiated with cold light for 15 minutes for 3 times; the semiconductor laser group was coated with 35% hydrogen peroxide enamel and irradiated with 1/2 wave of 1.5 W/20 Hz, 15 s, repeated 3~4 times; ND: YAP laser group was coated with 35% hydrogen peroxide enamel irradiated with wave of 5 W/30 Hz,G mode 15 s, repeated 3~4 times. The color changes of each group were observed under the scanning electron microscope and recorded. Results: There was no statistically significant difference in the change of color among the three experimental groups (P > 0.05).The surface of normal tooth enamel was smooth; the enamel surface of semiconductor laser group had irregular fracture and remineralization crystallization; the dentine tube of ND: YAP laser group had been eroded into molten state and deep depressions formed locally; the surface of cold light group had etching changes with microporous dents. Conclusion: All the whitening techniques can achieve satisfactory results.Semiconductor laser and ND: YAP laser led to less damage of tooth enamel with shorter operation time. At the same time the most effective treatment of semiconductor laser led tominimal damage of the enamel surface.

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