上海口腔医学

上海口腔医学 ›› 2022, Vol. 31 ›› Issue (4): 367-373.doi: 10.19439/j.sjos.2022.04.006

• 论著 • 上一篇    下一篇

Er:YAG 激光在小型猪牙髓血运重建术中的应用效果评价

马智菲1, 周梦琪2, 王丽珍3, 承清4, 洪瑾1   

  1. 1.上海交通大学医学院附属第九人民医院 口腔第一门诊,2.口腔第二门诊,3.口腔病理科, 4.牙体牙髓病科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011
  • 收稿日期:2021-02-07 修回日期:2021-03-26 出版日期:2022-08-25 发布日期:2022-08-30
  • 通讯作者: 洪瑾,E-mail: hongjin1221@163.com
  • 作者简介:马智菲（1994-）,女,硕士,住院医师,E-mail: mazf1017@163.com
  • 基金资助:
    上海市科学技术委员会科研计划（16140903400）

Effect of Er:YAG laser in pulp revascularization in miniature pigs

MA Zhi-fei1, ZHOU Meng-qi2, WANG Li-zhen3, CHENG Qing4, HONG Jin1   

  1. 1. First Dental Consultation Clinic, 2. Second Dental Clinic, 3. Department of Oral Pathology, 4. Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Received:2021-02-07 Revised:2021-03-26 Online:2022-08-25 Published:2022-08-30

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摘要： 目的: 比较Er:YAG激光和Ca(OH)2在小型猪牙髓血运重建术中的应用效果。方法: 选择3只14~15月龄的年轻恒牙列巴马系小型猪,上颌第一前磨牙不做处理,自然生长,作为阳性对照组。将第二、第三前磨牙随机分为3组：激光组、封药组和阴性对照组。分别在3组建立牙髓坏死模型后,阴性对照组不做处理,激光组和封药组进行牙髓血运重建术。其中,激光组采用Er:YAG激光,封药组采用Ca(OH)2进行根管消毒。术后3个月拍摄X线根尖片和锥形束CT（CBCT）,处死动物后,制作小型猪牙H-E染色切片,通过影像学和组织学评估,比较激光组和封药组牙根发育和根管内组织学表现。采用SPSS 24.0软件包对数据进行统计学分析。结果: 影像学结果显示,术后3个月,激光组和封药组根尖孔闭合,根管腔内有高密度钙化影像,部分出现牙根吸收,2组在牙根增长、根管壁增厚和根尖孔减小方面无统计学差异（P>0.05）;组织学结果显示,术后3个月,激光组和封药组根管壁有牙本质样和牙骨质样组织沉积,根尖孔闭合,根管腔内有纤维结缔组织和牙骨质样或骨样组织形成,2组根管内组织学表现无统计学差异（P>0.05）。结论: Er:YAG激光可用于小型猪牙髓血运重建术,且与根管内封Ca(OH)2效果相当。

关键词: 牙髓血运重建术, Er:YAG 激光, 锥形束CT, 小型猪

Abstract: PURPUSE: To compare the effectiveness of Er:YAG laser and Ca(OH)2 in pulp revascularization in miniature pigs. METHODS: The second and third premolars of three 14-15-month-old miniature pigs were randomly divided into three groups: laser group, medication group and negative control group. After establishment of pulp necrosis model in each group, the negative control group had no more procedures, while the laser group and medication group were treated with pulp revascularization. Intracanal antisepsis operation was conducted using Er:YAG laser in laser group and Ca(OH)2 in medication group. The maxillary first premolars, as a positive control group, were left untreated and grew naturally. Three months after surgery, X-ray and cone-beam CT(CBCT) were taken. The animals were sacrificed, and the teeth were used to make H-E staining sections. The development of the teeth and the histological manifestations in the root canals of both groups were compared and evaluated by radiographic and histological assessment. SPSS 24.0 software package was used for statistical analysis of the data. RESULTS: Radiographic results showed that 3 months after surgery, apical foramen was closed in the laser group and the medication group. It also showed that intracanal calcification, and some specimens manifested root absorption. There was no significant difference between the two groups in the aspects of increase of root length, root thickness, or decrease of apical foramen size(P>0.05). Histological results showed that there was dentin-like and cementum-like tissue deposition along the root canal walls; apical closure was apparent; and fibrous connective tissue and cementum-like tissue or bone-like tissue formation in the root canal space were evident in the laser group and the medication group 3 months after surgery. There was no significant difference in the histological findings between the two groups(P>0.05). CONCLUSIONS: Er: YAG laser can be applied to pulp revascularization in miniature pigs, and the effect is equivalent to that of intracanal medication using Ca(OH)2.

Key words: Pulp revascularization, Er:YAG, CBCT, Miniature pigs

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