上海口腔医学

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (6): 578-582.doi: 10.19439/j.sjos.2023.06.004

• 论著 • 上一篇    下一篇

Er-YAG激光对不同瓷贴面拆除效率的体外评价

庄娇玲1,2, 许志强1, 金地1, 吴千驹1,3   

  1. 1.厦门医学院附属口腔医院,厦门市口腔疾病诊疗重点实验室,福建 厦门 361008;
    2.厦门市儿童医院（复旦大学附属儿科医院厦门医院） 口腔科,福建 厦门 361000;
    3.上海交通大学医学院附属第九人民医院,上海交通大学口腔医学院,上海 200011
  • 收稿日期:2023-01-09 修回日期:2023-02-16 出版日期:2023-12-15 发布日期:2024-01-12
  • 通讯作者: 吴千驹,E-mail：qianjuwu@163.com
  • 作者简介:庄娇玲（1988-）,女,硕士,住院医师,E-mail：453848520@qq.com
  • 基金资助:
    厦门医学院教育教学改革研究项目（XBJK2019020）; 厦门市科技局医疗卫生指导性项目（3502Z20224ZD1332）

Clinical comparative study of efficacy of Er:YAG laser for debonding different veneers

ZHUANG Jiao-ling1,2, XU Zhi-qiang1, JIN Di1, WU Qian-ju1,3   

  1. 1. Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment. Xiamen 361008, Fujian Province;
    2. Xiamen Children's Hospital (Children's Hospital of Fudan University at Xiamen). Xiamen 361000, Fujian Province;
    3. Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University. Shanghai 200011, China
  • Received:2023-01-09 Revised:2023-02-16 Online:2023-12-15 Published:2024-01-12

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摘要： 目的: 比较Er:YAG激光拆除不同厚度和透明度的二硅酸锂玻璃陶瓷贴面的时间,观察其对贴面和牙面表面形貌的影响。方法: 对12颗离体上颌第一前磨牙的颊面进行贴面预备,通过计算机辅助设计与制作系统完成12个全瓷（IPS e.max CAD二硅酸锂玻璃陶瓷材料）贴面制作,颜色均为A2色。依据材料和厚度不同将12个贴面分成4组,即e.max HT 0.5 mm组、e.max HT 1.0 mm组、e.max LT 0.5 mm组和e.max LT 1.0 mm组。采用树脂水门汀将贴面与对应的预备体粘接,室温下利用生理盐水进行样本储存。7天后通过Er:YAG激光拆除各组贴面,记录所需时间。将拆除后的离体牙、e.max HT 0.5 mm贴面组和e.max LT 0.5 mm贴面组进行扫描电镜（scanning electron microscopy,SEM）观察,检测拆除后的表面形貌改变。采用SPSS 19.0软件包对数据进行统计学分析。结果: 1.0 mm厚的全瓷贴面较0.5 mm厚的拆除时间长,e.max LT 0.5 mm组拆除时间长于e.max HT 0.5 mm组,e.max LT 1.0 mm组拆除时间长于e.max HT 1.0 mm组,均有统计学差异。经Er:YAG激光拆除的全瓷贴面SEM未发现明显裂缝裂纹、“凹坑状”破坏等;牙面SEM见粘接剂覆盖,未发现裂纹、牙釉质熔融现象。结论: Er:YAG激光可成功拆除二硅酸锂玻璃陶瓷贴面;材料类型、厚度影响其拆除时间,e.max LT贴面透光率较低则拆除时间较长,并且贴面越厚所需的拆除时间越长。Er:YAG激光能量不会导致陶瓷和牙体组织的表面形貌受损。

关键词: Er:YAG激光, 全瓷贴面, 二硅酸锂玻璃陶瓷贴面, 拆除

Abstract: PURPOSE: To compare the debonding time of IPS e.max CAD lithium disilicate glass-ceramic veneers in different thickness and transparency using Er:YAG laser, and evaluate the effect of Er:YAG laser on the surface topography of the veneers and the underlying tooth. METHODS: A total of twelve maxillary first premolar teeth were collected and prepared, then veneers were made by computer aided design and computer aided manufacture(CAD/CAM) system. The veneers were divided into four groups according to different thicknesses and transparency: e.max HT with 0.5 mm and 1.0 mm thickness, e.max LT with 0.5 mm and 1.0 mm thickness. Three veneers of each group were cemented to prepared premolar with resin cement and then stored in normal saline solution at room temperature for 7 days. All veneers were debonded with Er:YAG laser and the debonding time of all-ceramic veneers of all groups was recorded. Scanning electron microscopy(SEM) observation was performed to detect the surface topography of the veneers and the underlying tooth. SPSS 19.0 software package was used for statistical analysis. RESULTS: The debonding time of 1.0 mm-thick groups were longer than 0.5 mm-thick groups. When the veneer thickness was 0.5 mm, the average debonding time of e.max LT group was longer than e.max HT. Consistent with the finding of 0.5 mm, the longer debonding time was found in the e.max LT group of 1.0mm. No cracks and crater structure were found in SEM observation of veneers after Er:YAG laser irradiation. Teeth surface was covered with bonding cement with no signs of ablation or damage of the enamel. CONCLUSIONS: Er:YAG laser can completely debond lithium disilicate glass-ceramic veneers, and the debonding time depends on the transparency and thickness of the veneers. The lower translucent porcelain veneers (e.max LT) and thicker ones (1.0 mm-thick) had a longer debonding time. Moreover, Er:YAG laser does not damage the morphology and topography of the veneer and the teeth surface.

Key words: Er:YAG laser, All-ceramic veneers, Lithium disilicate glass-ceramic veneers, Debonding

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