中国实用口腔科杂志

中国实用口腔科杂志

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不同频率和单脉冲能量下Er∶YAG激光辅助单根管荡洗对根尖压力影响的研究

李依洲1，何新宇1，聂铭远2，于悦2，雷争辉1，潘翀2，赵继志1   

  1. 1. 中国医学科学院北京协和医学院·北京协和医院口腔科，北京  100730；2. 北京航空航天大学，流体力学教育部重点实验室，北京 100191
  • 出版日期:2021-05-30 发布日期:2021-06-03
  • 基金资助:
    北京市自然科学基金（7212075）

  • Online:2021-05-30 Published:2021-06-03

摘要： 目的　采用高频脉动压力传感器测量不同频率和单脉冲能量下前牙单根管模型Er∶YAG激光辅助化学预备产生的根尖压力值。方法    前牙单根直根管模型内注满去离子水，根尖孔外接50 000 Hz高频大量程传感器。Er∶YAG激光工作尖置于根管口上3 mm处，激光激励频率设置为20 ~ 50 Hz（以10 Hz为间隔），单脉冲能量设置为5 ~ 50 mJ（以5 mJ为间隔）；采用超短脉宽模式，记录不同频率和单脉冲能量下Er∶YAG激光辅助荡洗时的根尖瞬时压力。结果    单根管模型根尖压力值随单脉冲能量升高而线性增加。当单脉冲能量≥ 35 mJ时，根尖压力在荡洗过程中出现累积，压力值显著增加。功率设置越高，压力值升高幅度越大。结论    根尖压力值随单脉冲能量升高而线性增加，高功率下根尖区会出现高压累积，增加根尖损伤风险。临床合理设置参数，对Er∶YAG激光辅助化学预备的安全性有重要意义。

关键词: Er∶YAG激光, 牙髓病学, 根管治疗术, 根尖压力, 安全性

Abstract: Objective    To measure the apical pressure of Er∶YAG laser activated endodontic therapy in single root canal model of anterior teeth by high frequency sensor under different frepuency and pulse energy. Methods    A single straight root canal model of anterior teeth was filled with deionized water，with a 50 000 Hz pressure sensor inserted apically. The fiber tip of Er∶YAG laser was placed at 3 mm from the root canal orifice. Apical pressure was recorded during the irrigation performed at 5-50 mJ and 20-50 Hz with super short pulse mode. Results    Apical pressure rose with the growing of pulse energy in single straight root canal model. Once energy was set to 35 mJ or over，accumulated apical pressure was frequently observed and the pressure was significantly increased. Significant elevated pressure was found as power setting went up. Conclusion    Apical pressure increases with the growing of pulse energy. Accumulated apical pressure indicates higher risk of apical damage under high power. Thus，reasonable parameter setting is crucial for the safety of Er∶YAG laser activated endodontic therapy.

Key words: Er∶YAG laser, endodontics, root canal therapy, apical pressure, safety