Nd：YAG激光联合生物活性材料在直接盖髓术中的临床研究

葛超　褚亚辉

摘要：临床上牙髓暴力的治疗方法主要有直接盖髓术、根管治疗术以及活髓切断术。直接盖髓术是将生物活性材料放置在由于深龋治疗过程中意外穿髓或者牙外伤等原因导致暴露的牙髓上，然后通过促进牙本质桥形成和阻断细菌渗漏而使牙髓保存的治疗方法。口腔中常用的激光有CO激光、Er：YGA激光、Nd：YAG激光等，针对Nd：YAG脉冲激光在直接盖髓术中的作用进行观察研究。选取100例意外露髓患者，随机分成实验组和对照组，实验组用Nd：YAG脉冲激光照射穿髓孔区5 s，再用氢氧化钙对穿髓孔进行封闭;对照组直接采用盖髓剂氢氧化钙对穿髓孔进行直接盖髓术。对100例意外露髓患者进行术后观察，分别记录2周、半年、1年后复诊的牙髓活力情况，对直接盖髓术成功的病例进行记录。结果发现：采用适当能量Nd：YAG激光照射能够提高直接盖髓术的成功率。Nd：YAG激光不仅能够对牙髓孔区牙体组织碎屑进行清除，还能使牙体暴露组织表面止血凝固，能够对穿髓孔区进行消毒灭菌，还能够促进牙髓组织细胞再生修复。

关键词：YAG激光;直接盖髓术;氢氧化钙

中图分类号：R781.05

文献标识码：A文章编号：1001-5922（2022）06-0059-05

Clinical study of Nd： YAG laser combined with bioactive materials in direct pulp capping

GE Chao，CHU Yahui

（Cangzhou Central Hospital oral Clinic， Cangzhou 061000， Hebei China

）

Abstract：The clinical treatment methods of pulp violence mainly include direct pulp capping， root canal therapy and pulpotomy. Direct pulp capping is a treatment method in which bioactive materials are placed on the exposed dental pulp caused by accidental pulp penetration or tooth trauma during the treatment of deep caries， and then the dental pulp is preserved by promoting the formation of dentin bridge and blocking bacterial leakage. The commonly used lasers in oral cavity include CO laser， Er： YGA laser， Nd： YAG laser， etc. The role of Nd： YAG pulse laser in direct pulp capping will be observed and studied in this paper. 100 patients with accidental pulp exposure will be randomly divided into experimental group and control group. In the experimental group， Nd： YAG pulsed laser was used to irradiate the perforator area for 5 seconds， and then calcium hydroxide was used to seal the perforator; Control group applied direct pulp capping with calcium hydroxide as pulp capping agent. Finally， 100 patients with accidental pulp exposure were observed after operation， and the pulp vitality was recorded after two weeks， half a year and one year， and the successful cases of direct pulp capping were recorded. The results showed that the success rate of direct pulp capping could be improved by using appropriate energy YAG laser irradiation. YAG laser can not only remove the debris of dental tissue in the pulp hole area， but also make the surface of exposed dental tissue hemostasis and coagulation， disinfect and sterilize the pulp hole area， but also promote the regeneration and repair of dental pulp tissue cells.

Key words：YAG laser; direct pulp capping; calcium hydroxide

蓋髓术是一种保护活髓的方法，是将能使牙髓病变恢复的制剂覆盖在近髓的牙本质上面，或者已被穿透的牙髓创面上面，以此来保护牙髓，使病变消除;盖髓术分为间接盖髓术和直接盖髓术[1]。成功的直接盖髓术能够保存牙髓的活力，使牙体功能良好保持，它是目前口腔内科最重要的治疗方法之一。……