Nd-YAG激光及不同脱敏剂治疗牙本质过敏远期疗效观察.docVIP

Nd:YAG激光及不同脱敏剂治疗牙本质过敏远期疗效观察 　【摘要】 目的 对比观察Nd:YAG激光和不同脱敏剂联合治疗牙本质过敏症的远期疗效并选择出临床最佳治疗方案。方法 选择临床确诊的牙本质过敏症患者122例，患牙238颗，随机分为3组治疗，分即刻、3个月、6个月和1年观察疗效。A组：激光加氟化钙脱敏治疗，B组：激光加氟化钠甘油脱敏治疗，C组：激光脱敏治疗。结果 即刻疗效3组间无显著性差异(Pgt;0.05)，随观察时间延长，3组疗效有效率均呈下降趋势，其中A组在6个月后与C组出现显著性差异(P=0.018)，在1年后A组与B、C组有效率均有显著性差异(PA，B=0.025; PA，C=0.007)。结论 三种方法均有较好的即刻疗效。其中激光加氟化钙的远期疗效最优。 【关键词】 牙本质过敏症;Nd:YAG激光; 氟 　　ABSTRACT Objective To observe the long-term curative effect of the combined treatment of Nd:YAG laser and different desensitizers for dentin hypersensitivity. Methods 238 teeth in 122 cases with dentin hypersensitivity were randomly divided into 3 groups: Group A (desensitization therapy with laser and calcium fluoride), Group B (desensitization therapy with laser and sodium fluoride glycerin) and Group C (desensitization therapy with laser only); the curative effects in the 3 groups were observed instantly, 3 months, 6 months and 1 year after treatment respectively. Results There existed no obvious difference of the instant curative effect among the 3 groups (Pgt;0.05); the effective rates of the 3 groups kept descending with the time going; 6 months after treatment, the rate of Group A was obviously different from that of Group C (P=0.018) and it was significantly different from those of Group B and Group C 1 year after treatment (PA,B=0.025; PA,C=0.007). Conclusions All the 3 desensitization therapies are of good instant curative effect while that with laser plus calcium fluoride provides a better long-term curative effect. 　　KEYWORDS dentin hypersensitivity Nd:YAG laser fluoride 　　牙本质过敏症(dentine hypersensitivity)是临床常见的非龋类疾病，多见于牙齿经长时间磨耗，牙本质暴露，牙本质小管开放，而导致的对温度(冷、热)，化学变化(酸、甜等)和机械刺激的酸痛感觉。目前治疗方法较多，都是以机械性堵塞牙本质小管为关键点，但远期疗效并不确定[1]。我科搜集2004～2008年共122例临床确诊牙本质过敏症患者，应用Nd:YAG 激光联合不同药物进行治疗，并评价其远期疗效，现报告如下。 　　1 材料与方法 　　1.1 材料 HSM-Ⅲ 脉冲 Nd:YAG激光治疗机 (中国航天工业总公司 7306研究所)。工作波长1.064 μm，最大功率6 W，脉宽150 μs，光纤直径500 μm。选择单脉冲能量150mJ，脉冲频率15Hz。将氟化钙(成都军区总医院制剂室提供)以 0.12MPa、125℃、15min 高压蒸汽灭菌 ,使用时与墨汁调成糊状备用。75%氟化钠甘油(上二医口腔