半導体レーザーと光熱変換チップを用いた根管洗浄剤活性化時の根尖孔外への圧力の評価
目的 : レーザーを用いた根管洗浄法は優れた根管清掃効果を示すことが報告されているが, 根尖孔からの洗浄液溢出のリスクが懸念されている. 本研究では, 光熱変換チップ (Thermo-optically Powered tip : TOPチップ) を使用した980nm半導体レーザー (Alta Modular Laser System : MLS) によって根管洗浄液の活性化を行った際に, 根尖孔外に生じる圧力を評価することを目的とした. 材料と方法 : プラスチック製根管模型 (先端径0.40mm, テーパー6%) に蒸留水を満たし, MLSおよびTOPチップによる根管洗浄 (TOP群) あ...
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| Published in | 日本歯科保存学雑誌 Vol. 62; no. 6; pp. 304 - 310 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本歯科保存学会
2019
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0387-2343 2188-0808 |
| DOI | 10.11471/shikahozon.62.304 |
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| Abstract | 目的 : レーザーを用いた根管洗浄法は優れた根管清掃効果を示すことが報告されているが, 根尖孔からの洗浄液溢出のリスクが懸念されている. 本研究では, 光熱変換チップ (Thermo-optically Powered tip : TOPチップ) を使用した980nm半導体レーザー (Alta Modular Laser System : MLS) によって根管洗浄液の活性化を行った際に, 根尖孔外に生じる圧力を評価することを目的とした. 材料と方法 : プラスチック製根管模型 (先端径0.40mm, テーパー6%) に蒸留水を満たし, MLSおよびTOPチップによる根管洗浄 (TOP群) あるいは従来のシリンジ洗浄 (SI群) を, TOPチップならびに洗浄針の先端を根尖孔から2, 5, 10mmの位置に設置した状態で20秒間行った. レーザー設定値は2W (120mJ, 16pps) とした. 洗浄中に根尖孔外に生じる圧力は, 根管模型根尖部に圧力計測装置を接続して計測した. 二元配置分散分析およびTukey-Kramer法により, 有意水準5%で統計解析した. 結果 : SI群 (根尖孔から2, 5mm) では, 他群と比較して有意に大きい圧力が生じた (p<0.05). TOP群では, チップ挿入深度の相違による圧力の有意差は認められなかった (p>0.05). 結論 : 本実験条件下では, MLSおよびTOPチップによる根管洗浄液活性化を行った場合に根尖孔外に生じる圧力は, チップ挿入深度が深い条件では従来のシリンジ洗浄と比較して有意に低値を示した. |
|---|---|
| AbstractList | 目的 : レーザーを用いた根管洗浄法は優れた根管清掃効果を示すことが報告されているが, 根尖孔からの洗浄液溢出のリスクが懸念されている. 本研究では, 光熱変換チップ (Thermo-optically Powered tip : TOPチップ) を使用した980nm半導体レーザー (Alta Modular Laser System : MLS) によって根管洗浄液の活性化を行った際に, 根尖孔外に生じる圧力を評価することを目的とした. 材料と方法 : プラスチック製根管模型 (先端径0.40mm, テーパー6%) に蒸留水を満たし, MLSおよびTOPチップによる根管洗浄 (TOP群) あるいは従来のシリンジ洗浄 (SI群) を, TOPチップならびに洗浄針の先端を根尖孔から2, 5, 10mmの位置に設置した状態で20秒間行った. レーザー設定値は2W (120mJ, 16pps) とした. 洗浄中に根尖孔外に生じる圧力は, 根管模型根尖部に圧力計測装置を接続して計測した. 二元配置分散分析およびTukey-Kramer法により, 有意水準5%で統計解析した. 結果 : SI群 (根尖孔から2, 5mm) では, 他群と比較して有意に大きい圧力が生じた (p<0.05). TOP群では, チップ挿入深度の相違による圧力の有意差は認められなかった (p>0.05). 結論 : 本実験条件下では, MLSおよびTOPチップによる根管洗浄液活性化を行った場合に根尖孔外に生じる圧力は, チップ挿入深度が深い条件では従来のシリンジ洗浄と比較して有意に低値を示した. |
| Author | 佐竹, 和久 渡辺, 聡 高野, 晃 山内, 慎也 興地, 隆史 星原, 康宏 八尾, 香奈子 本郷, 智之 |
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| References | 19) Romanos GE, Belikov AV, Skrypnik AV, Feldchtein FI, Smirnov MZ, Altshuler GB. Uncovering dental implants using a new thermo-optically powered (TOP) technology with tissue air-cooling. Lasers Surg Med 2015; 47: 411-420. 20) Dental Photonics Inc. Alta-ST soft tissue surgical modular system user manual. https://media.dentalcompare.com/m/25/Downloads/Alta-ST%20Brochure.pdf (cited 2019.9.1 10) Blanken JW, Verdaasdonk R. Cavitation as a working mechanism of the Er, Cr: YSGG laser in endodontics: a visualization study. J Oral Laser Applic 2007; 7: 97-106. 13) George R, Walsh LJ. Apical extrusion of root canal irrigants when using Er: YAG and Er, Cr: YSGG lasers with optical fibers: An in vitro dye study. J Endod 2008; 34: 706-708. 15) Levy G, Rizoiu I, Friedman S, Lam H. Pressure waves in root canals induced by Nd: YAG laser. J Endod 1996; 22: 81-84. 28) Peeters HH, Mooduto L. Radiographic examination of apical extrusion of root canal irrigants during cavitation induced by Er, Cr: YSGG laser irradiation: an in vivo study. Clin Oral Investig 2013; 17: 2105-2112. 11) De Moor RJG, Meire M, Goharkhay K, Moritz A, Vanobbergen J. Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs. J Endod 2010; 36: 1580-1583. 24) de Sermeño RF, da Silva LAB, Herrera H, Herrera H, Silva RAB, Leonardo MR. Tissue damage after sodium hypochlorite extrusion during root canal treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e46-e49. 31) Sirtes G, Waltimo T, Schaetzle M, Zehnder M. The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod 2005; 31: 669-671. 1) Peters OA. Current challenges and concepts in the preparation of root canal systems: A review. J Endod 2004; 30: 559-567. 27) Yao K, Satake K, Watanabe S, Ebihara A, Kobayashi C, Okiji T. Effect of laser energy and tip insertion depth on the pressure generated outside the apical foramen during Er: YAG laser-activated root canal irrigation. Photomed Laser Surg 2017; 35: 682-687. 8) Jensen SA, Walker TL, Hutter JW, Nicoll BK. Comparison of the cleaning efficacy of passive sonic activation and passive ultrasonic activation after hand instrumentation in molar root canals. J Endod 1999; 25: 735-738. 25) Serper A, Özbek M, Çalt S. Accidental sodium hypochlorite-induced skin injury during endodontic treatment. J Endod 2004; 30: 180-181. 23) Gatot A, Arbelle J, Leiberman A, Yanai-Inbar I. Effects of sodium hypochlorite on soft tissues after its inadvertent injection beyond the root apex. J Endod 1991; 17: 573-574. 17) Hmud R, Kahler WA, George R, Walsh LJ. Cavitational effects in aqueous endodontic irrigants generated by near-infrared lasers. J Endod 2010; 36: 275-278. 7) Zehnder M. Root canal irrigants. J Endod 2006; 32: 389-398. 16) Hongo T, Watanabe S, Yao K, Kazuhisa S, Okiji T. Evaluation of cleaning efficacy-related properties of root canal irrigant activation using a computer-controlled hot tip powered with a diode laser. Asian Pac J Dent 2019; 19: 9-15. 14) Matsumoto H, Yoshimine Y, Akamine A. Visualization of irrigant flow and cavitation induced by Er: YAG laser within a root canal model. J Endod 2011; 37: 839-843. 9) van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 2007; 40: 415-426. 12) De Groot SD, Verhaagen B, Versluis M, Wu MK, Wesselink PR, van der Sluis LWM. Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J 2009; 42: 1077-1083. 33) Gutknecht N, Franzen R, Meister J, Vanweersch L, Mir M. Temperature evolution on human teeth root surface after diode laser assisted endodontic treatment. Lasers Med Sci 2005; 20: 99-103. 3) Nair PNR, Henry S, Cano V, Vera J. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99: 231-252. 6) Paqué F, Ganahl D, Peters OA. Effects of root canal preparation on apical geometry assessed by micro-computed tomography. J Endod 2009; 35: 1056-1059. 18) George R, Chan K, Walsh LJ. Laser-induced agitation and cavitation from proprietary honeycomb tips for endodontic applications. Lasers Med Sci 2015; 30: 1203-1208. 26) Witton R, Henthorn K, Ethunandan M, Harmer S, Brennan PA. Neurological complications following extrusion of sodium hypochlorite solution during root canal treatment. Int Endod J 2005; 38: 843-848. 34) Watanabe S, Hanada T, Kobayashi C, Suda H. Root canal irrigation activated by new diode laser system and Er: YAG laser. 22nd Academy of laser dentistry annual conference & exhibition program guide 2015: 68. 4) Fornari VJ, Silva-Sousa YTC, Vanni JR, Pécora JD, Versiani MA, Sousa-Neto MD. Histological evaluation of the effectiveness of increased apical enlargement for cleaning the apical third of curved canals. Int Endod J 2010; 43: 988-994. 29) Khan S, Niu LN, Eid AA, Looney SW, Didato A, Roberts S, Pashley DH, Tay FR. Periapical pressures developed by nonbinding irrigation needles at various irrigation delivery rates. J Endod 2013; 39: 529-533. 32) Eriksson AR, Albrektsson T. Temperature threshold levels for heat-induced bone tissue injury: A vital-microscopic study in the rabbit. J Prosthet Dent 1983; 50: 101-107. 30) Baumann UA, Marquis C, Stoupis C, Willenberg TA, Takala J, Jakob SM. Estimation of central venous pressure by ultrasound. Resuscitation 2005; 64: 193-199. 21) Yusupov VI, Chudnovskii VM, Bagratashvili VN. Laser-induced hydrodynamics in water-saturated biotissues. 1. Generation of bubbles in liquid. Laser Phys 2010; 20: 1641-1646. 2) Ricucci D, Bergenholtz G. Bacterial status in root-filled teeth exposed to the oral environment by loss of restoration and fracture or caries―a histobacteriological study of treated cases. Int Endod J 2003; 36: 787-802. 5) Wu MK, van der Sluis LW, Wesselink PR. The capability of two hand instrumentation techniques to remove the inner layer of dentine in oval canals. Int Endod J 2003; 36: 218-224. 22) Yusupov VI, Chudnovskii VM, Bagratashvili VN. Laser-induced hydrodynamics in water-saturated biotissues: 2. Effect on delivery fiber. Laser Phys 2011; 21: 1230-1234. |
| References_xml | – reference: 4) Fornari VJ, Silva-Sousa YTC, Vanni JR, Pécora JD, Versiani MA, Sousa-Neto MD. Histological evaluation of the effectiveness of increased apical enlargement for cleaning the apical third of curved canals. Int Endod J 2010; 43: 988-994. – reference: 10) Blanken JW, Verdaasdonk R. Cavitation as a working mechanism of the Er, Cr: YSGG laser in endodontics: a visualization study. J Oral Laser Applic 2007; 7: 97-106. – reference: 28) Peeters HH, Mooduto L. Radiographic examination of apical extrusion of root canal irrigants during cavitation induced by Er, Cr: YSGG laser irradiation: an in vivo study. Clin Oral Investig 2013; 17: 2105-2112. – reference: 8) Jensen SA, Walker TL, Hutter JW, Nicoll BK. Comparison of the cleaning efficacy of passive sonic activation and passive ultrasonic activation after hand instrumentation in molar root canals. J Endod 1999; 25: 735-738. – reference: 3) Nair PNR, Henry S, Cano V, Vera J. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99: 231-252. – reference: 26) Witton R, Henthorn K, Ethunandan M, Harmer S, Brennan PA. Neurological complications following extrusion of sodium hypochlorite solution during root canal treatment. Int Endod J 2005; 38: 843-848. – reference: 34) Watanabe S, Hanada T, Kobayashi C, Suda H. Root canal irrigation activated by new diode laser system and Er: YAG laser. 22nd Academy of laser dentistry annual conference & exhibition program guide 2015: 68. – reference: 24) de Sermeño RF, da Silva LAB, Herrera H, Herrera H, Silva RAB, Leonardo MR. Tissue damage after sodium hypochlorite extrusion during root canal treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e46-e49. – reference: 14) Matsumoto H, Yoshimine Y, Akamine A. Visualization of irrigant flow and cavitation induced by Er: YAG laser within a root canal model. J Endod 2011; 37: 839-843. – reference: 17) Hmud R, Kahler WA, George R, Walsh LJ. Cavitational effects in aqueous endodontic irrigants generated by near-infrared lasers. J Endod 2010; 36: 275-278. – reference: 7) Zehnder M. Root canal irrigants. J Endod 2006; 32: 389-398. – reference: 32) Eriksson AR, Albrektsson T. Temperature threshold levels for heat-induced bone tissue injury: A vital-microscopic study in the rabbit. J Prosthet Dent 1983; 50: 101-107. – reference: 12) De Groot SD, Verhaagen B, Versluis M, Wu MK, Wesselink PR, van der Sluis LWM. Laser-activated irrigation within root canals: cleaning efficacy and flow visualization. Int Endod J 2009; 42: 1077-1083. – reference: 27) Yao K, Satake K, Watanabe S, Ebihara A, Kobayashi C, Okiji T. Effect of laser energy and tip insertion depth on the pressure generated outside the apical foramen during Er: YAG laser-activated root canal irrigation. Photomed Laser Surg 2017; 35: 682-687. – reference: 6) Paqué F, Ganahl D, Peters OA. Effects of root canal preparation on apical geometry assessed by micro-computed tomography. J Endod 2009; 35: 1056-1059. – reference: 2) Ricucci D, Bergenholtz G. Bacterial status in root-filled teeth exposed to the oral environment by loss of restoration and fracture or caries―a histobacteriological study of treated cases. Int Endod J 2003; 36: 787-802. – reference: 5) Wu MK, van der Sluis LW, Wesselink PR. The capability of two hand instrumentation techniques to remove the inner layer of dentine in oval canals. Int Endod J 2003; 36: 218-224. – reference: 13) George R, Walsh LJ. Apical extrusion of root canal irrigants when using Er: YAG and Er, Cr: YSGG lasers with optical fibers: An in vitro dye study. J Endod 2008; 34: 706-708. – reference: 25) Serper A, Özbek M, Çalt S. Accidental sodium hypochlorite-induced skin injury during endodontic treatment. J Endod 2004; 30: 180-181. – reference: 11) De Moor RJG, Meire M, Goharkhay K, Moritz A, Vanobbergen J. Efficacy of ultrasonic versus laser-activated irrigation to remove artificially placed dentin debris plugs. J Endod 2010; 36: 1580-1583. – reference: 23) Gatot A, Arbelle J, Leiberman A, Yanai-Inbar I. Effects of sodium hypochlorite on soft tissues after its inadvertent injection beyond the root apex. J Endod 1991; 17: 573-574. – reference: 29) Khan S, Niu LN, Eid AA, Looney SW, Didato A, Roberts S, Pashley DH, Tay FR. Periapical pressures developed by nonbinding irrigation needles at various irrigation delivery rates. J Endod 2013; 39: 529-533. – reference: 22) Yusupov VI, Chudnovskii VM, Bagratashvili VN. Laser-induced hydrodynamics in water-saturated biotissues: 2. Effect on delivery fiber. Laser Phys 2011; 21: 1230-1234. – reference: 15) Levy G, Rizoiu I, Friedman S, Lam H. Pressure waves in root canals induced by Nd: YAG laser. J Endod 1996; 22: 81-84. – reference: 31) Sirtes G, Waltimo T, Schaetzle M, Zehnder M. The effects of temperature on sodium hypochlorite short-term stability, pulp dissolution capacity, and antimicrobial efficacy. J Endod 2005; 31: 669-671. – reference: 9) van der Sluis LW, Versluis M, Wu MK, Wesselink PR. Passive ultrasonic irrigation of the root canal: a review of the literature. Int Endod J 2007; 40: 415-426. – reference: 21) Yusupov VI, Chudnovskii VM, Bagratashvili VN. Laser-induced hydrodynamics in water-saturated biotissues. 1. Generation of bubbles in liquid. Laser Phys 2010; 20: 1641-1646. – reference: 18) George R, Chan K, Walsh LJ. Laser-induced agitation and cavitation from proprietary honeycomb tips for endodontic applications. Lasers Med Sci 2015; 30: 1203-1208. – reference: 19) Romanos GE, Belikov AV, Skrypnik AV, Feldchtein FI, Smirnov MZ, Altshuler GB. Uncovering dental implants using a new thermo-optically powered (TOP) technology with tissue air-cooling. Lasers Surg Med 2015; 47: 411-420. – reference: 16) Hongo T, Watanabe S, Yao K, Kazuhisa S, Okiji T. Evaluation of cleaning efficacy-related properties of root canal irrigant activation using a computer-controlled hot tip powered with a diode laser. Asian Pac J Dent 2019; 19: 9-15. – reference: 33) Gutknecht N, Franzen R, Meister J, Vanweersch L, Mir M. Temperature evolution on human teeth root surface after diode laser assisted endodontic treatment. Lasers Med Sci 2005; 20: 99-103. – reference: 20) Dental Photonics Inc. Alta-ST soft tissue surgical modular system user manual. https://media.dentalcompare.com/m/25/Downloads/Alta-ST%20Brochure.pdf (cited 2019.9.1) – reference: 30) Baumann UA, Marquis C, Stoupis C, Willenberg TA, Takala J, Jakob SM. Estimation of central venous pressure by ultrasound. Resuscitation 2005; 64: 193-199. – reference: 1) Peters OA. Current challenges and concepts in the preparation of root canal systems: A review. J Endod 2004; 30: 559-567. |
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| Title | 半導体レーザーと光熱変換チップを用いた根管洗浄剤活性化時の根尖孔外への圧力の評価 |
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| ispartofPNX | 日本歯科保存学雑誌, 2019, Vol.62(6), pp.304-310 |
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