Non-inferiority of water laser pre-treatment against Er:YAG laser pre-treatment of all-ceramic inlay dental restorations

doi:10.3760/cma.j.cn441417-20241024-07030

Abstract

Abstract:

Objective　To investigate the clinical results of water laser pretreatment of all-ceramic inlay dental restorations and to analyze the factors influencing the long-term prognosis. Methods　Convenience sampling method was used to select 136 patients with dental defects admitted to The Third Affiliated Hospital of Air Force Medical University from May 2022 to January 2023 as the study subjects, and they were divided into two groups by the random number table method with 68 cases in each group. After excluding patients with detachment, there were 65 cases in the control group, 33 males and 32 females, aged 22-63 (46.06±8.50) years, with the number of dental defects being 1 in 45 cases, 2 in 16 cases, and 3 in 4 cases, and Er:YAG laser pretreatment was carried out; there were 64 cases in the observation group, 34 males and 30 females, aged 23-66 (44.22±9.83) years, with the number of dental defects being 1 in 48 cases, 2 in 14 cases, and 3 in 2 cases, and water laser pretreatment was carried out. On the basis, both groups were given all-ceramic inlay dental restoration. The results of the two groups were compared at 12 months after dental restoration [United States Public Health Service (USPHS) revised evaluation criteria], as well as oral health before and 12 months after restoration [probing depth (PD), gingival index (GI), and plaque index (PI)], amount of blood loss during dental restoration, pain and discomfort disappeared time after dental restoration, and survival rate of all-ceramic inlays at 18 months after dental restoration. Independent sample t test, paired t test, Mann-Whitney U test, and χ² test were used for statistical analysis. COX regression analysis was used to analyze the factors affecting the survival rate of all ceramic inlays. Results　At 12 months after dental restoration, there was no statistically significant difference in the grading of the dental restoration effect (restoration integrity, edge fitness, color matching, edge staining, retention, sensitivity, gingival health, and secondary caries) between the two groups (all P>0.05). At 12 months after dental restoration, there was no statistically significant difference in the PD, GI, or PI between the two groups (all P>0.05). The amount of blood loss in the observation group was less than that in the control group [(1.23±0.41) ml vs. (1.57±0.47) ml] (P<0.05). The pain and discomfort disappeared time after dental restoration in the observation group were shorter than those in the control group [(7.53±3.03) d vs. (8.69±2.77) d, (9.33±3.04) d vs. (10.51±3.18) d] (both P<0.05). There was no statistically significant difference in the survival rate of all ceramic inlays between the two groups (P>0.05). COX regression analysis showed that PD (HR=44.349, 95%CI= 7.519-261.594) and GI (HR=5.036, 95%CI= 1.232-20.594) were independent risk factors for the survival rate of all ceramic inlays after dental restoration (both P<0.05). Conclusions　The use of water laser pretreatment before dental restoration of all-ceramic inlays can obtain the same effect of Er:YAG laser pretreatment, and at the same time, it can reduce the amount of bleeding in the restoration process to a certain extent, and shorten the disappearance time of pain and discomfort after restoration. It is necessary to strengthen the oral health management after dental restoration, in order to improve the survival rate of all-ceramic inlays.

Key words:

Dental defects, Water laser pretreatment, Er:YAG laser pre-treatment, All-ceramic inlays, Repair

摘要：

目的　探讨水激光预处理全瓷嵌体牙体修复的效果，并分析全瓷嵌体存活率的影响因素。方法　本研究为前瞻性非劣效性研究。采用便利抽样法选取2022年5月至2023年1月空军军医大学第三附属医院收治的136例牙体缺损患者作为研究对象。采用随机数字表法，将患者分为对照组和观察组各68例，失访7例，对照组3例、观察组4例。对照组男33例，女32例；年龄22～63（46.06±8.50）岁；缺损牙数量：1颗45例，2颗16例，3颗4例。观察组男34例，女30例；年龄23～66（44.22±9.83）岁；缺损牙数量：1颗48例，2颗14例，3颗2例。对照组采用Er：YAG激光预处理，观察组采用水激光预处理。在此基础上，两组均行全瓷嵌体牙体修复。比较两组牙体修复后12个月的效果［美国公共卫生署（USPHS）改良版评价标准］；牙体修复前和修复后12个月口腔健康情况［探诊深度（PD）、牙龈指数（GI）、牙菌斑指数（PI）］；牙体修复中的出血量；牙体修复后的疼痛感和不适感消失时间；牙体修复后18个月全瓷嵌体的存活率。采用独立样本t检验、配对t检验、Mann-Whitney U检验、χ²检验进行统计学分析；采用COX回归分析影响患者全瓷嵌体存活率的因素。结果　牙体修复后12个月，两组牙体修复效果（修复体完整度、边缘适合性、颜色匹配、边缘染色、固位、敏感性、牙龈健康、继发龋）分级比较，差异均无统计学意义（均P>0.05）。牙体修复后12个月，两组PD、GI、PI比较，差异均无统计学意义（均P>0.05）。观察组牙体修复中的出血量少于对照组［（1.23±0.41）ml比（1.57±0.47）ml］，牙体修复后疼痛感和不适感消失时间均短于对照组［（7.53±3.03）d比（8.69±2.77）d、（9.33±3.04）d比（10.51±3.18）d］（均P<0.05）。两组全瓷嵌体存活率比较，差异无统计学意义（P>0.05）。COX回归分析结果显示，牙体修复后12个月PD（HR=44.349，95%CI=7.519～261.594）和GI（HR=5.036，95%CI=1.232～20.594）均是全瓷嵌体存活率的独立危险因素（均P<0.05）。结论　水激光预处理与Er：YAG激光预处理的牙体修复效果相似。水激光预处理可减少修复过程中的出血量，缩短修复后疼痛感和不适感的消失时间。牙体修复后需加强口腔健康管理，提高全瓷嵌体存活率。

关键词:

牙体缺损, 水激光预处理, Er, YAG激光预处理, 全瓷嵌体, 修复

Wang Lei, Li Ying, Bai Qingxia.

Non-inferiority of water laser pre-treatment against Er:YAG laser pre-treatment of all-ceramic inlay dental restorations [J]. International Medicine and Health Guidance News, 2025, 31(7): 1204-1208.

王蕾李影白庆霞.

水激光预处理对照Er：YAG激光预处理全瓷嵌体牙体修复的非劣效性研究 [J]. 国际医药卫生导报, 2025, 31(7): 1204-1208.

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