激光手术在猪颌部非创伤性切除的可行性研究。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-09-13 DOI:10.1016/j.jdent.2025.106107

Rodwan K. Ibrahim , Brendan B. Louis , Madelyn Ritter , Ridham Varsani , Samir Nammour , Praveen R. Arany

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引用次数: 0

摘要

目的：人类寿命的增加导致老年人口中慢性病发病率的增加。老年患者，尤其是女性，通常由于骨质疏松症而出现脆性颌骨，在常规拔牙时骨折的风险显著增加。本研究的目的是探讨利用外科牙科激光实现微创、无创性拔牙的可行性。方法：采用64颗猪前磨牙（每组16颗），研究了Er、Cr:YSGG （8w, 20Hz）、CO₂（3 ~ 6W，超脉冲）和二极管（8w，连续波）激光配合空气-水冷却辅助拔牙的可行性。垂直释放切口后，将粘骨膜瓣抬起，激光尖端平行于骨质表面对齐。采用米勒移动指数、数字和热成像以及力传感器评估牙齿移动和拔牙力。进行组织学分析以评估组织变化。结果：我们注意到，Er、Cr:YSGG和CO₂激光器对周围组织的激光消融可以实现2级迁移，可以用较低的手动力（分别为16和11 N）进行提取，而二极管激光器只能实现1级迁移（28 N）。Er，Cr:YSGG激光对牙槽骨的碳化作用最小，CO₂和Diode激光对牙槽骨的碳化作用最明显。结论：综上所述，这些结果表明激光辅助拔牙可以提高易感患者的整体护理质量。临床意义：激光辅助拔牙对于颌骨骨折和骨质疏松或骨坏死并发症高风险的老年人群提供了一种有效的非创伤性方法。这种方法代表了常规拔牙的微创方法，减少了疼痛和不适，改善了愈合和整体患者体验。

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Feasibility of atraumatic extractions with surgical lasers: A pilot study in porcine jaws

Objectives

The positive increases in human lifespan have resulted in an increasing incidence of chronic diseases in the geriatric population. Elderly patients, especially females, often present with brittle jaw bones due to osteoporosis that have significantly increased risk of fractures during routine tooth extractions. The aim of this study was to examine the feasibility of utilizing surgical dental lasers to achieve minimally invasive, atraumatic tooth extraction.

Methods

In this study we utilized 64 porcine premolars (16 per group) and examined the feasibility of using Er,Cr:YSGG (8 W, 20 Hz), CO₂ (3 to 6 W, super-pulsed), and diode (8 W, CW) lasers with air-water cooling to assist with tooth extractions. Mucoperiosteal flaps were raised following a vertical release incision, and laser tips were aligned parallel to the cementum surface. Tooth mobility and extraction force were assessed using the Miller Mobility Index, digital and thermal imaging, and force transducers. Histological analysis was performed to evaluate tissue changes.

Results

We noted laser ablation of surrounding tissues enabled Grade 2 mobility with the Er,Cr:YSGG and CO₂ lasers enabling extractions with lower manual force (16 and 11 N respectively), while the diode laser could only achieve Grade 1 mobility (28 N). Minimal charring of alveolar bone was seen with the Er,Cr:YSGG laser, while the CO₂ and Diode lasers displayed most prominent charring.

Conclusions

Together, these results suggest that laser-assisted extractions in vulnerable patients could improve overall quality of care.

Clinical Significance

Laser-assisted tooth extraction can provide a potent atraumatic approach in geriatric populations with high risk of jaw fractures and complications from osteoporosis or osteonecrosis. This approach represents a minimally invasive approach for routine extractions resulting in less pain and discomfort, and improved healing and overall patient experience.

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.