A Scanning electron microscopic study of the dentinal tubule obliteration effect by the different irradiations of a pulsed Nd:YAG laser

Nd:YAG 레이저의 조사방법의 차이에 따른 상아세관 폐쇄효과에 관한 주사전자현미경적 연구

Dentin hypersensitivity must be one of the most frequent postoperative complaints in periodontal patients. Obliterating the open dentinal tubules or decreasing the diameter of their orifices would, therefore, be an objective of treatment for hypersensitive teeth. The purpose of this study was to evaluate the effect of a pulsed Nd:YAG laser irradiation on obliteration of dentinal tubules and to determine any difference according to irradiation methods. The 45 posterior teeth that had been extracted due to periodontal disease were initially treated with tetracycline HCI(100 mg/ml, 4 min.) to remove the smear layer after root planing. The root surfaces were then irradiated by a pulsed Nd:YAG laser(EL.EN.EN060, Italy) by different laser beam spot size and different exposure condition: ${\cdot}$ group 1: irradiated group by small spot(beam diameter=1mm, lW, 2 sec) ${\cdot}$ group 2: irradiated group by large spot(beam diameter=10mm, 1W, 200 sec) ${\cdot}$ group 3: irradiated group by gradual increase of watt (from 0.3W to 1.0W), beam diameter=4mm ${\cdot}$ group 4: irradiated group by fixed watt(1.0 W), beam diameter=4mm ${\cdot}$ control group: no irradiation but root planing and tetracycline HCI conditioning only. Additionally, the specimens were retreated with tetracycline HCI(100mg/ml, 4min.) to evaluate the stability of obliteration effect by Nd:YAG laser. Specimens were examined under the scanning electron microscope(JEOL, JSM-840A, Japan). Photomicrographs were taken at ${\times}4,000$ magnification and were analyzed statistically. The results were as follows: l. Scanning electron micrographs of root surface treated by tetracycline HCI alone(control group) showed widened, funnel-shaped dentinal tubules, while those of the root surface irradiated by various methods showed partially or completely obliterated dentinal tubules and various surface alterations, eg, flat, multiple pitted, melted and resolidified surface at the same energy density. 2. There was no significant difference in the obliteration effect of dentinal tubules between group 1 and group 2, and between group 3 and group 4(p>0.05). 3. The obliteration effect of dentinal tubules by a Nd:YAG laser irradiation was relatively stable to tetracycline HCI. The results demonstrate that a pulsed Nd:YAG laser irradiation within 1.0W, regardless of irradiation methods, can obliterate dentinal tubules effectively.