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1 Effects of Nd:YAG Laser Irradiation with TiO2 Solution on Dentin Surface Observation of Morphological Change \ Tomoo ANJO, Hidetoshi SAEGUSA, Hidetoshi NOGUCHI*, Arata EBIHARA and Hideaki SUDA Pulp Biology and Endodontics, Graduate School, Tokyo Medical and Dental University (Chief:Prof.Hideaki *MANI Inc SUDA) (Received:June 30, Accepted for Publication:July26,2005) Abstract:Recently, a fine flexible glass fiber made of quartz has been developed to transmit laser beams more effectively, which permits energy to be concentrated in a specific area This has increased the potential usefulness of the Nd:YAG laser in root canal treatment, and so it is expected that the Nd:YAG laser will be increasingly employed in the dental clinic, especially in the field of endodontics. This investigation evaluated the effects of Nd:YAG laser irradiation with TiO2 solution on dentin surface and fiber tip by light microscopy and electron microscopy. Dentin disks were prepared from the crown of bovine teeth. The optical fiber was processed by irradiating Nd:YAG laser (MDLNd8, MANI) through itself for 30 sec in TiO2 solu tion. The specimens were irradiated using the following parameters:pulse energy of 200mJ, 300mJ and 350mJ at 20 pulses per sec, and irradiation time of 5 sec. Samples and the processed fiber were observed under a light microscope and a scanning electron microscope (SEM), and the depth and width of cavities were evaluated using a CCD laser sensor (LB02, KEY ENCE). No carbonization was observed for the processed fiber, the tip of which had become conical. The irradiated beam pattern was changed from straight to spherical after processing the fiber. The mean depths of cavities were 125 }68/um (200mJ 20pps), 155 }89um (300mJ 20pps) and 243 } 66um (350mJ 20pps), respectively. The mean widths of cavities were 185 }75um (200mJ 20pps), 297 }128um (300mJ 20pps) and 422 }156um (350mJ 20pps), respectively. The SEM obser vation showed that vaporized dentin was hardly found in the 200mJ group. Vaporized dentin and no carbonization were found in the 300mJ group, and vaporized dentin and little carbonized dentin were found in the 350mJ group. These results suggest that Nd:YAG laser irradiation with a processed fiber and TiO2 solution could vaporize dentin safely and effectively. (J.Jpn. Soc. Laser Dent. 16:80 `85, 2005 Reprint request to Dr.ANJO) Key words=nd:yag laser, TiO2, Dentin

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4 2005年9月 安 生 智 郎 他 酸 化 チ タ ン液 を併 用 したNd:YAGレ 図6 200mJ群 にお け る レー ザ ー照 射 後 の象 牙 質 プ レー トの実 体 顕微 鏡 像 切 削 像 は み られ ず,フ ァ イバ ー が 通 過 した痕 跡 の み確 認 された 100 図7 83 ーザー照射が象牙質に及ぼす影響 mJ群 に お け る レーザ ー 照射 後 の 象 牙 質 プ レー トの 走 査 電 子 顕 微 鏡 像 照 射 部 と非 照 射 部 と の 間 に大 きな 相 違 はみ られ な か っ た 図8 300mJ群 に お け る レー ザ ー 照 射 後 の 象 牙 質 プ レー トの 実 体 顕 微 鏡 像 レ ーザ ー照 射 に よる実 質 欠損 が 確 認 され た もの の,炭 化 等 の 異 常 所 見 はみ られ なか っ た は,象 牙 質 が 切 削 さ れ て い る 所 見 は ほ とん どみ ら れ ず, さ れ な か っ た(図8) フ ァ イ バ ー が 通 過 し た痕 跡 が 表 面 に わ ず か に 確 認 され た に比 較 し,切 削 痕 が 明確 に確 認 で き,辺 縁 部 で は一 部 の象 (図6) 走 査 電 子 顕 微 鏡 像 で も,レ ー ザ ー 照 射 に よ る大 き 牙 質 が溶 融 して い る像 も認 め られ た(図9) な 変化 は み られ な か っ た(図7) 300mJ群 の 実 体 顕 微 鏡 像 で は,照 射 面 にお け る 象 牙 質 の 切 削 痕 が 明確 に 認 め られ た が,炭 化 等 の 異常 所 見 は観 察 350mJ群 走 査 電 子 顕 微 鏡 像 で は,200mJ群 の 実 体 顕 微 鏡 像 で は,照 射 面 に 象 牙 質 の切 削 像 が 明 瞭 に観 察 され,辺 縁 部 で は所 々 に炭 化 像 も認 め られ た(図10) 走 査 電子 顕 微 鏡 像 で は,象 牙 細 管 の 開 口 と象

5 84 日 本 レー ザ ー 歯 学 会 誌16: 80-85, 図 mJ群 にお け る レー ザ ー照 射 後 の 象 牙 質 プ レー トの 走 査 電 子 顕 微 鏡 像 明確 な 象 牙 質 切 削 像 が 認 め られ,一 部 に は 象 牙 質 の溶 融 像 が み られ た 図 図 mJ群 にお け る レー ザ ー 照 射 後 の 象 牙 質 プ レー トの 実 体 顕 微 鏡 像 300mJ群 に 比 べ,よ り明確 な実 質 欠 損 が 認 め られ, 辺 縁 部 に は わず か に炭 化 像 が み られ た mJ群 に お け る レ ーザ ー 照 射 後 の 象 牙 質 プ レー トの走 査 電 子 顕 微 鏡 像 明確 な 象 牙 質 欠損 と一 部 に象 牙 質 の 溶 融 像 が み られ,300mJ群 と 同様 の所 見 であ っ た 牙 質 が 辺 縁 の ご く一 部 で 溶 融 し て い る 像 が 見 ら れ,300mJ ラ ミ ック粒 子 が エ ネ ルギ ー を吸 収 放 出 す る こ とで,レ ー 群 と ほ ぼ 同 様 の 所 見 で あ っ た(図11) ザ ー光 が 散 乱 す る と考 え る7) ま た酸 化 チ タ ン液 中 で レー 考 察 光 酸 化 作 用 で有 機 物 を強 力 に分 解 す る能 力 を持 つ 酸 化 チ タ ン(TiO2)は,光 触 媒 と し て 近 年 多 く の 注 目 を 集 め, ザ ー を照 射 す る と石 英 フ ァイバ ー の 先 端 形 状 が 円 錐 形 と な り,照 射 光 の 幅 が 拡 が るた め,根 管 治 療 な ど側 方 へ の 照 射 が 必 要 なケ ー ス に適 して い る と考 え る フ ァイ バ ー 先 端 の 走 査 電 子 顕 微 鏡 観 察 で は,不 整 な 円 錐 形 に 加 工 され た 表 面 様 々 な 分 野 で 応 用 さ れ て い る4-6,10) 酸 化 チ タ ン 液 中 で に多 くの 凹 凸 が 見 られ,こ の 微 妙 な凹 凸 の 連 続 に よっ て 散 レ ー ザ ー を 照 射 す る と,照 乱 光 が 形 成 され る もの と思 う 8,9) 射 部 周 囲 の 酸 化 チ タ ン液 中 の セ

6 5) Yoshida, K., Taira, Y. and Atsuta, M.: Properties of opaque resin composite containing coated and silanized titanium di oxide. J Dent Res, 80: , ) Yoshida, K., Tanagawa, M. and Atsuta, M.: Effects of filler composition and surface treatment on the characteristics of opaque resin composites. J Biomedical Materials Res, , ) Damen, J.M., Ten cate, J.M. and Ellingsen, J.E.: Induction of calcium phosphate precipitation by titanium dioxide. J Dent Res, 70: , ) Lehmann, R.R. and Sluka, H.: Distribution TiO2 after partial and total pulpectomy. Int Endod J, 15: , ) Miserendino, L.J., Levy, G.C. and Rizoiu, I.M.: Effects of Nd: YAG laser on the permeability of root canal wall dentin. J Endodon, 21: 83-87, ) Hardee, M.W., Miserendino, L.J., Kos, W. and Walia, H.: Evaluation of the antibacterial effects of intracanal Nd: YAG laser irradiation. J Endodon, 20: , ) Moshonov, J., Orstavik, D., Yamauchi, S., Pettiette, M. and Trope, M.: Nd: YAG laser irradiation in root canal disinfec tion. Endod Dent Traumatol, 11: , ) Fegan, S.E. and Steinman, H.R.: Comparative evaluation of the antibacterial effects of intracanal Nd: YAG laser irradia tion: an in vitro study. J Endodon, 21: , ) Ramskold, L.O., Fong, C.D., and Stromberg, T.: Thermal ef fects and antibacterial properties of energy levels required to sterilize stained root canals with an Nd: YAG laser. J Endodon, 23: , ) Marchesini, R., Andreola, S., Emanuelli, H., Melloni, E., Schir oli, A., Spinelli, P. and Fava, G.: Temperature rise in biologi cal tissue during Nd: YAG laser irradiation in the root canal. Lasers Surg Med, 5: 75-82, ) Lan, W.H.: Temperature evaluation on the root surface dur ing Nd: YAG laser irradiation in the root canal. J Endodon, 25: , ) Koba, K., Kimura, Y., Matsumoto, K., Watanabe, H., Shinoki, T., Koji, R. and Ito, M.: Post-operative symptoms and heal ing after endodontic treatment of infected teeth using pulsed Nd: YAG laser. Endod Dent Traumatol, 15: 68-72, 1999.

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