口腔医学研究

口腔医学研究 ›› 2026, Vol. 42 ›› Issue (7): 591-595.DOI: 10.13701/j.cnki.kqyxyj.2026.07.007

• 口腔修复学研究 • 上一篇    下一篇

水气冷却模式与激光能量参数对Er:YAG激光拆除瓷贴面效率与安全影响的体外研究

李筱文1, 许新怡1, 薛淼2, 孙睿2, 盛涵星2, 毕文雅3, 闫卓群3, 孙磊1,2*   

  1. 1.安徽医科大学第二附属医院口腔科 安徽 合肥 230601;
    2.合肥市口腔医院颞颌关节/老年口腔中心 安徽 合肥 230001;
    3.爱尔创合作研究中心,辽宁爱尔创生物材料有限公司 辽宁 沈阳 110000
  • 收稿日期:2026-01-09 发布日期:2026-07-22
  • 通讯作者: *孙磊,E-mail:sunlei_45@126.com
  • 作者简介:李筱文(1999~ ),女,安徽阜阳人,硕士在读,研究方向:Er:YAG激光在口腔的应用。
  • 基金资助:
    2023年度安徽省自然科学基金面上项目(编号:2308085MH264)

In Vitro Study on Effects of Water-air Cooling Mode and Laser Energy Parameters on Efficiency and Safety of Er:YAG Laser in Ceramic Veneer Removal

LI Xiaowen1, XU Xinyi1, XUE Miao2, SUN Rui2, SHENG Hanxing2, BI Wenya3, YAN Zhuoqun3, SUN Lei1,2*   

  1. 1. Department of Stomatology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China;
    2. TMD/Geriatric Stomatology Center, Hefei Stomatology Hospital, Hefei 230001, China;
    3. UPCERA Collaborative Research Center, Liaoning Upcera Co., Ltd., Shenyang 110000, China
  • Received:2026-01-09 Published:2026-07-22

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摘要： 目的: 研究水气冷却模式与激光能量参数对掺铒钇铝石榴石(erbium-doped yttrium aluminum garnet,Er:YAG)激光拆除瓷贴面的效率及其对牙体软硬组织安全性的影响。方法: 在体外建立贴面粘接模型,根据有无水气冷却随机分为两组,A组:无水气冷却,B组:有水气冷却。每组分别采用5个梯度能量(A组:60~140 mJ;B组:140~220 mJ,n=4)的Er:YAG激光照射至贴面脱粘,记录脱粘时间及髓腔温度变化,场发射扫描电子显微镜(scanning electron microscope,SEM)观察脱粘后牙面形貌。结果: 水气冷却与激光能量均会显著影响脱粘时间(P<0.0001)。脱粘时间随能量增加而缩短的趋势存在“能量阈值”:A组阈值约100 mJ,B组约200 mJ;超过阈值后,继续增加能量对脱粘时间的缩短不再具有统计学意义。且当两组参数均设置于各自阈值以上时,其脱粘时间比较无统计学差异(P>0.05)。A组髓腔温度升高显著高于B组。SEM显示,A组牙面均发现釉质暴露与损伤;B组仅在220 mJ时偶见点状釉质暴露。结论: 水气冷却是Er:YAG激光实现安全、微创拆除瓷贴面的必要措施。对于0.5 mm的二硅酸锂玻璃陶瓷贴面,建议在全程水气冷却下,激光能量设置在阈值附近(200 mJ),即可达到“效率-安全”平衡。

关键词: Er:YAG激光, 水气冷却, 贴面, 去粘接

Abstract: Objective: To investigate the effects of water-air spray cooling modes and laser energy parameters of erbium doped yttrium aluminum garnet (Er:YAG) laser in veneer removal and its safety regarding both soft and hard dental tissues. Methods: An in vitro veneer bonding model was established. Specimens were randomly assigned to two groups based on the presence or absence of water-air spray cooling: Group A (no cooling) and Group B (with cooling). In each group, five incremental energy levels of Er:YAG laser irradiation were applied (Group A: 60-140 mJ; Group B: 140-220 mJ, n=4 per level) until veneer debonding. The debonding time and changes in pulpal chamber temperature were recorded. The tooth surface morphology after debonding was observed using scanning electron microscopy (SEM). Results: Both water-air cooling and laser energy significantly affected the debonding time (P<0.0001). The trend of decreasing debonding time with increasing energy exhibited an "energy threshold": approximately 100 mJ for Group A and 200 mJ for Group B. Beyond these thresholds, further energy increase did not lead to a statistically significant reduction in debonding time. Furthermore, when parameters for both groups were set above their respective thresholds, no statistically significant difference in debonding time was observed (P>0.05). The temperature rise in the pulpal chamber of Group A was significantly higher than that of Group B. SEM observations revealed enamel exposure and damage on all tooth surfaces in Group A, whereas in Group B, only occasional pinpoint enamel exposure was observed at the 220 mJ level. Conclusion: Water-air spray cooling is a necessary safety measure for achieving safe and minimally invasive ceramic veneer removal with Er:YAG laser. For 0.5-mm lithium disilicate glass-ceramic veneers, it is recommended to employ continuous water-air cooling and set the laser energy near the identified threshold (200 mJ) to achieve an optimal "efficiency-safety" balance.

Key words: Er:YAG laser, water-air cooling, veneer, debonding