宋明宇　林 江　乔丽艳　陈会珍

[关键词]Nd：YAG激光;3M FiltekTMZ350 XT纳米树脂;楔状缺损;治疗效果

[中圖分类号]R783.3    [文献标志码]A    [文章编号]1008-6455（2021）12-0140-03

Effect of 3M FiltekTM Z350 XT Nano-resin Combined with Nd：YAG Laser Filling Wedge Defect

SONG Ming-yu， LIN Jiang， QIAO Li-yan， CHEN Hui-zhen

（Department of Stomatology， Beijing Tongren Hospital， Capital Medical University， Beijing 100176，China）

Abstract： Objective  To investigate the clinical effect of 3M resin and Nd：YAG laser in the treatment of wedge-shaped defects. Methods  A total of 152 teeth were randomly divided into two groups， the control group and the combined group.In the control group of 40 patients， 74 affected teeth were directly filled with 3M resin.In the combined group of 40 patients， 78 affected teeth were treated with Nd：YAG laser desensitization composite resin for wedge defects.Observation and comparison of the treatment efficiency of the two groups （immediately after the operation， 1， 6， 12 months after the review）. Results  The control group lost 7 teeth and 9 teeth after 6 months and 12 months， respectively.In the Nd：YAG laser combined resin group， 1 tooth and 3 fillings fell out 6 and 12 months after operation.There was statistically significant difference in the efficacy between the two groups （P<0.05）. The effective rates of desensitization in the Nd：YAG laser group were 94.87%， 91.06%， 87.20% and 84.46% immediately after surgery and 1， 6 and 12 months after surgery， respectively， which were significantly higher than those in the control group （81.08%， 78.37%， 70.27% and 66.22%， respectively） （P<0.05）. Conclusion  Nd：YAG laser combined with composite resin has a good effect in the treatment of sensitive wedge-shaped defects， and can obviously improve the symptoms of tooth sensitivity.

Key words： Nd： YAG laser; 3M FiltekTMZ350 XT nano-resin; wedge shaped defect; treatment effect

楔状缺损是一种常见牙科慢性损伤性疾病，好发于牙的唇、颊侧颈部牙体组织，牙本质敏感为其最常见症状，中老年人为高发群体[1]。随着无痛医疗技术的发展，临床医师开始研究减少牙本质敏感症状的方法，使患者在治疗过程中舒适度更好。临床上目前采用激光疗法对牙本质敏感进行治疗，相较于传统治疗手段，激光治疗有更明显的优势[2-3]。本文旨在研究Nd：YAG激光联合3M FiltekTM Z350 XT纳米树脂充填治疗楔状缺损的临床效果，现报道如下。

1  资料和方法

1.1 一般资料：选择2018年6月-2019年3月来笔者医院口腔综合科就诊的敏感型楔状缺损患者80例（共152颗患牙）为研究对象，随机分为两组。对照组：40例（74颗患牙），牙敏感程度分级中3度18颗，2度22颗，1度21颗，0度13颗;联合组：40例（78颗患牙），牙敏感程度分级中3度16颗，2度22颗，1度24颗，0度16颗。患者年龄37～76岁。

1.2 纳入标准：①存在冷、热、酸等刺激敏感症状，经检查为楔状缺损，牙髓电活力正常;②未作过充填术;③患者知情同意，签署知情同意书。

1.3 排除标准：①存在牙髓电活力异常，急、慢性牙髓炎症患者;②存在咬牙不良习惯;③配合度不高者;④存在全身性系统疾病者。牙敏感程度分级见表1。

1.4 材料和设备：Nd：YAG激光治疗机（FOTONA），Filtek Z350纳米复合树脂，AdpNd Easy One自酸蝕粘接剂。

1.5 治疗方法

1.5.1 对照组：缺损牙面消毒（75%酒精棉球），清水冲洗，隔湿、吹干，随后涂布自酸蚀粘接剂、轻吹，光固化后用Z350纳米复合树脂充填楔状缺损，光照、调磨抛光。……