う蝕象牙質除去後の残存細菌にEr:YAGレーザーが与える影響  [in Japanese] Effect of Er: YAG Laser Irradiation on Residual Bacteria in the Cavity after Removal of Softened Dentin  [in Japanese]

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Author(s)

    • 高橋 雄介 TAKAHASHI Yusuke
    • 大阪大学大学院歯学研究科口腔分子感染制御学講座(歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 吉岡 靖介 YOSHIOKA Seisuke
    • 大阪大学大学院歯学研究科口腔分子感染制御学講座(歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 朝日 陽子 ASAHI Yoko
    • 大阪大学大学院歯学研究科口腔分子感染制御学講座(歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 永山 智崇 NAGAYAMA Tomotaka
    • 大阪大学大学院歯学研究科口腔分子感染制御学講座(歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 野杁 由一郎 NOIRI Yuichiro
    • 大阪大学大学院歯学研究科口腔分子感染制御学講座(歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry
    • 林 美加子 HAYASHI Mikako
    • 大阪大学大学院歯学研究科口腔分子感染制御学講座(歯科保存学教室) Department of Restorative Dentistry and Endodontology, Division of Oral Infections and Disease Control, Osaka University Graduate School of Dentistry

Abstract

目的:Minimal Interventionの概念が普及して,歯髄保存の重要性がより注目される一方で,う蝕象牙質の除去範囲についてはいまだに明確な基準が存在しない.本研究では,う蝕除去後の残存象牙質に対するEr:YAGレーザーの照射が,残存細菌に与える影響について多面的評価を行った.材料と方法:う蝕治療が必要な患歯57歯を対象とした.う蝕検知液にて象牙質が淡いピンク色に染色されるまでう蝕象牙質を除去した後,レーザー照射群(28歯)ではEr:YAGレーザーをう蝕除去後の残存象牙質に照射し,同部の象牙質採取を行い,定性的かつ定量的な細菌学的検索に供した.非照射群(29歯)では,レーザー照射を行わずに象牙質を採取し,レーザー照射群と同様の手順で実験を行った.また,一部の試料では採取した象牙質を共焦点レーザー顕微鏡にて観察した.成績:レーザー照射群・非照射群とも,術後に臨床症状が出現した症例は認めなかった.また,非照射群では69%の試料から細菌が検出されたのに対し,レーザー照射群では43%の試料から細菌が検出され,照射群では有意に残存細菌の検出率が低下していた(p<0.05).一方,細菌が検出された試料で細菌数について評価したところ,非照射群と比較してレーザー照射群では検出された細菌数が有意に減少しており(p<0.05),このことは共焦点レーザー顕微鏡による観察でも確認された.検出された細菌種については,レーザー照射群と非照射群の問で明確な違いは認められなかった.結論:う蝕象牙質除去後の残存細菌に対する殺菌効果について,低出力Er:YAGレーザーの照射は有用であることが明らかとなった.

Purpose: The concept of minimal intervention has become popular and the importance of pulp conservation is now recognized. However, a standard for the removal of dental caries has not yet been determined. In the present study, we qualitatively and quantitatively investigated the effect of Er: YAG laser irradiation on residual bacteria after removal of softened dentin. Methods: Fifty-seven teeth which needed caries treatment were studied. After removing the caries with Caries Detector until the dentin was stained light pink, Er: YAG laser was irradiated to the cavity and the dentin sample was collected. In the control specimens, the dentin specimen was collected without Er: YAG laser irradiation. Then, the number and species of bacteria collected from the sample were evaluated. Some samples were subjected to confocal laser microscopic observation. Results: No patients complained of any clinical symptoms in either the experimental group or control group. In the control group, residual bacteria were detected in 69% of samples, whereas in the Er: YAG laser irradiated group the detection rate was only 43 % (p<0.05). The number of bacteria detected in the experimental samples was significantly less than that in the control samples (p<0.05). Confocal microscopic observation showed a similar tendency to these results. We could not find clear differences between the control and experimental groups concerning the species of detected bacteria. Conclusion: Er: YAG laser irradiation after removal of caries effectively reduced residual bacteria in the cavity.

Journal

  • The Japanese Journal of Conservative Dentistry

    The Japanese Journal of Conservative Dentistry 56(1), 1-8, 2013

    The Japanese Society of Conservative Dentistry

References:  29

Codes

  • NII Article ID (NAID)
    110009596775
  • NII NACSIS-CAT ID (NCID)
    AN00191201
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    0387-2343
  • Data Source
    CJP  NII-ELS  J-STAGE 
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