国际口腔医学杂志

国际口腔医学杂志 ›› 2023, Vol. 50 ›› Issue (2): 195-202.doi: 10.7518/gjkq.2023034

• 综述 • 上一篇    下一篇

磷酸钛氧钾激光在牙齿漂白治疗中的研究进展

赵雅丽1(),王植2,高阳3,辛鹏飞3,张宽收2,刘青梅1,3()   

  1. 1.山西医科大学口腔医学院 太原 030001
    2.山西大学光电研究所量子光学与光量子器件国家重点实验室;山西大学极端光学协同创新中心 太原 030006
    3.山西医科大学第三医院（山西白求恩医院·山西医学科学院·同济山西医院）口腔科 太原 030032
  • 收稿日期:2022-08-05 修回日期:2022-12-02 出版日期:2023-03-01 发布日期:2023-03-14
  • 通讯作者: 刘青梅
  • 作者简介:赵雅丽，住院医师，硕士，Email：719941324@qq.com
  • 基金资助:
    山西白求恩医院“烽火计划”人才培养基金(2022FH18);量子光学与光量子器件国家重点实验室（山西大学）开放课题(KF-202105)

Research progress on the application of KTiOPO4 laser in tooth bleaching

Zhao Yali1(),Wang Zhi2,Gao Yang3,Xin Pengfei3,Zhang Kuanshou2,Liu Qingmei1,3()   

  1. 1.Shanxi Medical University School of Stomatology, Taiyuan 030001, China
    2.State Key Laboratory of Quantum Optics and Quantum Optics Devices, Institute of Opto-Electronics & Collaborative Innovation Center of Extreme Optics, Shanxi University, Taiyuan 030006, China
    3.Dept. of Stomatology, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China
  • Received:2022-08-05 Revised:2022-12-02 Online:2023-03-01 Published:2023-03-14
  • Contact: Qingmei Liu
  • Supported by:
    Fund for Shanxi Bethune Hospital “Beacon Project” Talent Training(2022FH18);Open Program of State Key Laboratory of Quantum Optics and Quantum Optics Devices, Shanxi University(KF202105)

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摘要：

激光因其高效、安全、便捷的优势可极大地提高牙齿漂白的临床疗效。目前应用于牙齿漂白的激光种类繁多，其中磷酸钛氧钾（KTP）激光可通过与光敏剂结合应用于牙齿漂白中，引发光动力效应，产生优异的漂白效果，且具有较高的安全性。KTP激光的波长特殊（532 nm），除了上述漂白作用外，可以对四环素着色牙起到直接的光化学氧化作用，有望应用于临床难治性着色牙齿的治疗，尤其是四环素着色牙的治疗。本文就KTP激光漂白的特点、机制、效率、安全性以及与其他激光漂白的比较等进行综述，为KTP激光应用于临床牙齿漂白治疗提供参考。

关键词: 牙齿漂白, 磷酸钛氧钾激光, 光动力效应, 漂白效果

Abstract:

Laser can greatly improve the curative effect of tooth bleaching because of its high efficiency, safety, and convenience. In recent years, many kinds of lasers have been used in tooth bleaching, among which KTiOPO4 laser can be used in combination with a photosensitizer to exhibit a photodynamic effect, produce excellent bleaching effect, and confer higher safety. The special wavelength (532 nm) of this laser can also play a direct role in the photochemical oxidation of tetracycline-stained teeth. KTiOPO4 laser is expected to be used in clinical treatment of refractory tooth coloring, especially in tetracycline-stained teeth. This paper reviews the characteristics, mechanism, efficiency, and safety of KTiOPO4 laser and its comparison with other methods to provide reference for its application in clinical tooth bleaching.

Key words: tooth bleaching, KTiOPO4 laser, photodynamic effect, bleaching effect

中图分类号: 

  • R 781

表 1

常用的牙齿漂白激光类型及其特点"

激光种类波长性质漂白特点常用参数
KTP激光532 nm（可见光波段）组织透过性激光，波长在血红蛋白和黑色素中有较高的吸收峰可通过光热、光氧化（四环素族螯合物）、光动力作用提高漂白效率，牙体组织几乎不吸收该波长的激光，使用较为安全连续波模式，光斑直径6~8 mm，距牙面10~12 mm，功率0.8~1.0 W，照射时间30 s×3[21，25]
Nd: YAG激光1 064 nm（近红外波段）组织透过性激光可通过光热作用提高漂白效率，并可通过止痛作用降低漂白后敏感症状，但可造成髓腔温度较高脉宽60 Hz，光斑直径6 mm，距牙面20 mm，功率8 W，照射时间20 s[8]
半导体激光810 nm（近红外波段）；组织透过性激光可通过诱导止痛、抗炎的生物刺激作用减少漂白术后的敏感性连续波模式，功率1.5 W，距牙面5~6 mm，照射时间30 s[26]；
940 nm（近红外波段）；连续波模式，功率7 W，距牙面1 mm，照射时间30 s[52]；
980 nm（近红外波段）连续波模式，功率7 W，距牙面5 mm，照射时间12 s[53]
Er: YAG激光2 940 nm（中红外波段）组织表面吸收性激光，波长在水和羟磷灰石中有较高的吸收峰激光被漂白凝胶中的水吸收，减少激光向深层组织穿透造成的不利影响；激光照射牙面通过微爆破而产生蚀刻作用，增强了牙面的粘接性能脉冲能量40 mJ，脉冲持续时间1 000 μs，脉宽10 Hz，光斑直径5 mm，距牙面20 mm，照射时间20 s×3[51-52]
CO2激光10 600 nm（远红外波段）组织表面吸收性激光，波长在水和羟磷灰石中有较高的吸收峰用于牙齿漂白可造成髓腔温度升高超过牙髓组织安全阈值，已不建议用于牙齿漂白无
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[1] 张雪雯,李聪,徐小茵,高静,申静. 混合光源系统用于活髓牙漂白的临床研究进展[J]. 国际口腔医学杂志, 2021, 48(6): 683-689.
[2] 姜雪,黄淡远,廖文. 磷酸钛氧钾激光应用于口腔疾病治疗的研究进展[J]. 国际口腔医学杂志, 2019, 46(4): 456-462.
[3] 翁嘉华 麦理想 王大为. 牙齿漂白及其对正畸托槽粘接强度的影[J]. 国际口腔医学杂志, 2013, 40(1): 105-108.
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