지각과민치아에 대한 Nd:YAG 레이저 조사의 효과

Desensitizing Effects of a Nd:YAG Laser Irradiation on Hypersensitive Dentine

  • 정성용 (부산대학교 치과대학 구강내과학교실) ;
  • 김경희 (부산대학교 치과대학 구강내과학교실) ;
  • 고명연 (부산대학교 치과대학 구강내과학교실) ;
  • 안용우 (부산대학교 치과대학 구강내과학교실) ;
  • 박준상 (부산대학교 치과대학 구강내과학교실)
  • Jung, Sung-Yong (Department of Oral Medicine, College of Dentistry, Pusan National University) ;
  • Kim, Kyoung-Hee (Department of Oral Medicine, College of Dentistry, Pusan National University) ;
  • Ko, Myong-Yun (Department of Oral Medicine, College of Dentistry, Pusan National University) ;
  • Ahn, Yong-Woo (Department of Oral Medicine, College of Dentistry, Pusan National University) ;
  • Park, Jun-Sang (Department of Oral Medicine, College of Dentistry, Pusan National University)
  • 발행 : 2005.12.30

초록

냉온자극 또는 잇솔질에 불편감을 호소하는 치과 외래 환자를 72명을 대상으로 레이저 조사를 시행한 실험군(45명)과 모의 레이저 조사를 시행한 대조군(27명)으로 나누어 지각 과민 치아의 치경부에 냉자극 및 기계적 자극을 가하여 대상자가 느끼는 불편감을 NPS로 평가하였다. 치아의 통증역치 평가를 위하여 전기치수검사기(EPT)를 사용하였다. 각 치아에 대한 레이저 조사에는 pulsed Nd:YAG 레이저를 사용하였고 조사조건은 1.5W, 20Hz, 75mJ/pulse으로 4분간 비접촉식으로 시행하였다. 대상자의 반응을 레이저 조사 전과 직후, 1주 이내, 2주 이내 각각 평가하여 다음과 같은 결과를 얻었다. 1. 지각 과민 치아에 대한 Nd:YAG 레이저 조사는 지각 과민을 완화시켜 주었으며 대조군에 비해 그 효과가 현저하였다. 2. 심한 지각 과민을 호소하는 치아에 대한 위약 효과는 존재하였으나 중등도의 지각 과민을 호소하는 치아에 대한 위약효과는 배제할 수 있었다. 3. 지각 과민 치아에 대한 Nd:YAG 레이저 조사는 전기치수검사에 의한 통증역치에 영향을 주지 않았다. 4. 지각 과민 치아에 대한 Nd:YAG 레이저 조사의 효과는 최소 2주는 지속되었다. 따라서 지각 과민 치아에 대한 치료법의 하나로 Nd:YAG 레이저 조사가 임상적으로 유용할 것으로 사료된다.

The purpose of this study was to evaluate the desensitizing effects of a Nd:YAG laser (Sunlase, SUNRISE Technologies, Inc., USA) irradiation on cervically exposed hypersensitive dentine. 45 patients was irradiated with pulsed Nd:YAG laser (1.5 W, 20 Hz, 75 mJ/pulse, 4 minutes) as the experimental group, 27 patients was mock irradiated as the control group. The degree of sensitivity to the thermal and tactile stimuli were determined qualitatively with an evaporative stimulus defined as two times air blast at a distance of 3 mm from each site to be tested and with a mechanical stimulus as a slightly scratching the cervical site with a dental explorer. A qualitative registration of the degree of discomfort was determined according to a numerical pain scale(NPS) in an 11-point scale in which 0= "no pain" and 10="most excruciating pain imaginable". Recordings were assessed before treatment, immediately after, 1 and 2 weeks after treatment. Pain tolerance threshold and pulp vitality were evaluated with electric pulp tester before and immediately after treatment. 1. Desensitizing of hypersensitive dentine with Nd:YAG laser irradiation was more effective than that with mock irradiation. 2. The placebo effect of mock irradiation was recognized for severe sensitive teeth($NPS\;{\geqq}\;6$), but not for moderate sensitive teeth(NPS < 6). 3. Laser irradiation did not affect the pain tolerance threshold and pulp vitality of the hypersensitive teeth. 4. Desensitizing effect of laser irradiation for the hypersensitive teeth had been continuing at least 2 weeks. It was concluded that desensitizing of hypersensitive dentine with a Nd:YAG laser is effective and the maintenance of the positive result was more prolonged than the placebo effect.

키워드

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