粘接样本保存方式对Er:YAG激光去除瓷贴面的影响

Effect of Bonded Sample Storage Method on Er:YAG Laser Removal of Porcelain Veneers

摘要: 目的：比较即刻脱粘、24 h生理盐水保存及冷热循环老化(5000次)三种样本保存方式对Er:YAG激光去除瓷贴面脱粘效率的影响。方法：制作标准化瓷贴面(3 mm × 3 mm × 0.5 mm)，将其粘接在离体牙上，按处理方法随机分为三组：A组(粘接后立即激光脱粘)、B组(粘接后生理盐水保存24 h)、C组(粘接后冷热循环5000次，5℃~55℃)。使用Er:YAG激光在100、150、200 mJ三种能量下进行脱粘，记录脱粘时间及成功率。采用Fisher精确检验，双因素方差分析、独立样本t检验进行统计分析。结果：结果显示，保存方法与激光能量均对脱粘效率有显著影响，且二者存在交互作用。在100 mJ能量水平，仅即刻组能够成功脱粘。在150 mJ和200 mJ能量水平，B组与C组的脱粘时间均显著长于A组，而BC两组之间无显著差异。各组内，除A组150 mJ与200 mJ间无统计学差异外，高能量对应的脱粘时间均显著缩短。结论：即刻脱粘样本的激光拆除效率显著高于老化样本，而24 h生理盐水保存与冷热循环老化对脱粘效率的影响无显著差异。体外研究应明确样本保存状态，以利结果比较。

Abstract: Objective: This paper aims to compare the effects of three sample storage methods: immediate debonding, 24-hour saline storage, and thermocycling aging (5000 cycles) on the efficiency of Er:YAG laser removal of porcelain veneers. Methods: Standardized porcelain veneers (3 mm × 3 mm × 0.5 mm) were fabricated and bonded to extracted teeth. Samples were randomly divided into three groups according to storage method: Group A (laser debonding immediately after bonding), Group B (stored in saline for 24 hours after bonding), and Group C (thermocycled for 5000 cycles at 5˚C~55˚C after bonding). An Er:YAG laser was used for debonding at three energy levels (100, 150, and 200 mJ). Debonding time and success rate were recorded. Statistical analyses were performed using Fisher’s exact test, two-way ANOVA, and independent samples t-test. Results: Both storage method and laser energy significantly affected debonding efficiency, and an interaction between the two factors was observed. At 100 mJ, only the immediate debonding group achieved successful debonding. At 150 mJ and 200 mJ, debonding times in Groups B and C were significantly longer than in Group A, while no significant difference was found between Groups B and C. Within each group, higher energy was associated with significantly shorter debonding times, except between 150 mJ and 200 mJ in Group A, where no statistical difference was observed. Conclusion: The laser removal efficiency of immediately debonded samples was significantly higher than that of aged samples, while no significant difference in debonding efficiency was found between 24-hour saline storage and thermocycling aging. In vitro studies should clearly report sample storage conditions to facilitate comparison of results.