Er:YAGレーザーによるファイバー切開と低レベルレーザー治療による切歯回旋の再発抑制効果

Effectiveness of Er:YAG laser-aided fiberotomy and low-level laser therapy in alleviating relapse of rotated incisors.

抄録

はじめに:

本研究では、矯正された切歯回転の再発を減少させるためのレーザー補助円周上ファイバー切開術（CSF）と低レベルレーザー治療（LLLT）の有効性を従来のCSFと比較した。

INTRODUCTION: In this study, we compared the effectiveness of laser-aided circumferential supracrestal fiberotomy (CSF) and low-level laser therapy (LLLT) with conventional CSF in reducing relapse of corrected rotations.

方法:

本研究では、矯正治療の仕上げ段階にあり、治療開始前に少なくとも1本の上顎切歯が30°～70°回転していた24名の患者を対象とした。対象者を治療法別に、従来のCSF、Er:YAGレーザーを用いたCSF、LLLT、コントロールの4群に分けた。アルジネート印象採得後、実験切歯からアーチワイヤーを切り離し、再発させた。1ヵ月後に2回目の印象採得を行い、模型写真から再発の程度と割合を算出した。歯肉退縮、ポケットの深さ、痛みもCSF群で測定した。

METHODS: The study included 24 patients who were at the finishing stage of orthodontic treatment and had at least 1 maxillary incisor with 30° to 70° of rotation before starting therapy. The subjects were divided into 4 groups by treatment: conventional CSF, Er:YAG laser-aided CSF, LLLT, and control. After alginate impressions were taken, the archwire was sectioned from the experimental incisors, and they were allowed to relapse. The second impression was taken 1 month later, and the degree and percentage of relapse were calculated in photographs taken from the dental models. Gingival recession, pocket depth, and pain were also measured in the CSF groups.

結果:

平均再発率は、従来のCSF群で9.7％、Er:YAGレーザー支援CSF群で12.7％、LLLT群で11.7％、対照群で27.8％であった。再発は、実験群よりも対照群で有意に大きかったが（P<0.05）、統計学的な差はなかった。溝の深さと歯肉退縮の変化は小さく、CSF群間で有意差はなかったが（P>0.05）、痛みの強さは従来のCSFを受けた被験者で大きかった（P=0.003）。

RESULTS: The mean percentages of relapse were 9.7% in the conventional CSF, 12.7% in the Er:YAG laser-aided CSF, 11.7% in the LLLT, and 27.8% in the control groups. Relapse was significantly greater in the control than the experimental groups (P <0.05), which were not statistically different from each other. The changes in sulcus depth and gingival recession were small and not significantly different among the CSF groups (P >0.05), but pain intensity was greater in subjects who underwent conventional CSF (P = 0.003).

結論:

Er:YAGレーザー補助CSFは、回転性再発の抑制において、従来のCSFに代わる効果的な方法であることが証明された。エネルギー密度が高すぎるLLLTも、少なくとも短期的には、再発の軽減においてCSF処置と同程度に有効であった。

CONCLUSIONS: Er:YAG laser-aided CSF proved to be an effective alternative to conventional CSF in reducing rotational relapse. LLLT with excessively high energy density was also as effective as the CSF procedures in alleviating relapse, at least in the short term.