DOI QR코드

DOI QR Code

임플란트 주위염 치료용 diode laser의 파장 및 조사시간에 따른 온도 변화와 살균효과 분석

Analysis of temperature changes and sterilization effect of diode laser for the treatment of peri-implantitis by wavelength and irradiation time

  • 설정환 (서울대학교 치의학대학원 치과보철학교실) ;
  • 이준재 (서울대학교 치의학대학원 치과보철학교실) ;
  • 금기연 (서울대학교 치과병원 치과보존학교실) ;
  • 이종호 (서울대학교 치과병원 구강악안면외과) ;
  • 임영준 (서울대학교 치의학대학원 치과보철학교실)
  • Seol, Jeong-Hwan (Department of Prosthodontics, School of Dentistry, Seoul National University) ;
  • Lee, Jun Jae (Department of Prosthodontics, School of Dentistry, Seoul National University) ;
  • Kum, Kee-Yeon (Department of Conservative Dentistry and Dental Research Institute, Seoul National University) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, Clinical Trial Center, Seoul National University) ;
  • Lim, Young-Joon (Department of Prosthodontics, School of Dentistry, Seoul National University)
  • 투고 : 2017.04.24
  • 심사 : 2017.07.22
  • 발행 : 2017.09.30

초록

목적:본 연구에서는 새로 개발된 다이오드 레이저 제품을 이용하여 레이저 파워에 따른 온도변화와 박테리아 멸균 비교실험을 통하여 기존 제품과의 임플란트 주위염치료에 대한 효과를 비교 실험하였다. 연구 재료 및 방법: 808 nm Diode laser와 810 nm Diode laser를 사용하여 디스크에 레이저를 60초간 조사하였으며, 출력은 1 - 2.5 W로 설정하였다. 온도측정 모듈과 온도측정 프로그램을 이용하여 disc 표면온도변화를 측정하였다. 또한, SLA, RBM이 코팅된 disc에 bacteria 도포 후, 808 nm Diode laser를 30초간 조사하였으며, 출력은 0.5 - 3 W로 설정하였다. 결과: 808 nm, 810 nm 두 장치 모두 출력이 증가함에 따라 온도 상승폭은 증가하였다. 모든 조건에서 810 nm laser를 조사하였을 때 초기온도상승속도, 하강속도 및 전후의 온도변화량은 808 nm laser 보다 높았다. 레이저 조사 후 티타늄 디스크 표면의 변화는 두 레이저 모두에서 관찰되지 않았다. Bacteria가 도포된 디스크에 808 nm laser를 조사한 결과, 출력이 증가 함에 따라 살균효과가 증가하는 것을 확인하였다. 결론: Diode laser를 임상에 적용하는 경우, 동일한 출력에서 온도의 변동폭이 적고 최대 상승온도가 낮은 808 nm laser가 환자에 안전할 것으로 사료된다. 하지만 실제로 임상에 적용하기 위해서는 보다 다양한 안전성평가를 실시하여 장비에 대한 신뢰성을 확보하여야 할 것이다.

Purpose: We compared the effects of newly developed diode laser (Bison 808 nm Diode laser) on the treatment of peri-implantitis with conventional products (Picasso 810 nm Diode laser) by comparing the surface temperature of titanium disc and bacterial sterilization according to laser power. Materials and Methods: The titanium disc was irradiated for 60 seconds and 1 - 2.5 W using diode laser 808 nm and 810 nm. The surface temperature of the titanium disc was measured using a temperature measurement module and a temperature measurement program. In addition, in order to investigate the sterilizing effect according to the laser power, 808 nm laser was irradiated after application of bacteria to sandblasted large-grit acid-etched (SLA) and resorbable blast media (RBM) coated titanium discs. The irradiated disks were examined with scanning electron microscopy. Results: Both 808 nm and 810 nm lasers increased disk surface temperature as the power increased. When the 810 nm was irradiated under all conditions, the initial temperature rise rate, the descending rate, and the temperature change before and after was higher than that of 808 nm. Disk surface changes were not observed on both lasers at all conditions. Bacteria were irradiated with 808 nm, and the bactericidal effect was increased as the power increased. Conclusion: When applying these diode lasers to the treatment of peri-implantitis, 808 nm which have a bactericidal effect with less temperature fluctuation in the same power conditions would be considered safer. However, in order to apply a laser treatment in the dental clinical field, various safety and reliability should be secured.

키워드

참고문헌

  1. Ishikawa I, Aoki A, Takasaki AA, Mizutani K, Sasaki KM, Izumi Y. Application of lasers in periodontics: true innovation or myth? Periodontol 2000 2009;50:90-126. https://doi.org/10.1111/j.1600-0757.2008.00283.x
  2. Dortbudak O, Haas R, Bernhart T, Mailath-Pokorny G. Lethal photosensitization for decontamination of implant surfaces in the treatment of periimplantitis. Clin Oral Implants Res 2001;12:104-8. https://doi.org/10.1034/j.1600-0501.2001.012002104.x
  3. Schwarz F, Sculean A, Rothamel D, Schwenzer K, Georg T, Becker J. Clinical evaluation of an Er:YAG laser for nonsurgical treatment of periimplantitis: a pilot study. Clin Oral Implants Res 2005;16:44-52.
  4. Atieh MA, Alsabeeha NH, Faggion CM Jr, Duncan WJ. The frequency of peri-implant diseases: a systematic review and meta-analysis. J Periodontol 2013;84:1586-98.
  5. Lindhe J, Meyle J; Group D of European Workshop on Periodontology. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008;35:282-5. https://doi.org/10.1111/j.1600-051X.2008.01283.x
  6. Froum SJ, Rosen PS. A proposed classification for peri-implantitis. Int J Periodontics Restorative Dent 2012;32:533-40.
  7. Esposito M, Grusovin MG, Kakisis I, Coulthard P, Worthington HV. Interventions for replacing missing teeth: treatment of peri implantitis. Cochrane Database Syst Rev 2008 Apr 16;(2):CD004970. doi: 10.1002/14651858.CD004970.pub3.
  8. Ntrouka VI, Slot DE, Louropoulou A, Van der Weijden F. The effect of chemotherapeutic agents on contaminated titanium surfaces: a systematic review. Clin Oral Implants Res 2011;22:681-90. https://doi.org/10.1111/j.1600-0501.2010.02037.x
  9. Kotsovilis S, Karoussis IK, Trianti M, Fourmousis I. Therapy of peri-implantitis: a systematic review. J Clin Periodontol 2008;35:621-9. https://doi.org/10.1111/j.1600-051X.2008.01240.x
  10. Tosun E, Tasar F, Strauss R, Kivanc DG, Ungor C. Comparative evaluation of antimicrobial effects of Er:YAG, diode, and CO2 lasers on titanium discs: and experimental study. J Oral Maxillofac Surg 2012;70:1064-9. https://doi.org/10.1016/j.joms.2011.11.021
  11. Stubinger S, Etter C, Miskiewicz M, Homann F, Saldamli B, Wieland M, Sader R. Surface alterations of polished and sandblasted and acid-etched titanium implants after Er:YAG, carbon dioxide, and diode laser irradiation. Int J Oral Maxillofac Implants 2010;25:104-11.
  12. Park JH, Heo SJ, Koak JY, Kim SK, Han CH, Lee JH. Effects of laser irradiation on machined and anodized titanium disks. Int J Oral Maxillofac Implants 2012;27:265-72.
  13. Kreisler M, Al Haj H, Gotz H, Duschner H, d'Hoedt B. Effect of simulated $CO_{2}$ and GaAlAs laser surface decontamination on temperature changes in Ti-Plasma sprayed dental implants. Lasers Surg Med 2002;30:233-9. https://doi.org/10.1002/lsm.10025
  14. Kim JH, Choi BK, Choi SH, Cho KS, Chai JK, Kim CK. Ribotyping of Porphyromonas Gingivalis isolated from rapidly progressive periodontitis patients. J Korean Acad Periodontol 1999;29:963-77. https://doi.org/10.5051/jkape.1999.29.4.963
  15. Kim SY, Woo DH, Lee MA, Kim JS, Lee JH, Jeong SH. Red fluorescence of oral bacteria interacting with Porphyromonas gingivalis. J Korean Acad Oral Health 2017;41:22-7. https://doi.org/10.11149/jkaoh.2017.41.1.22
  16. Peck SY, Ku Y, Rhyu IC, Hahm BD, Han SB, Choi SM, Chung CP. The frequency of detecting Prevotella intermedia and Prevotella nigrescens in Korean adult periodontitis patients. J Korean Acad Periodontol 2000;30:419-27. https://doi.org/10.5051/jkape.2000.30.2.419
  17. Romanos GE, Everts H, Nentwig GH. Effects of diode and Nd:YAG laser irradiation of titanium discs: a scanning electron microscope examination. J Periodontol 2000;71:810-5. https://doi.org/10.1902/jop.2000.71.5.810
  18. Slater SC, Voige WH, Dennis DE. Cloning and expression in Escherichia coli of the Alcaligenes eutrophus H16 poly-beta-hydroxybutyrate biosynthetic pathway. J Bacteriol 1988;170:4431-6. https://doi.org/10.1128/jb.170.10.4431-4436.1988
  19. McDaniel TK, Kaper JB. A cloned pathogenicity island from enteropathogenic Escherichia coli confers the attaching and effacing phenotype on E. coli K 12. Mol Microbiol 1997;23:399-407. https://doi.org/10.1046/j.1365-2958.1997.2311591.x
  20. Cooper GM. The cell: a molecular approach. 4th ed. Sunderland; Sinauer Associates, Inc; 2007. p 43-73.
  21. Lee KJ, Lee JH, Kum KY, Lim YJ. Laser therapy in peri-implantitis treatment: literature review. J Dent Rehabil Appl Sci 2015;31:340-8. https://doi.org/10.14368/jdras.2015.31.4.340
  22. Kreisler M, Kohnen W, Marinello C, Gotz H, Duschner H, Jansen B, D'Hoedt B. Bactericidal effect of the Er: YAG laser on dental implant surfaces: an in vitro study. J Periodontol 2002;73:1292-8. https://doi.org/10.1902/jop.2002.73.11.1292
  23. Koo PM, Lee DW. The diagnosis and treatment of peri-implantitis. J Dent Implant Res 2015;34:76-80.
  24. Oh WS, Ryu JJ, Ji S. Microbiology of Peri-implantitis. J Dent Implant Res 2013;32:1-6.