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目的：评价超声预备根管及Ｎｄ：ＹＡＧ 激光照射根管壁后，根管内壁的清洁度和管壁牙本质微结构的变化。方法：１２ 个离体成人上前牙分为４ 组制备根管：手用器械、超声根管治疗仪、手用器械＋ Ｎｄ：ＹＡＧ 激光照射、超声波＋ Ｎｄ：ＹＡＧ 激光照射，扫描电镜下观察并照像记录。结果：手用扩锉预备的根管内壁有涂层污染和病理组织残留；超声波预备后根管内壁清洁、涂层消除，牙本质小管口开放；手用器械或超声制备后辅以适当能量激光照射的管内壁牙本质小管口封闭，管间牙本质熔融，并形成空泡状结晶。结论：超声波预备根管可达到理想的清洁效果，但牙本质小管口开放易造成根管术后渗漏。而Ｎｄ：ＹＡＧ 激光照射有利于封闭牙本质小管口，减少根尖孔渗漏，还具有封闭根管内壁死腔的作用。
OBJECTIVE: To evaluate the cleanliness of the root canal and the changes of the dentin microstructure of the root canal after ultrasonic root canal preparation and Nd: YAG laser irradiation. Methods: Twelve isolated adult upper anterior teeth were divided into 4 groups to prepare root canal: hand instruments, root canal therapy instruments, hand instruments + Nd: YAG laser irradiation, ultrasound + Nd: YAG laser irradiation and scanning electron microscope And photo recording. Results: The inner wall of the root canal prepared by hand expanded file was contaminated by coating and residual of pathological tissue. The inner wall of root canal was cleaned after ultrasonic preparation, the coating was eliminated and the dentinal orifice was opened. After hand or ultrasonic preparation, Irradiated tube dentin tube orifice closed, interdental dentin melting, and the formation of vacuolar crystals. Conclusion: Ultrasonic preparation of root canal can achieve the ideal cleaning effect, but the opening of dentinal tubules can easily lead to postoperative root canal leakage. The Nd: YAG laser irradiation is conducive to the closure of the dentinal orifice, reduce the leakage of apical foramen, also has the role of dead space in the inner wall of the closed root canal.