目的:比较传统旋转器械和Er:YAG激光治疗楔形缺损过程中患者的主观感受及树脂充填后的远期临床疗效。方法:选择35~68岁口内同颌对称性且程度相似的楔形缺损患者26例共104个患牙,采用自身对照法,随机选取一侧作为对照组,机械预备窝洞;另一侧实验组用Er:YAG激光预备窝洞。采用自酸蚀粘结技术,3M复合树脂充填。术后即刻填写调查问卷,对两种方法的疼痛、气味、噪音、恐惧程度及患者的接受程度进行评估,术后1年采用改良的评定系统USPHS对充填体进行临床评价。结果:治疗后即刻问卷调查结果显示:22/26位患者(85%)认为激光备洞较机械备洞疼痛和不适感轻,在下次治疗时更愿意优先选择激光;4/26的患者认为两种治疗方法差别不大。术后1年26例患者中失访2例,其余24例共98个牙复查结果显示:实验组和对照组总有效率分别为86%和88%(P>0.05)。结论:Er:YAG激光在窝洞预备过程中患者感觉更舒适,修复体粘结效果与机械预备相当。 OBJECTIVE: To compare the subjective perceptions of patients with wedge-shaped defects and the long-term clinical efficacy after filling resin with traditional rotary instruments and Er: YAG laser. Methods: A total of 104 teeth were selected from 26 patients with similar degree of wedged defect in oral mandibular symmetry between 35 and 68 years old. The control group was randomly selected as the control group, and the rabbits were mechanically prepared. On the other side of the experimental group Prepare holes with Er: YAG laser. Using self-etching adhesive technology, 3M composite resin filling. Immediately after the completion of the questionnaire to fill in the two methods of pain, odor, noise, fear level and patient acceptance were assessed 1 year after surgery using a modified USPHS evaluation system for clinical evaluation. Results: Immediately after treatment, the results of the questionnaire survey showed that 22/26 (85%) patients thought that the laser hole was lighter and less painful than the mechanical hole, and the laser was preferable to the next treatment. In 4/26 patients, The kind of treatment is not very different. Two patients were lost to follow-up in 26 patients at one year after operation, and the remaining 24 teeth were examined in 98 teeth. The total effective rate was 86% in the experimental group and 88% in the control group (P> 0.05). CONCLUSIONS: Er: YAG laser patients feel more comfortable in the preparation of cavities, and prosthesis bonding results are comparable to mechanical preparation.