BACKGROUND:The methods to remove the smear layer mainly include mechanical, Carisolv chemomechanical, laser, ozone methods and so on. But studies after caries removal are limited. At present, there is no research for the observation of the smear layer after caries removal using Er:YAG laser, Carisolv chemomechanical and traditional dental turbine. OBJECTIVE:To observe the morphologic changes of the dentin smear layer after treated with the three methods of Er:YAG laser, Carisolv chemomechanical and traditional high speed dental turbine under a scanning electron microscope. METHODS:Thirty newly removed premolars or molars with moderate caries were divided into three groups, 10 teeth in each group. The bottom surface of the tooth cavity was observed with the naked eyes after caries removal with Er:YAG laser, Carisolv chemomechanical and traditional dental turbine, respectively. Then, the surface was observed using the scanning electron microscope (magnification ×1 000 and ×2 000). RESULTS AND CONCLUSION:The texture of the tooth cavity was hard in the three groups. After caries removal, the dentin surface of Er:YAG laser group was rough and uneven, and showed a peak-like shape;The dentin surface of Carisolv chemomechanical group was dark and the bottom was flat;The dentin surface of traditional dental turbine group was smooth and bright, and there was an obvious cutting trace. It was found that the surface of Er:YAG laser group did not have the smear layer, and the dentinal tubule was clearly visible. The most dentinal tubules were visible in the Carisolv chemomechanical group, and the surface was covered with a less smear layer. The surface of the traditional dental turbine group was covered with a thick smear layer, and the dentinal tubule was unseen. The differences in dentin smear layer cleanliness were significant between the three groups. These result indicate that Er:YAG laser can effectively remove the smear layer, which is better than Carisolv chemomechanical method and traditional dental turbine. Traditional dental turbine group is the worst among the three methods.%背景：目前去除牙本质玷污层的方法主要有机械去腐法、化学机械去腐法、激光去腐法、空气喷砂去腐法、臭氧去腐法等，但对各去腐方法去腐后效果的研究有限，目前还没有对Er：YAG激光、Carisolv化学机械、传统高速涡轮牙法3种方法去腐后玷污层的效果比较的研究。 目的：应用电子扫描电镜观察 Er：YAG激光、Carisolv化学机械、传统高速涡轮牙钻3种方法去腐后，观察人牙本质玷污层的形态变化。 方法：选择新近拔除的中度龋坏的30颗人前磨牙或磨牙，分为3组，每组10颗，分别用Er：YAG激光、Carisolv化学机械、传统高速涡轮牙钻去腐后，用肉眼观察洞底表面，然后用电子扫描电镜放大1000，2000倍进行观察。 结果与结论：3组去腐后用探针检查窝洞，质地均坚硬，Er：YAG 激光组牙本质表面凸凹不平，似山峰状；Carisolv 化学机械组牙本质表面光泽较暗，底面较平；传统高速涡轮牙钻组牙本质表面平整，光亮，并有明显的切割痕迹。Er：YAG激光组表面无玷污层，牙本质小管清晰可见；Carisolv化学机械组可见大部分牙本质小管，表面覆盖较少的玷污层；传统高速涡轮牙钻组表面覆盖厚厚的一层玷污层，未见牙本质小管，3组间牙本质玷污层清洁度比较差异均有显著性意义(P<0.05)。表明Er：YAG激光能有效去除玷污层，且较Carisolv化学机械、传统高速涡轮牙钻法效果好，传统高速涡轮牙钻法效果最差。
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