A new sealed RF-excited CO2 laser for hard tissue ablation operating at 9.4μm with pulse duration of 26 μs

Several studies over the past 20 years have shown that carbon dioxide lasers operating at wavelengths between 9.3 and 9.6-μm with pulse durations near 20-μs are ideal for hard tissue ablation. Those wavelengths are coincident with the peak absorption of the mineral phase. The pulse duration is close to the thermal relaxation time of the deposited energy of a few microseconds which is short enough to minimize peripheral thermal damage and long enough to minimize plasma shielding effects to allow efficient ablation at practical rates. The desired pulse duration near 20-μs has been difficult to achieve since it is too long for transverse excited atmospheric pressure (TEA) lasers and too short for radio-frequency (RF) excited lasers for efficient operation. Recently, Coherent Inc. (Santa Clara, CA) developed the Diamond J5-V laser for microvia drilling which can produce laser pulses greater than 100-mJ in energy at 9.4-μm with a pulse duration of 26-μs and it can achieve pulse repetition rates of 3 KHz. We report the first results using this laser to ablate dental enamel. Efficient ablation of dental enamel is possible at rates exceeding 50-μm per pulse. This laser is ideally suited for the selective ablation of carious lesions

Influence of a pulsed CO2 laser operating at 9.4 μm on the surface morphology, reflectivity, and acid resistance of dental enamel below the threshold for melting

Below the threshold for laser ablation, the mineral phase of enamel is converted into a purer phase hydroxyapatite with increased acid resistance. Studies suggest the possibility of achieving the conversion without visible surface alteration. In this study, changes in the surface morphology, reflectivity, and acid resistance were monitored with varying irradiation intensity. Bovine enamel specimens were irradiated using a CO 2 laser operating at 9.4 ?? ? m with a Gaussian spatial beam profile—1.6 to 3.1 mm in diameter. After laser treatment, samples were subjected to demineralization to simulate the acidic intraoral conditions of dental decay. The resulting demineralization and erosion were assessed using polarization-sensitive optical coherence tomography, three-dimensional digital microscopy, and polarized light microscopy. Distinct changes in the surface morphology and the degree of inhibition were found within the laser-treated area in accordance with the laser intensity profile. Subtle visual changes were noted below the melting point for enamel that appear to correspond to thresholds for denaturation of the organic phase and thermal decomposition of the mineral phase. There was significant protection from laser irradiation in areas in which the reflectivity was not increased significantly, suggesting that aesthetically sensitive areas of the tooth can be treated for caries prevention

Influence of multi‐wavelength laser irradiation of enamel and dentin surfaces at 0.355, 2.94, and 9.4 μm on surface morphology, permeability, and acid resistance

ObjectiveUltraviolet (UV) and infrared (IR) lasers can be used to specifically target protein, water, and mineral, respectively, in dental hard tissues to produce varying changes in surface morphology, permeability, reflectivity, and acid resistance. The purpose of this study was to explore the influence of laser irradiation and topical fluoride application on the surface morphology, permeability, reflectivity, and acid resistance of enamel and dentin to shed light on the mechanism of interaction and develop more effective treatments.MethodsTwelve bovine enamel surfaces and twelve bovine dentin surfaces were irradiated with various combinations of lasers operating at 0.355 (Freq.-tripled Nd:YAG (UV) laser), 2.94 (Er:YAG laser), and 9.4 μm (CO2 laser), and surfaces were exposed to an acidulated phosphate fluoride gel and an acid challenge. Changes in the surface morphology, acid resistance, and permeability were measured using digital microscopy, polarized light microscopy, near-IR reflectance, fluorescence, polarization sensitive-optical coherence tomography (PS-OCT), and surface dehydration rate measurements.ResultsDifferent laser treatments dramatically influenced the surface morphology and permeability of both enamel and dentin. CO2 laser irradiation melted tooth surfaces. Er:YAG and UV lasers, while not melting tooth surfaces, showed markedly different surface roughness. Er:YAG irradiation led to significantly rougher enamel and dentin surfaces and led to higher permeability. There were significant differences in acid resistance among the various treatment groups.ConclusionSurface dehydration measurements showed significant changes in permeability after laser treatments, application of fluoride and after exposure to demineralization. CO2 laser irradiation was most effective in inhibiting demineralization on enamel while topical fluoride was most effective for dentin surfaces. Lasers Surg. Med. 49:913-927, 2017. © 2017 Wiley Periodicals, Inc