Dela Rosa Alfredo, Sarma Anupama V, Le Charles Q, Jones Robert S, Fried Daniel
University of California, San Francisco, San Francisco, California 94143-0758, USA.
Lasers Surg Med. 2004;35(3):214-28. doi: 10.1002/lsm.20090.
It is desirable to minimize peripheral thermal damage during laser irradiation, since thermal damage to collagen and mineral compromises the bond strength to restorative materials in dentin and inhibits healing and osteointegration in bone. There were two primary objectives of this study. The first objective was to measure the degree of thermal damage peripheral to incisions in dentin produced with lasers resonant to the specific absorption bands of water, collagen, and hydroxyapatite with varying pulse duration using polarized-light microscopy (PLM). The second objective was to use synchrotron radiation infrared spectromicroscopy (SR-FTIR) to identify the specific chemical nature of the optical changes observed under PLM in the respective zones of thermal damage peripheral to the laser incisions.
STUDY DESIGN/MATERIALS AND METHODS: Precise incisions were produced in 3 x 3 mm2 blocks of human dentin using CO2 (9.6 microm), Er:YSGG (2.79 microm), and Nd:YAG (355 nm) lasers with and without a computer controlled water-spray. Optical coherence tomography (OCT) was used to obtain optical cross-sections of each incision to determine the rate of ablation. The peripheral thermal damage zone around each incision was analyzed using PLM and SR-FTIR.
Thermally induced chemical changes to both mineral and the collagen matrix were observed with SR-FTIR with a 10 microm spatial resolution and those changes were correlated with optical changes observed with PLM. Minimal (<10 microm) thermal damage was observed for pulse durations less than the thermal relaxation time (Tr) of the deposited laser energy, with and without applied water at 9.6 microm and with only applied water at 2.79 microm. For pulse durations greater than Tr, greater peripheral thermal damage was observed for both IR laser wavelengths with and without the water-spray. There was minimal thermal damage for 355 nm laser pulses less than Tr with and without applied water; however, extensive mechanical damage (cracks) was observed.
High resolution SR-FTIR is well suited for characterization of the chemical changes that occur due to thermal damage peripheral to laser incisions in proteinaceous hard tissues. Sub-microsecond pulsed IR lasers resonant with water and mineral absorption bands ablate dentin efficiently with minimal thermal damage. Similar laser parameters are expected to apply to the ablation of alveolar bone.
在激光照射过程中尽量减少周围组织的热损伤是很有必要的,因为对胶原蛋白和矿物质的热损伤会损害牙本质与修复材料之间的粘结强度,并抑制骨组织的愈合和骨整合。本研究有两个主要目的。第一个目的是使用偏光显微镜(PLM)测量在不同脉冲持续时间下,与水、胶原蛋白和羟基磷灰石的特定吸收带共振的激光在牙本质中产生的切口周围的热损伤程度。第二个目的是使用同步辐射红外光谱显微镜(SR-FTIR)来确定在PLM下观察到的激光切口周围热损伤各区域光学变化的具体化学性质。
研究设计/材料与方法:使用CO2(9.6微米)、Er:YSGG(2.79微米)和Nd:YAG(355纳米)激光,在有或没有计算机控制喷水的情况下,在3×3平方毫米的人牙本质块上制作精确切口。使用光学相干断层扫描(OCT)获取每个切口的光学横截面,以确定消融速率。使用PLM和SR-FTIR分析每个切口周围的热损伤周边区域。
使用SR-FTIR以10微米的空间分辨率观察到了矿物质和胶原蛋白基质的热致化学变化,这些变化与PLM观察到的光学变化相关。对于脉冲持续时间小于所沉积激光能量的热弛豫时间(Tr)的情况,无论有无喷水,在9.6微米波长下热损伤最小(<10微米),在2.79微米波长下仅喷水时热损伤最小。对于脉冲持续时间大于Tr的情况,无论有无喷水,两种红外激光波长下的周边热损伤都更大。对于355纳米激光脉冲,无论有无喷水,脉冲持续时间小于Tr时热损伤最小;然而,观察到了广泛的机械损伤(裂纹)。
高分辨率SR-FTIR非常适合表征蛋白质硬组织中激光切口周围热损伤引起的化学变化。与水和矿物质吸收带共振的亚微秒脉冲红外激光能有效地消融牙本质,同时热损伤最小。预计类似的激光参数也适用于牙槽骨的消融。