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用超短脉冲激光精确消融牙体硬组织。适当激光参数的初步探索性研究。

Precise ablation of dental hard tissues with ultra-short pulsed lasers. Preliminary exploratory investigation on adequate laser parameters.

机构信息

Post Graduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro 249, 01504-001, São Paulo, SP, Brazil.

出版信息

Lasers Med Sci. 2013 Jan;28(1):171-84. doi: 10.1007/s10103-012-1107-2. Epub 2012 May 8.

Abstract

This study aimed to evaluate the possibility of introducing ultra-short pulsed lasers (USPL) in restorative dentistry by maintaining the well-known benefits of lasers for caries removal, but also overcoming disadvantages, such as thermal damage of irradiated substrate. USPL ablation of dental hard tissues was investigated in two phases. Phase 1--different wavelengths (355, 532, 1,045, and 1,064 nm), pulse durations (picoseconds and femtoseconds) and irradiation parameters (scanning speed, output power, and pulse repetition rate) were assessed for enamel and dentin. Ablation rate was determined, and the temperature increase measured in real time. Phase 2--the most favorable laser parameters were evaluated to correlate temperature increase to ablation rate and ablation efficiency. The influence of cooling methods (air, air-water spray) on ablation process was further analyzed. All parameters tested provided precise and selective tissue ablation. For all lasers, faster scanning speeds resulted in better interaction and reduced temperature increase. The most adequate results were observed for the 1064-nm ps-laser and the 1045-nm fs-laser. Forced cooling caused moderate changes in temperature increase, but reduced ablation, being considered unnecessary during irradiation with USPL. For dentin, the correlation between temperature increase and ablation efficiency was satisfactory for both pulse durations, while for enamel, the best correlation was observed for fs-laser, independently of the power used. USPL may be suitable for cavity preparation in dentin and enamel, since effective ablation and low temperature increase were observed. If adequate laser parameters are selected, this technique seems to be promising for promoting the laser-assisted, minimally invasive approach.

摘要

本研究旨在评估超短脉冲激光(USPL)在修复牙科中的应用可能性,通过保持激光去除龋齿的已知优势,同时克服其缺点,如辐照基底的热损伤。USPL 对牙体硬组织的消融作用在两个阶段进行了研究。第一阶段——不同波长(355、532、1045 和 1064nm)、脉冲持续时间(皮秒和飞秒)和照射参数(扫描速度、输出功率和脉冲重复率)被用于评估牙釉质和牙本质。测定了消融率,并实时测量了温度升高。第二阶段——评估最有利的激光参数,以将温度升高与消融率和消融效率相关联。进一步分析了冷却方法(空气、空气水喷雾)对消融过程的影响。所有测试的参数都提供了精确和选择性的组织消融。对于所有激光,更快的扫描速度导致更好的相互作用和更低的温度升高。1064nm ps 激光和 1045nm fs 激光观察到最适宜的结果。强制冷却导致温度升高适度变化,但降低了消融,因此在 USPL 照射期间被认为是不必要的。对于牙本质,对于两种脉冲持续时间,温度升高与消融效率之间的相关性都令人满意,而对于牙釉质,fs 激光的相关性最好,与使用的功率无关。USPL 可能适用于牙本质和牙釉质的窝洞制备,因为观察到有效的消融和较低的温度升高。如果选择了适当的激光参数,这种技术似乎很有前途,可以促进激光辅助、微创的方法。

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