Chan Kenneth H, Fried Daniel
University of California, San Francisco, San Francisco, CA 94143-0758.
Proc SPIE Int Soc Opt Eng. 2012 Feb 9;8208:82080U-. doi: 10.1117/12.914632.
Lasers can ablate/remove tissue in a non-contact mode of operation and a pulsed laser beam does not interfere with the ability to image the tooth surface, therefore lasers are ideally suited for integration with imaging devices for image-guided ablation. Laser energy can be rapidly and efficiently delivered to tooth surfaces using a digitally controlled laser beam scanning system for precise and selective laser ablation with minimal loss of healthy tissues. Under the appropriate irradiation conditions such laser energy can induce beneficial chemical and morphological changes in the walls of the drilled cavity that can increase resistance to further dental decay and produce surfaces with enhanced adhesive properties to restorative materials. Previous studies have shown that images acquired using near-IR transillumination, optical coherence tomography and fluorescence can be used to guide the laser for selective removal of demineralized enamel. Recent studies have shown that NIR reflectance measurements at 1470-nm can be used to obtain images of enamel demineralization with very high contrast. The purpose of this study was to demonstrate that image guided ablation of occlusal lesions can be successfully carried out using a NIR reflectance imaging system coupled with a carbon dioxide laser operating at 9.3-μm with high pulse repetition rates.
激光可以在非接触操作模式下消融/去除组织，并且脉冲激光束不会干扰对牙齿表面成像的能力，因此激光非常适合与成像设备集成以进行图像引导消融。使用数字控制的激光束扫描系统，可以将激光能量快速有效地传递到牙齿表面，以进行精确和选择性的激光消融，同时使健康组织的损失最小化。在适当的照射条件下，这种激光能量可以在钻孔腔壁上诱导有益的化学和形态变化，从而增加对进一步龋齿的抵抗力，并产生对修复材料具有增强粘附特性的表面。先前的研究表明，使用近红外透照、光学相干断层扫描和荧光获得的图像可用于引导激光选择性去除脱矿釉质。最近的研究表明，1470纳米的近红外反射测量可用于获得具有非常高对比度的釉质脱矿图像。本研究的目的是证明使用近红外反射成像系统与工作在9.3微米、具有高脉冲重复率的二氧化碳激光相结合，可以成功地进行图像引导的咬合面病变消融。
