de Menezes Rebeca Ferraz, Harvey Catherine Malinda, de Martínez Gerbi Marleny Elizabeth Márquez, Smith Zachary J, Smith Dan, Ivaldi Juan C, Phillips Alton, Chan James W, Wachsmann-Hogiu Sebastian
Department of Endodontics/Restorative Dentistry, University of Pernambuco (UPE), 1650 Gal Newton Cavalcanti Avenue, Camaragibe, PE, 54753-020, Brazil.
Center for Biophotonics, University of California-Davis, 2700 Stockton Blvd, Sacramento, CA, 95817, USA.
J Biophotonics. 2017 Oct;10(10):1292-1304. doi: 10.1002/jbio.201700042. Epub 2017 May 24.
The goal of this work is to investigate the thermal effects of femtosecond laser (fs-laser) ablation for the removal of carious dental tissue. Additional studies identify different tooth tissues through femtosecond laser induced breakdown spectroscopy (fsLIBS) for the development of a feedback loop that could be utilized during ablation in a clinical setting. Scanning Election Microscope (SEM) images reveal that minimal morphological damages are incurred at repetition rates below the carbonization threshold of each tooth tissue. Thermal studies measure the temperature distribution and temperature decay during laser ablation and after laser cessation, and demonstrate that repetition rates at or below 10kHz with a laser fluence of 40 J/cm would inflict minimal thermal damage on the surrounding nerve tissues and provide acceptable clinical removal rates. Spectral analysis of the different tooth tissues is also conducted and differences between the visible wavelength fsLIBS spectra are evident, though more robust classification studies are needed for clinical translation. These results have initiated a set of precautionary recommendations that would enable the clinician to utilize femtosecond laser ablation for the removal of carious lesions while ensuring that the solidity and utility of the tooth remain intact.
这项工作的目标是研究飞秒激光(fs-激光)消融去除龋坏牙体组织的热效应。其他研究通过飞秒激光诱导击穿光谱法(fsLIBS)识别不同的牙齿组织,以开发一种反馈回路,该回路可在临床环境中的消融过程中加以利用。扫描电子显微镜(SEM)图像显示,在低于每种牙齿组织碳化阈值的重复频率下,形态损伤最小。热学研究测量了激光消融期间及激光停止后的温度分布和温度衰减,并表明,在激光能量密度为40 J/cm²时,重复频率为10kHz或更低时,对周围神经组织造成的热损伤最小,并能提供可接受的临床去除率。还对不同的牙齿组织进行了光谱分析,可见波长的fsLIBS光谱之间的差异很明显,不过要实现临床应用还需要更有力的分类研究。这些结果提出了一系列预防性建议,使临床医生能够利用飞秒激光消融去除龋损,同时确保牙齿的坚固性和功能保持完好。