Sánchez F, España Tost A J, Morenza J L
Departament de Física Aplicada i Electrònica, Universitat de Barcelona, Spain.
Lasers Surg Med. 1997;21(5):474-9. doi: 10.1002/(sici)1096-9101(1997)21:5<474::aid-lsm9>3.0.co;2-n.
The use of excimer lasers for treatment of dental hard tissues has considerable potential because the combined characteristics of low wavelength and short pulse result in limited heat diffusion and, therefore, tissue ablation without the problems of collateral damage. To date, there are relatively few published studies concerning the effects of excimer laser irradiation on dental hard tissues. Thus the present study was conducted to examine the morphological changes in tooth dentin subsequent to ArF excimer laser irradiation.
STUDY DESIGN/MATERIALS AND METHODS: The morphologic changes induced in normal, nondiseased human dentin following irradiation by an ArF excimer laser at fluences ranging from 1 to 4 J/cm2 and the number of laser pulses ranging from 50 to 1,000 were evaluated by scanning electron microscopy.
Two modes of ablation, photochemical at low fluences and thermal at high fluences, were observed. A fluence of 1 J/ cm2 when combined with 50 or 100 pulses produced a uniform ablation of the dentin surface without signs of tissue melting. At fluences > 1.5 J/cm2, the thermal mode of ablation was more efficient at removing intertubular dentin than peritubular dentin. Further, when compared to the lower fluences, the higher settings produced a rougher ablation crater surface. Additionally, the higher fluences produced surface melting with each pulse and sealing of exposed dentinal tubules after irradiation with 100-300 laser pulses.
The photochemical and thermal mechanisms of tooth dentin ablation were identified based on significant differences in tissue morphology following laser irradiation. The rates of tissue ablation and the observed morphologic changes indicate that the ArF excimer laser could be useful for caries removal and sealing of exposed dentinal tubules.
准分子激光用于治疗牙齿硬组织具有巨大潜力,因为其低波长和短脉冲的综合特性导致热扩散有限,从而实现组织消融且无附带损伤问题。迄今为止,关于准分子激光照射对牙齿硬组织影响的已发表研究相对较少。因此,本研究旨在探讨ArF准分子激光照射后牙本质的形态学变化。
研究设计/材料与方法:通过扫描电子显微镜评估在1至4 J/cm²的能量密度和50至1000个激光脉冲范围内,ArF准分子激光照射正常、未患病的人牙本质所引起的形态学变化。
观察到两种消融模式,低能量密度下为光化学模式,高能量密度下为热模式。1 J/cm²的能量密度与50或100个脉冲结合时,可使牙本质表面均匀消融,无组织熔化迹象。当能量密度>1.5 J/cm²时,热消融模式在去除管间牙本质方面比管周牙本质更有效。此外,与较低能量密度相比,较高设置产生的消融坑表面更粗糙。此外,较高能量密度在每个脉冲时都会产生表面熔化,并且在100 - 300个激光脉冲照射后会封闭暴露的牙本质小管。
基于激光照射后组织形态的显著差异,确定了牙本质消融的光化学和热机制。组织消融速率和观察到的形态学变化表明,ArF准分子激光可用于龋病去除和封闭暴露的牙本质小管。