Selectivity, efficiency, and surface characteristics of hard dental tissues ablated with ArF pulsed excimer lasers

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Abstract
Lasers are finding expanding applications in the field of dentistry. Cutting in soft tissue, hard dental material ablation, caries removal, and root canal therapy are only a few examples of dental laser uses. In this article, the application of short pulse ArF excimer laser to ablation of dentin and enamel is investigated. In particular, the effect of laser pulse repetition rates (PRR) and fluence levels on the efficiency of the ablation process and on the average thermal response of ablated surfaces is investigated. Ablation of dentin was found to be considerably more efficient than the ablation of enamel and depends exponentially on the laser fluence. Both dentin and enamel surfaces showed an increase in surface temperature with repetition rate. At lower PRR, however, temperature increases are very small. Surface temperature was also found to increase with laser fluence, although this increase is very small at laser PRR of 5 Hz or less. Tissue ablation rates were found to be comparable to or better than other nanosecond lasers, and left smooth surfaces, free of thermal damage. Microscopic examination of the ablated surface shows no crack formation, charring, discoloration, or any other thermal damage. The ablated surfaces appear to be very smooth, highly polished, and glossy looking as if they were subjected to thermal melting. This observation is indeed confirmed under scanning electron microscopy (SEM), where evidence of localized melting of the tissue is observed. Furthermore, a close SEM examination of the dentin surface reveals a selectively ablated intertubular dentin, while the remaining pillar-like dentin tubules are sealed off with fused peritubular dentin. At all fluence levels and PRR, the first three to four pulses impinging on an untreated enamel surface produced unusually large plumes of debris which were different in size, texture, and fluorescence emission characteristics from the ablation products of subsequent pulses. It is believed that these different ablation characteristics are a consequence of the pulsed ArF laser's ability to selectively remove residual matter from the more resistant enamel surface.