Florian Schelle

Transmission of 1064 nm laser radiation during ablation with an ultra-short pulse laser (USPL) system

During ablation of oral hard tissue with an USPL system a small amount of the incident laser power does not contribute to the ablation process and is being transmitted. Partial transmission of ultra-short laser pulses could potentially affect the dental pulp. The aim of this study was to assess the transmission during ablation and to deduce possible risks for the patient. The study was performed with an Nd:YVO4 laser, emitting pulses with a duration of 8 ps at a wavelength of 1064 nm. A repetition rate of 500 kHz and an average power of 9 W were chosen to achieve high ablation efficiency. A scanner system created square cavities with an edge length of 1 mm. Transmission during ablation of mammoth ivory and dentin slices with a thickness of 2 mm and 5 mm was measured with a power meter, placed directly beyond the samples. Effects on subjacent blood were observed by ablating specimens placed in contact to pork blood. In a separate measurement the temperature increase during ablation was monitored using an infrared camera. The influence of transmission was assessed by tuning down the laser to the corresponding power and then directly irradiating the blood. Transmission during ablation of 2 mm specimens was about 7.7% (ivory) and 9.6% (dentin) of the incident laser power. Ablation of specimens directly in contact to blood caused coagulation at longer irradiation times (t≈18s). Direct irradiation of blood with the transmitted power provoked bubbling and smoke formation. Temperature measurements identified heat generation as the main reason for the observed coagulation.

Influence of USP laser radiation on cell morphology: HaCat and MG-63 cell lines for bone and soft tissue modelling in dentistry

Due to the high intensities of USP laser radiation, the interaction with matter is always attended with a plasma formation. Therefore the surrounding tissue can be influenced by heat generation and additional light emission from the UV up to the near and mid infrared. In dentistry it is of importance that the treatment of bone and soft tissues, i.e. oral mucosa, with a USP laser should not cause any kind of morphological changes on the cell level leading to a delayed wound healing or cell mutation. HaCaT keratinocyte cells were used for epidermal (soft tissue) and MG-63 osteoblast-like cells for hard tissue (bone) modelling. Cell growing was realized on glas cover slips. Irradiation was carried out with a USP Nd:YVO4 laser having a center wavelength at 1064 nm. Based on the pulse duration of 8 ps and a pulse repetition rate of 500 kHz the laser emits an average power of 9 W. For efficiency testing of cell removal on glas cover slips, 1, 5, 25, 50 and 75 repetitions of the scanning pattern (scan loops) were used. Heat distribution during laser irradiation was measured with an infrared camera system. Subsequently haematoxylin staining and SEM investigations were used to analyse the morphological changes. Differences of cell removal efficiency were observed with repetitions ≤25. Irradiated areas with repetitions ≥50 were cell-free. Additionally, repetitions ≥25 showed side effects for both cell lines. Cell destruction in both cell lines could be verified using the haematoxylin staining and the SEM pictures.

A USPL functional system with articulated mirror arm for in-vivo applications in dentistry

Ultra-short pulsed laser (USPL) systems for dental application have overcome many of their initial disadvantages. However, a problem that has not yet been addressed and solved is the beam delivery into the oral cavity. The functional system that is introduced in this study includes an articulated mirror arm, a scanning system as well as a handpiece, allowing for freehand preparations with ultra-short laser pulses. As laser source an Nd:YVO4 laser is employed, emitting pulses with a duration of tp < 10 ps at a repetition rate of up to 500 kHz. The centre wavelength is at 1064 nm and the average output power can be tuned up to 9 W. The delivery system consists of an articulated mirror arm, to which a scanning system and a custom made handpiece are connected, including a 75 mm focussing lens. The whole functional system is compact in size and moveable. General characteristics like optical losses and ablation rate are determined and compared to results employing a fixed setup on an optical table. Furthermore classical treatment procedures like cavity preparation are being demonstrated on mammoth ivory. This study indicates that freehand preparation employing an USPL system is possible but challenging, and accompanied by a variety of side-effects. The ablation rate with fixed handpiece is about 10 mm3/min. Factors like defocussing and blinding affect treatment efficiency. Laser sources with higher average output powers might be needed in order to reach sufficient preparation speeds.

Particle characteristics of different materials after ultra-short pulsed laser (USPL) irradiation

The exposition of nanoparticles caused by laser application in dental health care is an open discussion. Based on the fact that nanoparticles can penetrate through the mucosa, the knowledge about particle characteristics after irradiation with an USPL is of high importance. Therefore, the aim of this study was to investigate the particle characteristics, especially the size of the ablated debris after USPL irradiation. The irradiation was carried out with an USP Nd:YVO4 laser with a center wavelength of 1064 nm. Based on the pulse duration of 8 ps and a pulse repetition rate of 500 kHz the laser emits an average power of 9 W. The materials investigated were dental tissues and dental restorative materials (composite and amalgam), ceramic and different metals (gold and aluminium). The samples were irradiated with a power density in the order of 300 GW/cm2 at distances of 5, 10, 15, and 20 mm. The debris was collected on an object plate. SEM pictures were used for analysis of the ablation debris. Depending on the irradiated material, we observed different kinds of structures: vitreous, flocculent, and pellet-like. The mean particle sizes were 10 x 10 up to 30 x 30 μm2. In addition, a cluster of ablated matter (nanometer range) distributed over the whole irradiated area was found. With increasing distances the cluster structure reduced from multi-layer to mono-layer clusters. Particle sizes in the micrometer and nanometer range were found after irradiation with an USPL. The nanoparticles create a cluster structure which is influenced by increasing distances.

Erratum to: Ablation of carious dental tissue using an ultrashort pulsed laser (USPL) system.

The published online version contains mistake in the author group section. Dr. Brede, Dr. Braun, and Dr. Schelle have contributed to the study. After the investigation conducted, it is found that the authors deserved to be recognized and earned them the right to authorship. Hence, the corresponding author, Dr. Frentzen decided to include the authors to give credit to their contribution. The corrected author group section is shown above and in the affiliation section below.

Fluorescence-based calculus detection using a 405-nm excitation wavelength

The aim of this study was to assess the difference of fluorescence signals of cement and calculus using a 405 nm excitation wavelength. A total number of 20 freshly extracted teeth was used. The light source used for this study was a blue LED with a wavelength of 405nm. For each tooth the spectra of calculus and cementum were measured separately. Fluorescence light was collimated into an optical fibre and spectrally analyzed using an echelle spectrometer (aryelle 200, Lasertechnik Berlin, Germany) with an additionally bandpass (fgb 67, Edmund Industrial Optics, Karlsruhe, Germany). From these 40 measurements the median values were calculated over the whole spectrum, leading to two different median spectra, one for calculus and one for cementum. For further statistical analysis we defined 8 areas of interest (AOI) in wavelength regions, showing remarkable differences in signal strength. In 7 AOIs the intensity of the calculus spectrum differed statistically significant from the intensity of the cementum spectrum (p < 0.05). A spectral difference could be shown between calculus and cement between 600nm and 700nm. Thus, we can conclude that fluorescence of calculus shows a significant difference to the fluorescence of cement. A differentiation over the intensity is possible as well as over the spectrum. Using a wavelength of 405nm, it is possible to distinguish between calculus and cement. These results could be used for further devices to develop a method for feedback controlled calculus removal.

Detection of calculus by laser-induced breakdown spectroscopy (LIBS) using an ultra-short pulse laser system (USPL)

The aim of this study was to assess the detection of calculus by Laser Induced Breakdown Spectroscopy (LIBS). The study was performed with an Nd:YVO4 laser, emitting pulses with a duration of 8 ps at a wavelength of 1064 nm. A repetition rate of 500 kHz at an average power of 5 W was used. Employing a focusing lense, intensities of the order of 1011 W/cm2 were reached on the tooth surface. These high intensities led to the generation of a plasma. The light emitted by the plasma was collimated into a fibre and then analyzed by an echelle spectroscope in the wavelength region from 220 nm - 900 nm. A total number of 15 freshly extracted teeth was used for this study. For each tooth the spectra of calculus and cementum were assessed separately. Comprising all single measurements median values were calculated for the whole spectrum, leading to two specific spectra, one for calculus and one for cementum. For further statistical analysis 28 areas of interest were defined as wavelength regions, in which the signal strength differed regarding the material. In 7 areas the intensity of the calculus spectrum differed statistically significant from the intensity of the cementum spectrum (p < 0.05). Thus it can be concluded that Laser Induced Breakdown Spectroscopy is well suited as method for a reliable diagnostic of calculus. Further studies are necessary to verify that LIBS is a minimally invasive method allowing a safe application in laser-guided dentistry.

Heat generation caused by ablation of dental restorative materials with an ultra short pulse laser (USPL) system

The aim of this study was to assess heat generation in dental restoration materials following laser ablation using an Ultra Short Pulse Laser (USPL) system. Specimens of phosphate cement (PC), ceramic (CE) and composite (C) were used. Ablation was performed with an Nd:YVO4 laser at 1064 nm and a pulse length of 8 ps. Heat generation during laser ablation depended on the thickness of the restoration material. A time delay for temperature increase was observed in the PC and C group. Employing the USPL system for removal of restorative materials, heat generation has to be considered.