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Biomedical subjects

Daniel Fried

Publications and source records attributed to Daniel Fried.

At least 19 recordsLinked to original sources

Adhesion of composite to enamel and dentin surfaces irradiated by IR laser pulses of 0.5-35 micros duration.

The characteristics of laser-treated tooth surfaces depend on the laser wavelength, pulse duration, spatial and temporal laser beam quality, incident fluence, surface roughness, and the presence of water during irradiation. Ablated surfaces are most commonly restored with adhesive dental materials and the characteristics of the ablated surfaces influence adhesion of restorative materials. Previous studies suggest that high bond strengths can be achieved using shorter laser pulses that minimize peripheral thermal damage. In this study, Er:YSGG, Er:YAG, and CO(2) lasers were used at irradiation intensities sufficient to simulate efficient clinical caries removal to uniformly irradiate bovine enamel and human dentin surfaces using a motion control system with a microprocessor-controlled water spray. The degree of spatial overlap of adjacent pulses was varied so as to investigate the influence of irradiation uniformity and surface roughness on the bond strength. Composite resin was bonded to the irradiated surfaces and shear bond tests were used to obtain bond strengths in MPa. The highest results were obtained using the Er:YAG pulses with pulse durations less than 35 mus without the necessity for postirradiation acid etching. Some of these groups were not significantly different from nonirradiated, acid-etch-only positive control groups.

Acrylic Resins↗

Dissolution studies of bovine dental enamel surfaces modified by high-speed scanning ablation with a lambda = 9.3-microm TEA CO(2) laser.

BACKGROUND AND OBJECTIVES: Previous studies have demonstrated that lasers can be used to modify the chemical composition of dental enamel to render the mineral phase more resistant to acid dissolution with minimal peripheral thermal damage. Transverse excited atmospheric (TEA) CO(2) lasers tuned to the strong mineral absorption of hydroxyapatite (HAP) near lambda = 9 microm are well-suited for the efficient ablation of dental hard tissues if the laser-pulse is stretched to greater than 5-10 microseconds to avoid plasma shielding phenomena. Moreover, TEA CO(2) lasers can be operated at very high repetition rates and are inherently less expensive and more versatile than Er:YAG and Er:YSGG solid-state lasers. In this study a lambda = 9.3-microm TEA CO(2) with a pulse duration of 8 microseconds and a repetition rate of 300 Hz was used to uniformly treat bovine enamel surfaces at ablative irradiation intensities. We hypothesized that a uniform surface layer of modified enamel of improved crystallinity and CaP phase composition would be formed with an enhanced resistance to acid-dissolution in the ablated areas at higher scanning rates used with the water spray. Such a modified layer of enamel formed at the base and walls of a cavity preparation under the irradiation conditions employed in this study have the potential to inhibit secondary caries under sealants and restorations. STUDY DESIGN/MATERIALS AND METHODS: The surfaces of bovine enamel blocks (3 x 3 mm(2)) were rapidly scanned across the laser beam at rates of 2, 3, and 6 mm/second with and without a water-spray at an incident fluence of 30 J/cm(2). The resistance to acid dissolution was evaluated using controlled surface dissolution experiments on laser-irradiated and control samples. RESULTS: The groups irradiated at a fluence of 30 J/cm(2) with a repetition rate of 300 Hz and a high scan rate of 6 mm/second with and without water-cooling significantly reduced the overall surface dissolution rates (P < 0.001). At low scan rates (2-3 mm/second) excessive heat deposition resulted in the formation of an outer layer of asperities containing non-apatitic CaP phases that were more susceptible to acid-dissolution. At a scanning rate of 6 mm/second even without the water spray a layer of purer phase HAP was formed without thermal damage, indicating that a high scanning rate can be used to avoid excessive thermal damage during ablation. The best results (80% inhibition) were attained for the higher scanning speed 6-mm/second combined with a water spray. CONCLUSION: This study demonstrates that an enamel surface with enhanced resistance to acid dissolution is produced after ablation with lambda = 9.3-microm TEA CO(2) laser pulses delivered at high-repetition rates if sufficiently high scanning rates are used with or without a water-spray.

Animals↗

Measurement of the severity of natural smooth surface (interproximal) caries lesions with polarization sensitive optical coherence tomography.

BACKGROUND AND OBJECTIVES: Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to image early dental caries. The purpose of this study was to compare the measured reflectivity of natural caries lesions found on smooth surfaces (interproximal lesions) with the mineral loss measured using digital microradiography (DM) in order to determine if PS-OCT can be used as a non-destructive method to measure the severity of dental decay and resolve the internal structure of caries lesions. MATERIALS AND METHODS: A PS-OCT system operating at 1,310 nm was used to acquire polarization resolved images of natural white spot lesions and pigmented lesions on the smooth surfaces of extracted teeth. The integrated reflectivity from lesion areas was compared to polarized light microscopic images (PLM) and to the integrated mineral loss from the same lesion area measured using high resolution DM. RESULTS: The frequently complex internal structure of caries lesions could be resolved with PS-OCT. Such structural information is potentially useful for determining whether or not the lesion is active and progressing or whether it has become arrested and remineralized and does not require intervention. There was a strong correlation between the integrated mineral loss of the caries lesions measured using DM and the integrated reflectivity in the perpendicular polarization axis of the PS-OCT system. CONCLUSIONS: The integrated reflectivity in the perpendicular polarization channel can be used to represent the severity of demineralization in natural early caries lesions. Therefore, PS-OCT has considerable potential as a non-destructive clinical probe of early caries lesions to assess their severity, monitor their progression over-time and potentially assess lesion activity.

Dental Caries↗

Early caries imaging and monitoring with near-infrared light.

Enamel is highly transparent in the near infrared (NIR); therefore, this region of the electromagnetic spectrum is suited ideally for the development of new optical diagnostic tools for the detection and imaging of early dental caries. This article discusses the NIR optical properties of sound and demineralized dental enamel and the potential use of polarization sensitive optical coherence tomography and NIR transillumination for the imaging of dental caries.

Dental Caries↗

Transmission of Q-switched erbium:YSGG (lambda=2.79 microm) and erbium:YAG (lambda=2.94 microm) laser radiation through germanium oxide and sapphire optical fibres at high pulse energies.

The erbium:YSGG and erbium:YAG lasers are used for tissue ablation in dermatology, dentistry and ophthalmology. The purpose of this study was to compare germanium oxide and sapphire optical fibres for transmission of sufficient Q-switched erbium laser pulse energies for potential use in both soft and hard tissue ablation applications. Fibre transmission studies were conducted with Q-switched (500 ns) Er:YSGG (lambda=2.79 microm) and Er:YAG (lambda=2.94 microm) laser pulses delivered at 3 Hz through 1-m-long, 450-mum germanium oxide and 425-mum sapphire optical fibres. Transmission of free-running (300 micros) Er:YSGG and Er:YAG laser pulses was also conducted for comparison. Each set of measurements was carried out on seven different sapphire or germanium fibres, and the data were then averaged. Fibre attenuation of Q-switched Er:YSGG laser energy measured 1.3+/-0.1 dB/m and 1.0+/-0.2 dB/m for the germanium and sapphire fibres, respectively. Attenuation of Q-switched Er:YAG laser energy measured 0.9+/-0.3 dB/m and 0.6+/-0.2 dB/m, respectively. A maximum Q-switched Er:YSGG pulse energy of 42 mJ (26-30 J/cm(2)) was transmitted through the fibres. However, fibre tip damage was observed at energies exceeding 25 mJ (n=2). Both germanium oxide and sapphire optical fibres transmitted sufficient Q-switched Er:YSGG and Er:YAG laser radiation for use in both soft and hard tissue ablation. This is the first report of germanium and sapphire fibre optic transmission of Q-switched erbium laser energies of 25-42 mJ per pulse.

Aluminum Oxide↗

Pulpal safety of 9.6 microm TEA CO2 laser used for caries prevention.

BACKGROUND AND OBJECTIVES: Lasers are used for several procedures involving hard and soft tissues of the oral cavity. A potential future application is the use of the CO2 laser to alter the surface structure of tooth enamel to render it more resistant to caries. A new 9.6 microm wavelength transverse excited atmospheric pressure (TEA) CO2 laser (Argus Photonics, Jupiter, FL) has been investigated as a device that can be used for this purpose without harming the dental pulp. STUDY DESIGN/MATERIALS AND METHODS: Erupted caries- and restoration-free third molars (n = 24 participants; 74 teeth) were used in the study. Teeth were irradiated at an incident fluence of 1.5 J/cm2, a repetition rate of 10 Hz and a spot size 1 mm in diameter. At the low and high settings, 200-400 pulses at 5-8 microseconds pulse duration were delivered at 12 mJ per pulse for a total energy of 2.4 or 4.8 J delivered for 20 or 40 seconds, respectively. Other teeth were subjected to a sham dental procedure (positive control) or no procedure (negative control). Prior to testing, radiographs were taken of all teeth, and they were assessed pulpally using heat, cold, and electricity to determine vitality. The teeth were removed either immediately or at 1 week or 1 month after testing. RESULTS: Teeth were bioprepared and examined histologically for signs of inflammation. Only one tooth developed symptoms of sensitivity to cold for 10 days following exposure to the high power level. The sensitivity was of fleeting duration and was judged to be reversible pulpitis. All teeth tested responded normally at pre-testing and pre-extraction time periods. Histological examination of all teeth disclosed no indication of an inflammatory response in the pulp tissue at any time point. All sections appeared normal with no changes seen in the normal pulpal morphology. CONCLUSIONS: We conclude that the 9.6 microm wavelength laser causes no permanent/serious pulpal damage at the energy levels used and can be used safely for caries prevention treatments in humans.

Adult↗

Peripheral thermal and mechanical damage to dentin with microsecond and sub-microsecond 9.6 microm, 2.79 microm, and 0.355 microm laser pulses.

BACKGROUND AND OBJECTIVES: It is desirable to minimize peripheral thermal damage during laser irradiation, since thermal damage to collagen and mineral compromises the bond strength to restorative materials in dentin and inhibits healing and osteointegration in bone. There were two primary objectives of this study. The first objective was to measure the degree of thermal damage peripheral to incisions in dentin produced with lasers resonant to the specific absorption bands of water, collagen, and hydroxyapatite with varying pulse duration using polarized-light microscopy (PLM). The second objective was to use synchrotron radiation infrared spectromicroscopy (SR-FTIR) to identify the specific chemical nature of the optical changes observed under PLM in the respective zones of thermal damage peripheral to the laser incisions. STUDY DESIGN/MATERIALS AND METHODS: Precise incisions were produced in 3 x 3 mm2 blocks of human dentin using CO2 (9.6 microm), Er:YSGG (2.79 microm), and Nd:YAG (355 nm) lasers with and without a computer controlled water-spray. Optical coherence tomography (OCT) was used to obtain optical cross-sections of each incision to determine the rate of ablation. The peripheral thermal damage zone around each incision was analyzed using PLM and SR-FTIR. RESULTS: Thermally induced chemical changes to both mineral and the collagen matrix were observed with SR-FTIR with a 10 microm spatial resolution and those changes were correlated with optical changes observed with PLM. Minimal (<10 microm) thermal damage was observed for pulse durations less than the thermal relaxation time (Tr) of the deposited laser energy, with and without applied water at 9.6 microm and with only applied water at 2.79 microm. For pulse durations greater than Tr, greater peripheral thermal damage was observed for both IR laser wavelengths with and without the water-spray. There was minimal thermal damage for 355 nm laser pulses less than Tr with and without applied water; however, extensive mechanical damage (cracks) was observed. CONCLUSIONS: High resolution SR-FTIR is well suited for characterization of the chemical changes that occur due to thermal damage peripheral to laser incisions in proteinaceous hard tissues. Sub-microsecond pulsed IR lasers resonant with water and mineral absorption bands ablate dentin efficiently with minimal thermal damage. Similar laser parameters are expected to apply to the ablation of alveolar bone.

Collagen↗

Selective targeting of protein, water, and mineral in dentin using UV and IR pulse lasers: the effect on the bond strength to composite restorative materials.

BACKGROUND AND OBJECTIVES: Previous studies have shown that during the laser irradiation of dentin and bone, thermal damage can be minimized by using a highly absorbed laser wavelength, laser pulses shorter than the thermal relaxation time of the deposited laser energy at that wavelength, and the addition of a layer of water to the tissue surface before ablation. The objective of this study was to investigate the influence of laser pulse duration and wavelength with and without the added water layer on the bond strength of composite to laser prepared dentin surfaces. The specific hypothesis that was tested was that thermal damage to the collagen matrix in dentin compromises the bond strength to composite restorative materials. STUDY DESIGN/MATERIALS AND METHODS: Three laser systems were employed that were tuned to water, collagen, and mineral absorption with pulse durations less than the thermal relaxation time of the deposited energy. The surfaces of human dentin were irradiated by laser irradiation from free-running and Q-switched Er:YSGG lasers, pulsed CO(2) lasers operating at 9.6-microm, and a Q-switched Nd:YAG laser operating at 355-nm. A motion control system and a pressurized spray system incorporating a microprocessor controlled pulsed nozzle for water delivery, were used to ensure uniform treatment of the entire surface. Shear bond testing was used to evaluate the adhesive strength in order to access the suitability of laser treated surfaces for bonding. Bonded interfaces were examined by SEM. RESULTS: All the laser groups had significantly lower bond strengths than the positive acid etch control group. The highest bond strengths were for the short pulse (< 5-microsecond) Er:YSGG and CO(2) laser groups with water. Laser groups without water had significantly reduced bond strengths and thicker layers of thermally damaged dentin. CONCLUSIONS: Thermal damage to the collagen matrix profoundly influences the bond strength to composite restorations.

Dental Bonding↗

Irradiation of dental enamel with Q-switched lambda = 355-nm laser pulses: surface morphology, fluoride adsorption, and adhesion to composite resin.

BACKGROUND AND OBJECTIVES: Lasers can be used to modify the chemical composition of dental enamel to increase the bond strength to restorative materials and to render the mineral phase more resistant to acid dissolution. Previous studies have suggested a synergistic relationship between CO(2) laser irradiation and fluoride treatment on increased resistance to acid dissolution. In this study a near-UV laser operating with lambda = 355-nm laser pulses of 3-5 nanoseconds duration was used to modify the surface morphology of dental enamel to increase the bond strength to restorative materials and increase the uptake of topical fluoride to render the surface more resistant to acid dissolution. We hypothesize that the short UV laser pulses are primarily absorbed by protein and lipid localized between the enamel prisms resulting in removal of intact mineral effectively etching the surface without thermal modification of the mineral phase. Such modification is likely to increase the permeability of the enamel surface and the subsequent absorption of fluoride. In addition, there is an increase in surface roughness without the formation of a layer of loosely adherent, thermally modified enamel that increases the bond strength to composite restorative materials. STUDY DESIGN/MATERIALS AND METHODS: The surfaces of blocks of bovine enamel, 5 x 5 mm(2), were uniformly irradiated by 355-nm laser pulses and subsequently bonded to composite. The shear bond test was used to assess the bond strength of non-irradiated blocks (negative control), acid etched blocks (positive control), and laser irradiated blocks. The resistance to acid dissolution was evaluated using controlled surface dissolution experiments on irradiated samples, irradiated samples exposed to topical fluoride, and non-irradiated control samples with and without fluoride. RESULTS: The laser surface treatments significantly increased the shear-bond strength of enamel to composite, to a level exceeding 20 MPa which was significantly more than the non-irradiated control samples and significantly less than the acid etch. Laser irradiation alone and topical fluoride application alone did not significantly increase the resistance to acid dissolution. The laser treatment followed by topical application of fluoride significantly increased the resistance to acid dissolution to a level of over 50% versus the control samples. CONCLUSIONS: We present a novel method for increasing bond strength to restorative materials and enhancing fluoride delivery to enamel surfaces and shed some light on the underlying mechanisms of caries inhibition via laser treatment and topical application of fluoride.

Animals↗

Influence of an optically thick water layer on the bond-strength of composite resin to dental enamel after IR laser ablation.

BACKGROUND AND OBJECTIVES: Several studies of hard tissue ablation with Er:YAG lasers have shown that the addition of an optically thick water layer ( approximately 1 mm) added to the surface of dental enamel before each incident laser pulse, profoundly influences the rate and efficiency of ablation and the resulting surface morphology. The objective of this study was the determination of laser parameters which result in clinically useful bond strengths without the need for phosphoric acid etching. The hypothesis to be tested was that laser irradiation through a relatively thick layer of water would result in a surface to which composite could be bonded with bond strength similar to surfaces etched with phosphoric acid. This hypothesis is predicated on the assumption that the water prevents the formation of non-apatite calcium phosphate phases on the enamel surface. MATERIALS AND METHODS: In this study, a calibrated syringe pump and a motion control system were used to uniformly treat flat enamel surfaces using free-running Er:YAG laser pulses with and without water, and 9.6 mum CO(2) laser pulses on a dry surface for comparison. The rate of water delivery that resulted in the most efficient ablation was determined by profiling the resulting laser incisions using optical coherence tomography. In addition, enamel surfaces of 5 x 5 mm(2) were uniformly treated and the resulting surface morphology was examined using synchrotron radiation-fourier transform infrared spectroscopy (SR-FTIR), and optical and electron microscopy. The influence of the modified surface morphology on the adhesion of composite resin was investigated. RESULTS: The shear-bond strength of composite bonded to enamel surfaces irradiated at intensities clinically relevant for caries removal approached values measured for conventional acid etching when the water delivery rate was optimized. CONCLUSIONS: This study demonstrates that composite restorative materials can be directly bonded to laser prepared surfaces without the necessity of further surface preparation and acid etching and that the addition of a thick water layer ( approximately 1 mm) prevents the formation of undesirable CaP phases that compromise adhesion to restorative materials. 2003.

Animals↗

Selective removal of residual composite from dental enamel surfaces using the third harmonic of a Q-switched Nd:YAG laser.

BACKGROUND AND OBJECTIVE: Conventional methods of residual composite removal after the debonding of orthodontic brackets involve the use of abrasives that damage the underlying enamel. The objective of this study was to demonstrate that 355-nm laser pulses with a pulse width of 10 ns are well suited for the removal of composite through selective laser ablation. STUDY DESIGN/MATERIALS AND METHODS: The residual composite remaining on the surface of extracted human third molars and bovine incisors was removed using multiple laser pulses from the third harmonic (355-nm) of a Q-switched Nd:YAG laser. RESULTS: There is selective ablation of composite from the enamel surface without any discernable damage to the underlying enamel. CONCLUSION: This study demonstrates that 355-nm, 10 ns laser pulses can be used for the selective ablation of dental composite without thermal or mechanical damage to the underlying enamel.

Acrylic Resins↗

Selective ablation of surface enamel caries with a pulsed Nd:YAG dental laser.

BACKGROUND AND OBJECTIVE: High intensity infrared light from the pulsed Nd:YAG dental laser is absorbed by carious enamel and not absorbed by healthy enamel. Consequently, this system has potential for selective removal of surface enamel caries. Safety and efficacy of the clinical procedure was evaluated in two sets of clinical trials at three dental schools. Selective ablation was evaluated with FTIR spectroscopy. STUDY DESIGN/MATERIALS AND METHODS: Carious lesions were randomized to drill or laser treatment. Pulp diagnosis, enamel surface condition, preparations, and restorations were evaluated by blinded evaluators. In Study I, surface caries were removed from 104 third molars scheduled for extraction. One-week post-treatment teeth were evaluated clinically, extracted, and the pulp was examined histologically. In Study II, 90 patients with 462 lesions on 374 teeth were randomized to laser or drill and followed for 6 months. RESULTS: Pulsed Nd:YAG laser removal of surface enamel caries was demonstrated to be both safe and effective. Caries were removed in all conditions. There were no adverse events and both clinical and histological evaluations of pulp vitality showed no abnormalities. A significantly greater number of preparations in the drill groups vs. laser groups entered dentin (drill = 11, laser = 1, P = 0.007). CONCLUSION: The more conservative laser treatment removed the caries but not the sound enamel below the lesion. The pulsed Nd:YAG dental laser was found to be both safe and effective for surface caries removal.

Adult↗

Mechanism of water augmentation during IR laser ablation of dental enamel.

BACKGROUND AND OBJECTIVES: The mechanism of water augmentation during IR laser ablation of dental hard tissues is controversial and poorly understood. The influence of an optically thick applied water layer on the laser ablation of enamel was investigated at wavelengths in which water is a primary absorber and the magnitude of absorption varies markedly. STUDY DESIGN/MATERIALS AND METHODS: Q-switched and free running Er: YSGG (2.79 microm) and Er:YAG (2.94 microm), free running Ho:YAG and 9.6 microm TEA CO(2) laser systems were used to produce linear incisions in dental enamel with and without water. Synchrotron-radiation IR spectromicroscopy with the Advanced Light Source at Lawrence Berkeley National Laboratory was used to determine the chemical changes across the laser ablation profiles with a spatial resolution of 10-microm. RESULTS: The addition of water increased the rate of ablation and produced a more desirable surface morphology during enamel ablation with all the erbium systems. Moreover, ablation was markedly more efficient for Q-switched (0.15 microsecond) versus free-running (150 microsecond) erbium laser pulses with the added water layer. Although the addition of a thick water layer reduced the rate of ablation during CO(2) laser ablation, the addition of the water removed undesirable deposits of non-apatite mineral phases from the crater surface. IR spectromicroscopy indicates that the chemical composition of the crater walls deviates markedly from that of hydroxyapatite after Er:YAG and CO(2) laser irradiation without added water. New mineral phases were resolved that have not been previously observed using conventional IR spectroscopy. There was extensive peripheral damage after irradiation with the Ho:YAG laser with and without added water without effective ablation of enamel. CONCLUSIONS: We postulate that condensed mineral phases from the plume are deposited along the crater walls after repetitive laser pulses and such non-apatitic phases interfere with subsequent laser pulses during IR laser irradiation reducing the rate and efficiency of ablation. The ablative recoil associated with the displacement and vaporization of the applied water layer removes such loosely adherent phases maintaining efficient ablation during multiple pulse irradiation.

Animals↗

Thermal and chemical modification of dentin by 9-11-microm CO2 laser pulses of 5-100-micros duration.

BACKGROUND AND OBJECTIVES: Previous studies have shown that dentin can be thermally modified by pulsed CO(2) laser irradiation to form a more highly mineralized tissue. The implications are important for the potential laser modification or removal of dentinal and root caries and the transformation of dentin to a more acid resistant mineralized tissue. STUDY DESIGN/MATERIALS AND METHODS: Time resolved radiometry measurements with TEA CO(2) laser pulses were used to determine the magnitude of the absorption coefficients of dentin at the highly absorbed CO(2) laser wavelengths and to measure the temperature excursions during lambda = 9.3, 9.6, 10.3, and 10.6 microm laser irradiation at irradiation intensities of 0.1-8 J/cm(2) per pulse. In addition, photoacoustic and transient reflectance measurements were used to monitor the loss of water and organics and to detect the thresholds for surface modification and tissue ablation. RESULTS: The absorption coefficients were measured to be 5,000; 6,500; 1,200; and 800 cm(-1) at lambda = 9.3, 9.6, 10.3, and 10.6 microm, respectively. The surface temperatures of dentin were markedly higher than those measured on enamel for similar irradiation intensities due to the lower reflectance losses of dentin and the lower thermal diffusivity of dentin at the respective wavelengths. Hence, lower fluences are required for the thermal decomposition of dentin. Ablation typically occurred with the first few laser-pulses during multiple pulse irradiation and eventually ceased after modification of dentin to a more highly mineralized enamel-like tissue. The debris ejected during the initial laser pulses shielded the surface by as much as 60% at the low fluences employed in this study. Optical and electron microscopy and IR spectroscopy indicated that incident laser pulses with incident fluence as low as 0.5 J/cm(2) at 9.3 and 9.6 microm wavelengths with a duration of 5-8-micros were sufficient to induce chemical and morphological changes in dentin. CONCLUSIONS: In this study, the laser parameters for the efficient thermal modification of dentin with minimum heat deposition at CO(2) laser wavelengths were firmly established.

Dental Caries↗

Imaging caries lesions and lesion progression with polarization sensitive optical coherence tomography.

New diagnostic tools are needed for the characterization of dental caries in the early stages of development. If carious lesions are detected early enough, they can be arrested without the need for surgical intervention. The objective of this study was to demonstrate that polarization sensitive optical coherence tomography (PS-OCT) can be used for the imaging of early caries lesions and for the monitoring of lesion progression over time. High-resolution polarization resolved images were acquired of natural caries lesions and simulated caries lesions of varying severity created over time periods of 1 to 14 days. Linearly polarized light was incident on the tooth samples and the reflected intensity in both orthogonal polarizations was measured. PS-OCT was invaluable for removing the confounding influence of surface reflections and native birefringence necessary for the enhanced resolution of the surface structure of caries lesions. This study demonstrated that PS-OCT is well suited for the imaging of interproximal and occlusal caries, early root caries, and for imaging decay under composite fillings. Longitudinal measurements of the reflected light intensity in the orthogonal polarization state from the area of simulated caries lesions linearly correlated with the square root of time of demineralization indicating that PS-OCT is well suited for monitoring changes in enamel mineralization over time.

Animals↗

Imaging artificial caries under composite sealants and restorations.

Polarization-sensitive optical coherence tomography (PS-OCT) is used to monitor the progression of simulated caries lesions on occlusal surfaces and image the lesions underneath composite sealants. The polarization-sensitive system, recording images in both the parallel and perpendicular axes, is useful for enhancing the image contrast of the artificial caries and minimizing the interference of the strong reflections at surface interfaces. Using the perpendicular-axis signal, the mean reflectivity increase from day 0 to day 14 is 5.1 dB (p<0.01, repeated-measures analysis of variation, Tukey-Kramer). For imaging lesions underneath the sealants, the mean reflectivity of the enamel underneath 250, 500, 750, and 1000 microm of composite is calculated for demineralized and control samples. The artificial lesions can be detected under 750 microm of visibly opaque sealant, with a 5.0-dB difference from the control samples (t-test, p<0.001). Tooth colored sealants allow deeper imaging depth. The artificial lesions could be detected under 1000 microm of sealant, with a 6.6-dB difference from the control samples (t-test, p<0.001). This study demonstrates that PS-OCT can be used to track lesion progression on occlusal surfaces nondestructively with or without sealants.

Artifacts↗

Selective removal of composite sealants with near-ultraviolet laser pulses of nanosecond duration.

It is often necessary to replace pit and fissure sealants and composite restorations. This task is complicated by the necessity for complete removal of the remaining composite to enable suitable adhesion of new composite. Previous studies have shown that 355-nm laser pulses from a frequency-tripled Nd:YAG laser can selectively remove residual composite after orthodontic bracket removal on enamel surfaces. Our objective is to determine if such laser pulses are suitable for selective removal of composite pit and fissure sealants and restorations. Optical coherence tomography is used to acquire optical cross sections of the occlusal topography nondestructively before sealant application, after sealant application, and after sealant removal. Thermocouples are used to monitor the temperature in the pulp chamber during composite removal under clinically relevant ablation rates, i.e., 30 Hz and 30 mJ/pulse. At an irradiation intensity of 1.3 J/cm2, pit and fissure sealants are completely removed without visible damage to the underlying enamel. At intensities above 1.5 J/cm2, incident laser pulses remove the resin layer while at the same time preferentially etching the surface of the enamel. Temperature excursions in the pulp chamber of extracted teeth are limited to less than 5 degrees C if air-cooling is used during the rapid removal (1 to 2 min) of sealants, water-cooling is not necessary. Selective removal of composite restorative materials is possible without damage to the underlying sound tooth structure.

Animals↗

Remineralization of in vitro dental caries assessed with polarization-sensitive optical coherence tomography.

Polarization-sensitive optical coherence tomography (PS-OCT) is potentially useful for imaging the nonsurgical remineralization of dental enamel. This study uses an all-fiber-based PS-OCT system operating at 1310 nm to image demineralized and fluoride-enhanced remineralized artificial lesions. PS-OCT images of lesions before and after remineralization are compared with the relative mineral loss DeltaZ (%vol x microm), obtained from high resolution digital microradiography (DM), and chemical composition changes by infrared spectroscopy. Severe early artificial caries show a significant increase in perpendicular-axis integrated reflectivity after remineralization. After sectioning the samples, DM demonstrates that the lesions remineralized with new mineral and the lesion surface zone show significant restoration of mineral volume. PS-OCT and DM both do not show a major change in lesion depth. For less severe artificial caries, the perpendicular-axis image resolves the scattering and depolarization of an outer growth layer after remineralization. This outer layer has a mineral volume close to that of sound enamel, and spectroscopic analysis indicates that the layer is a highly crystalline phase of apatite, without carbonate substitutions that increase the solubility of sound enamel. This study determines that PS-OCT can image the effects of fluoride-enhanced remineralization of mild and severe early artificial in vitro caries.

Bone Density↗