Selective Ablation of Dental Caries and Composites

描述（由申请人提供）：本拟议研究的总体目标是增加我们对高强度激光辐射与牙齿硬组织相互作用的基本理解，并将该知识应用于开发基于激光的方法，该方法使用计算机控制的激光束扫描结合光学反馈方法的集成方法选择性地去除龋齿和复合修复材料。除了消除与牙科手机相关的噪音和振动外，激光还提供了几个优于当前牙科保守手术技术的独特优势。在适当的照射条件下，激光能够实现明显更高的精度和选择性，非常适合电子控制，可以在钻孔腔的壁中诱导有益的化学和形态变化，这可以使组织更能抵抗进一步的龋齿，并增强对修复材料的粘附性能。本提案的具体目的是检验以下假设：1）使用图像引导的激光烧蚀，可以选择性地从牙齿表面去除天然和人工龋齿损伤，对健康组织的外围损伤最小，2）光学相干断层成像可以成功地用作激光烧蚀的原位诊断，3）牙科复合材料基材料可以选择性地从牙齿表面去除，而不会对周围的健康牙釉质和牙本质造成过度的热积聚或机械损伤。这些基础研究将大大提高我们对激光与组织相互作用的整体认识，并促进开发更安全、更有效的激光系统，用于去除龋齿和修复材料。使用高选择性激光系统去除龋齿和牙科复合材料可能会导致更保守的牙科手术的实践，这将减少通常与传统洞制备和现有复合材料修复相关的健康组织损失量。 公共卫生相关性：这些基础研究将大大提高我们对激光与组织相互作用的整体认识，并促进开发更安全、更有效的激光系统，用于去除龋齿和修复材料。使用这些激光系统可能会导致更保守的牙科手术，这将显著减少通常与传统洞制备相关的健康组织损失量。

DESCRIPTION (provided by applicant): The overall objective of this proposed research is to increase our fundamental understanding of the interaction of high intensity laser radiation with dental hard tissues and apply that knowledge to the development of laser- based methods that selectively remove dental caries and composite restorative materials using an integrated approach of computer-controlled laser beam scanning coupled with optical methods of feedback. In addition to eliminating the noise and vibration associated with the dental hand-piece, lasers offer several unique advantages over current surgical technology for conservative dentistry. Under the appropriate irradiation conditions, lasers are capable of achieving markedly higher precision and selectivity, are well-suited for electronic control, can induce beneficial chemical and morphological changes in the walls of the drilled cavity that can render the tissues more resistant to further dental decay with enhanced adhesive properties to restorative materials. The specific aims of this proposal are to test the following hypotheses: 1) natural and artificial caries lesions can be selectively removed from tooth surfaces with minimal peripheral damage to sound tissues using image-guided laser ablation, 2) optical coherence tomographic imaging can be successfully used as an in situ diagnostic for laser ablation, 3) dental composite based materials can be selectively removed from tooth surfaces without excessive heat accumulation or mechanical damage to the surrounding sound enamel and dentin. These fundamental studies will significantly advance our overall knowledge of laser-tissue interactions and facilitate the development of safer and more efficient laser systems for the removal of dental caries and restorative materials. The use of highly selective laser systems for the removal of dental caries and dental composites is likely to lead to the practice of more conservative dental procedures that will reduce the amount of healthy tissue loss that is generally associated with conventional cavity preparations and the repair of existing composite restorations. PUBLIC HEALTH RELEVANCE: These fundamental studies will significantly advance our overall knowledge of laser-tissue interactions and facilitate the development of safer and more efficient laser systems for the removal of dental caries and restorative materials. Use of those laser systems is likely to lead to the practice of more conservative dental procedures that will markedly reduce the amount of healthy tissue loss that is generally associated with conventional cavity preparations.