Selective Ablation of Dental Caries and Composites

描述(申请人提供)：这项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了解，并将这些知识应用于开发基于激光的方法，使用计算机控制的激光扫描与光学反馈方法相结合的综合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，激光还为牙科保守治疗提供了几个独特的优势，而不是目前的外科技术。在适当的照射条件下，激光能够实现显著更高的精度和选择性，非常适合于电子控制，可以在钻孔的洞壁中诱导有益的化学和形态变化，使组织更能抵抗进一步的牙齿腐烂，并增强对修复材料的粘附性。该建议的具体目的是检验以下假设：1)使用图像引导激光消融，可以有选择地从牙齿表面去除天然和人工龋损，对声音组织的外围损害最小，2)光学相干断层成像可以成功地作为激光消融的原位诊断，3)牙科复合材料可以从牙齿表面选择性去除，而不会对周围声音牙釉质和牙本质造成过多的热量积累或机械损伤。这些基础研究将极大地提高我们对激光-组织相互作用的全面了解，并促进开发更安全、更有效的激光系统来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体很可能导致更保守的牙科手术的实践，这将减少健康组织损失量，这通常与传统的洞穴准备和现有复合修复体的修复有关。 与公众健康相关：这些基础性研究将大大提高我们对激光与组织相互作用的全面了解，并促进开发更安全、更有效的激光系统来去除龋齿和修复材料。这些激光系统的使用可能会导致更保守的牙科手术的实践，这将显着减少健康组织损失量，这通常与传统的洞穴准备有关。

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.