This PDF file contains the front matter associated with SPIE Proceedings Volume 9692, including the Title Page, Copyright information, Table of Contents, and Conference Committee listing.

Dentin is a biological composite that forms the major bulk of tooth structure. Understanding the biomechanical response of dentin structure to forces is essential to restore the loss of mechanical integrity associated with dentin loss during disease or treatment procedures. Moiré interferometry is an optical interferometry based method, which allows wholefield, real-time analysis of dental structures with high-sensitivity. The aim of this study was to investigate the deformation gradients in dentin during function and subsequent to surface conditioning with bioactive biopolymeric nanoparticle. Slab shaped dentin specimens were prepared and a customized loading jig was used to compressively load the specimens from 10 N to 50 N. Specific regions of interest was chosen on the dentin specimens for strain analysis. The digital moiré interferometry experiments showed a distinct deformation pattern in dentin in the direction perpendicular to the dentinal tubules, which increased with increase in dentin loss. The dentin conditioned with nanoparticles did not display marked increase in strain gradients with loads. The current photomechanical experiment highlighted the impact of nanoparticle treatment to improve the mechanical integrity of dentin.

Although conventional method carries all the debris, studies on persisting infections in root canals show bacteria and their toxins spread from the root canal and contaminate the apical region. Thus developes apical periodontitis or symptoms, and loss of tooth. Even if the treatment has adequate success, anatomy of root canal system can be very complexwith accessory canals. The disinfecting effect of laser radiation has only recently been used in dentistry. Laser irradiation has a bactericidal effect. Each wavelength has its own advantages and limitations according to their different absorption characteristics, depending on their 'absorption coefficient'. The sterilizing efficiency of two types of wavelengths, a new fiber laser 1940- nm Thulium fiber Laser and an 2940 nm Er:YAG Laser were compared in this study. Irradiation with a power of 0.50 W with 1940- nm Thulium fiber Laser disinfected 95,15% of bacteria, however irradiation with same laser power with Er:YAG Laser caused a reduction of 96,48 %. But there was no significant difference in the disinfection effect of two different laser groups ( p < 0.05, Mann- U-Whitney Test). In addition to this, Er :YAG Laser caused three times more reduction from its own positive control group where 1940- nm Thulium fiber Laser caused 2,5 times effective disinfection.

Lasers have been previously been used for dental applications, however there remain issues with thermally-induced cracking. In this paper we investigate the impact of pulse length on CO₂ laser ablation of human dental enamel. Experiments were carried in vitro on molar teeth without any modification to the enamel surface, such as grinding or polishing. In addition to varying the pulse length, we also varied pulse energy and focal position, to determine the most efficient ablation of dental hard tissue and more importantly to minimize or eradicate cracking. The maximum temperature rise during the multi pulse ablation process was monitored using a set of thermocouples embedded into the pulpal chamber. The application of a laser device in dental surgery allows removal of tissue with higher precision, which results in minimal loss of healthy dental tissue. In this study we use an RF discharge excited CO₂ laser operating at 10.6μm. The wavelength of 10.6 μm overlaps with a phosphate band (PO₃^-4) absorption in dental hard tissue hence the CO₂ laser radiation has been selected as a potential source for modification of the tissue. This research describes an in-depth analysis of single pulse laser ablation. To determine the parameters that are best suited for the ablation of hard dental tissue without thermal cracking, a range of pulse lengths (10-200 μs), and fluences (0-100 J/cm²) are tested. In addition, different laser focusing approaches are investigated to select the most beneficial way of delivering laser radiation to the surface (divergent/convergent beam). To ensure that these processes do not increase the temperature above the critical threshold and cause the necrosis of the tissue a set of thermocouples was placed into the pulpal chambers. Intermittent laser radiation was investigated with and without application of a water spray to cool down the ablation site and the adjacent area. Results show that the temperature can be kept below the critical threshold either by using water spray or by decreasing the repetition rate. We demonstrate that CO₂ laser pulses with pulse lengths in the regime of 10 μs can provide precise enamel tissue removal without introducing any unwanted thermal damage.

Several studies over the past 20 years have identified that carbon dioxide lasers operating at wavelengths between 9.3 and 9.6-μm with pulse durations near 20-µs are ideal for hard tissue ablation. Those wavelengths are coincident with the peak absorption of the mineral phase and the pulse duration is close to the thermal relaxation time of the deposited energy of a few microseconds to minimize peripheral thermal damage and long enough to minimize plasma shielding effects to allow efficient ablation at practical rates. The desired pulse duration near 20-μs has been difficult to achieve since it is too long for TEA lasers and too short for RF-excited lasers for efficient operation. Recently, Coherent Inc. (Santa Clara, CA) developed the J5-V laser for microvia drilling which can produce laser pulses greater than 100 mJ in energy at 9.4-μm with a pulse duration of 26-µs and it can achieve pulse repetition rates of 3 KHz. We report the first results using this laser to ablate enamel and dentin. The onset of plasma shielding does not occur until the fluence exceeds 100 J/cm² allowing efficient ablation at rates exceeding 50-μm per pulse. This laser is ideally suited for the selective ablation of carious lesions.

The objective of this laboratory study was to test whether irradiation with a new 9.3µm microsecond short-pulsed CO2-laser enhances enamel caries resistance with and without additional fluoride applications. 101 human enamel samples were divided into 7 groups. Each group was treated with different laser parameters (Carbon-dioxide laser, wavelength 9.3µm, 43Hz pulse-repetition rate, pulse duration between 3μs to 7μs (1.5mJ/pulse to 2.9mJ/pulse). Using a pH-cycling model and cross-sectional microhardness testing determined the mean relative mineral loss delta Z (∆Z) for each group. The pH-cycling was performed with or without additional fluoride. The CO2 9.3μm short-pulsed laser energy rendered enamel caries resistant with and without additional fluoride use.

The goal of the study was investigation of Er:YAG radiation (wavelength 2.94 μm) interaction with various metal and ceramic brackets and adhesive materials. The source of radiation was a free-running Er: YAG laser generating pulses with energy 280 mJ, 250 μs long and repetition rate 6 Hz (mean power 1.7 W). During the treatment lasting 140 s, water cooling was implemented and only the brackets were irradiated. It has been observed that the brackets were removed easily after the Er:YAG laser irradiation, and temperature rise was limited also for metal brackets. SEM investigation has confirmed less damage of enamel in comparison with non-irradiated samples.

Dental caries is one of the most prevailing oral diseases which can be healed if detected in early stages of formation. In this paper, we present a clinically and commercially viable thermophotonic imaging technology for detection of early enamel caries using an inexpensive long-wavelength infrared (LWIR) camera. The efficacy of the system is verified through theoretical simulations as well as experiments carried out on extracted teeth with natural and artificially-induced caries.

Clinicians need technologies to improve the diagnosis of questionable occlusal carious lesions (QOC’s) and determine if decay has penetrated to the underlying dentin. Assessing lesion depth from near-infrared (NIR) images holds great potential due to the high transparency of enamel and stain to NIR light at λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. Unfortunately, NIR reflectance measurements alone are limited in utility for approximating occlusal lesion depth >200-μm due to light attenuation from the lesion body. Previous studies sought to combine NIR reflectance and transillumination measurements taken at λ=1300-nm in order to estimate QOC depth and severity. The objective of this study was to quantify the change in lesion contrast and size measured from multispectral NIR reflectance and transillumination images of natural occlusal carious lesions with increasing lesion depth and severity in order to determine the optimal multimodal wavelength combinations for estimating QOC depth. Extracted teeth with varying amounts of natural occlusal decay were measured using a multispectral-multimodal NIR imaging system at prominent wavelengths within the λ=1300-1700-nm spectral region. Image analysis software was used to calculate lesion contrast and area values between sound and carious enamel regions.

Accurate detection and measurement of the highly mineralized surface layer that forms on caries lesions is important for the diagnosis of lesion activity. Previous studies have demonstrated that optical imaging methods can be used to measure the degree of remineralization on enamel lesions. The purpose of this study was to determine if thermal and near-IR reflectance imaging could be used to assess the remineralization process in simulated dentin lesions. Artificial bovine (n=15) dentin lesions were prepared by immersion in a demineralization solution for 24 hours and they were subsequently placed in an acidic remineralization solution for up to 12 days. The samples were dehydrated using an air spray for 30 seconds and imaged using thermal and InGaAs cameras. The area enclosed by the time-temperature curve, ΔQ, from thermal imaging decreased significantly with longer periods of remineralization. However, near-IR reflectance intensity differences, ΔI, before and after dehydration failed to show any significant relationship with the degree of remineralization. This study shows that thermal imaging can be used for the assessment of the remineralization of dentin lesions.

The introduction of diode lasers in dentistry had several advantages, principally consisting on the reduced size, reduced cost and possibility to beam delivering by optical fibbers. Up today two diode wavelengths, 810 and 980 nm, were the most utilized in oral surgery but recently a new wavelength emitting in the blue had been proposed. The aim of this ex vivo study was to compare the efficacy of five laser wavelengths (450, 532, 808, 1064 and 1340 nm) for the ablation of soft tissues. Specimens were surgically collected from the dorsal surface of four bovine tongues and irradiated by the five different wavelengths. Thermal increase was measured by two thermocouples, the first at a depth of 0.5 mm, and the second at a depth of 2 mm while initial and final surface temperatures were recorded by IR thermometer. The quality of the incision was histologically evaluated by a pathologist by giving a score from 0 to 5. The time necessary to perform the excision varied between 215 seconds (1340 nm, 5W) and 292 seconds (808 nm, 3W). Surface temperature increase was highest for 1340 nm, 5W and lowest for 405 nm, 4 W. The most significant deep temperature increase was recorded by 1340 nm, 5 W and the lowest by 450 nm, 2 W. The quality of incision was better and the thermal elevation lower in the specimens obtained with shortest laser wavelength (450 nm).

[Objective] The current in vitro study was performed to evaluate Vickers hardness (VHN) of two different composite resins that were cured by using two different light curing units. [Materials and Methods] Porcelain tube samplers were used to fabricate composite cylinders from either Tetric Evoceram BulkFill (BF; Ivoclar/Vivadent, USA) or SonicFill composite (SF; Kerr, USA). Each composite type had 12 cylindrical specimens, and each specimen was cured with either Blue-phase N light-cure (Bp; Polywave, Ivoclar/Vivadent, USA) or Elipar S10 (El; Monowave, 3M ESPE, Germany). The VHN data were analyzed and tested by using Mann-Whitney U test at a significance level of 5%. [Results] Statistical analyses demonstrated an interaction between the type of composite and the type of light curing source. Significant differences (P<0.05) were recorded for all groups with higher VHN hardness of SF-El and lowest for BF-El. [Conclusions] It can be concluded that the surface hardness of bulk-fill composite is not dependent on the type of light-cure. This research was supported by King Abdulaziz University.

We developed a longitudinally excited CO2 laser that produces a short laser pulse with the almost same spike-pulse energy of about 0.8 mJ and the controllable pulse-tail energy of 0-21.26 mJ. The laser was very simple and consisted of a 45-cm-long alumina ceramic pipe with an inner diameter of 9 mm, a pulse power supply, a step-up transformer, a storage capacitance and a spark-gap switch. In single-shot irradiation using these laser pulses, the dependence of the drilling depth of dry ivory samples on the fluence was investigated. The drilling depth increased with the fluence in the same laser pulse waveform. In this work, the effective short laser pulse for the hard tissue drilling was the laser pulse with the spike pulse energy of 0.87 mJ and the pulse tail energy of 6.33 mJ that produced the drilling depth of 28.1 μm at the fluence of 3.48 J/cm² and the drilling depth per the fluence of 7.27 μm/J/cm².

The aim of the present study was to histologically assess the effect of laser therapy (AsGaAl, 830nm, 40mW, CW, φ ~0,6mm, 16J/cm² per session, four points of 4J/cm²) on the repair of surgical defects created in the femur of Wistar rats. Background data: Several techniques have been proposed for the correction of bone defects, including the use of grafts and membranes. Despite the increase in the use of laser therapy for the biomodulation of bone repair, very few studies have assessed the associations between laser light and biomaterials. Method: The defects were filled with synthetic micro granular hydroxyapatite (HA) Gen-phos® implants and associated with bovine bone membranes (Gen-derm®). Surgical bone defects were created in 48 rats and divided into four groups: Group IA (control, n=12); Group IB (laser, n=12); Group IIA (HA + membrane, n=12); Group IIB (HA + membrane + laser, n=12). The irradiated groups received the first irradiation immediately after surgery. This radiation was then repeated seven times every 48h. The animals were sacrificed after 15, 21, and 30 days. Results: When comparing the groups irradiated with implants and membranes, it was found that the repair of the defects submitted to laser therapy occurred more quickly, starting 15 and 21 days after surgery. By the 30th day, the level of repair of the defects was similar in the irradiated and the non-irradiated groups. New bone formation was confirmed inside the cavity by the implant’s osteoconduction. In the irradiated groups, there was an increment of this new bone formation. Conclusions: In conclusion, the use of laser therapy, particularly when associated with hydroxyapatite and biological membranes, produced a positive biomodulation effect on the healing process of bone defects on the femurs of rats.

This study aimed to evaluate, in vitro, the structural changes in dentin surfaces irradiated with Er:YAG (2940 nm, 90 mJ, 2 Hz, 300 μs, spot diameter 0.9 mm, 60 s/cm², using the handpiece at 6 cm of distance to surface) and Nd:YAG (1064 nm, 1 W, 10 Hz, 300 μs, optical fiber diameter 300 μm, 60 s/cm², using the handpiece at 2 mm of distance to surface) lasers to the treatment of cervical hypersensitivity and the respective bond strength compromising of resin composite restorations over these surfaces. 45 bovine teeth were selected, and removed the enamel portion of the buccal surface for laser irradiation and restorative procedure. Samples were divided into three groups: G1: control, only fluoride therapy; G2: irradiated with Er:YAG laser; G3: irradiated with Nd:YAG laser. Samples were submitted to optical coherence tomography analysis and subsequently they were restored with resin composite and sectioned into sticks for microtensile tests of achievement. ANOVA analysis of variance for the maximum force (N) and strength (MPa), with a significance level of 5% was performed. It was observed that G3 presented lower performance of maximum force (38,8 ± 11,3 N) and resistance (26,0 ± 9,3 MPa), and the G2 presented better results (51,0 ± 13,5 N and 36,5 ± 10,1 MPa), but still lower than those one obtained for G1 (56,0 ± 12,3 N and 43,5 ± 8,6 MPa). Although both lasers are effective in the cervical hypersensitivity treatment, when the aesthetic factor is the priority, the use of Er:YAG is preferable.

The aim of this in vitro study was to evaluate the microshear bond strength (μSBS) of resin composite to enamel etching by Er,Cr:YSGG laser with the use of two differents adhesives systems. Fifty freshly extracted human molars halves were embedded in acrylic resin before preparation for the study, making a total of up to 100 available samples. The specimens were randomly assigned into six groups (η=10) according to substrate pre-treatment and adhesive system on the enamel. A two-step self-etching primer system (Clearfil SE Bond) and a universal adhesive used as an etch-andrinse adhesive (Adper Single Bond Universal) were applied to the nonirradiated enamel surface according to manufacturer’s instructions, as control groups (Control CF and Control SB, respectively). For the other groups, enamel surfaces were previously irradiated with the Er,Cr:YSGG laser with 0.5 W, 75 mJ and 66 J/cm² (CF 5 Hz and SB 5 Hz) and 1.25 W, 50 mJ and 44 J/cm² (CF 15 Hz and SB 15 Hz). Irradiation was performed under air (50%) and water (50%) cooling. An independent t-test was performed to compare the adhesive systems. Mean μSBS ± sd (MPa) for each group was 16.857 ± 2.61, 17.87 ± 5.83, 12.23 ± 2.02, 9.88 ± 2.26, 15.94 ± 1.98, 17.62 ± 2.10, respectively. The control groups and the 50 mJ laser groups showed no statistically significant differences, regardless of the adhesive system used. The results obtained lead us to affirm that the bonding interaction of adhesives to enamel depends not only on the morphological aspects of the dental surface, but also on the characteristics of the adhesive employed and the parameters of the laser.

Lumineers are veneer laminates used as an alternative for aesthetic dental solutions of the highest quality, but the only current means of its performance assessment is visual inspection. The objective of this study was to use the Optical Coherence Tomography (OCT) technique working in spectral domain to analyze in vivo in a single patient, 14 lumineers 180 days after cementation. It was possible to observe images in various kinds of changes in the cementing line and the laminate. It was concluded that the OCT is an effective and promising method to clinical evaluation of the cementing line in lumineers.

The aim of this study was to use the Optical Coherence Tomography (OCT) technique working in spectral domain (Swept Source OCT at 1325 nm, Thorlabs, New Jersey, USA) to monitor the tissue repair in patients undergoing periodontal plastic surgery. The evaluations were done over a period of 60 days. It was observed that 15 days after periodontal surgery the gum was still in different healing process as compared to the observation after 60 days. Thus it is clear that, despite some technical limitations, the OCT is an efficient method in the evaluation of regeneration gingival.

This study aimed to evaluate the shear bond strength (SBS) of teeth prepared for orthodontic bracket bonding with 37% phosphoric acid and Er:YAG laser. Forty bovine incisors were divided into two groups. In Group I, the teeth were conditioned with 37% phosphoric acid and brackets were bonded with Transbond XT; in Group II, the teeth were irradiated with Er:YAG and bonding with Transbond XT. After SBS test, the adhesive remnant index was determined. Adhesion to dental hard tissues after Er:YAG laser etching was inferior to that obtained after acid etching but exceeded what is believed to be clinically sufficient strength, and therefore can be used in patients.

Selective removal of dental composite with high precision is best accomplished using lasers operating at high pulse repetition rates focused to a small spot size. Conventional flash-lamp pumped Er:YAG lasers are poorly suited for this purpose, but new diode-pumped Er:YAG lasers have become available operating at high pulse repetition rates. The purpose of this study was to compare the ablation rates and selectivity of enamel and composite for a 30 W diode-pumped Er:YAG laser operating with a pulse duration of 30-50-μs and evaluate it's suitability for the selective removal of composite from tooth surfaces. The depth of ablation and changes in surface morphology were assessed using digital microscopy. The fluence range of 30-50 J/cm² appeared optimal for the removal of composite, and damage to sound enamel was limited to less than 100-μm after the removal of composite as thick as 700-800-μm. Future studies will focus on the use of methods of feedback to further increase selectivity.

Several studies have shown that optical coherence tomography (OCT) can be used to measure the remaining enamel thickness and detect the location of subsurface lesions hidden under the sound enamel. Moreover studies have shown that high refractive index liquids can be used to improve the visibility of subsurface lesions in OCT images. In this study, we demonstrate that vinyl polysiloxane (VPS) impression materials which are routinely used in dentistry can be used to enhance the detection of dentinal lesions on tooth occlusal surfaces. Lesion presence was confirmed with polarized light microscopy and microradiography.

Dental composites are used for a wide range of applications such as fillings for cavities, adhesives for orthodontic brackets, and closure of gaps (diastemas) between teeth by esthetic bonding. Anterior restorations are used to replace missing, diseased and unsightly tooth structure for both appearance and function. When these restorations must be replaced, they are difficult to remove mechanically without causing excessive removal or damage to enamel because dental composites are color matched to teeth. Previous studies have shown that CO₂ lasers have high ablation selectivity and are well suited for removal of composite on occlusal surfaces while minimizing healthy tissue loss. A spectral feedback guidance system may be used to discriminate between dental composite and dental hard tissue for selective ablation of composite material. The removal of composite restorations filling diastemas is more challenging due to the esthetic concern for anterior teeth. The objective of this study is to determine if composite spanning a diastema between anterior teeth can be removed by spectral guided laser ablation at clinically relevant rates with minimal damage to peripheral healthy tissue and with higher selectivity than a high speed dental handpiece.

Previous studies have demonstrated that the structural changes on enamel due to demineralization and remineralization can be exploited through optical imaging methods such as QLF, thermal and NIR imaging. The purpose of this study is to investigate whether PS-OCT and NIR reflectance imaging can be utilized to assess lesion structure in artificial enamel lesions on the smooth surfaces of primary teeth exposed to fluoride. The smooth coronal surfaces of primary teeth (n=25) were divided into 4 windows: sound, demineralization, demineralization with remineralization and APF with demineralization. Windows were treated with either acidulated phosphate fluoride (APF) for 1 minute, a demineralization solution for 4 days, and/or an acidic remineralization solution for 12 days. The samples were imaged using PS-OCT, QLF and NIR reflectance at 1400–1700 nm wavelengths. This study demonstrated that both PS-OCT and NIR reflectance imaging were suitable for assessing lesion structure in the smooth surfaces of primary dentition.

At laser intensities below ablation, carbonated hydroxyapatite in enamel is converted into a purer phase hydroxyapatite with increased acid resistance. Previous studies suggested the possibility of achieving the conversion without surface modification. This study attempts to evaluate the thresholds for the modification without additional changes in physical and optical properties of the enamel. Bovine specimens were irradiated using an RF-excited CO₂ laser operating at 9.4-μm with a pulse duration of 26- μs, pulse repetition rates of 100-1000 Hz, with a Gaussian spatial beam profile - 1.4 mm in diameter. After laser treatment, the samples were subjected to acid demineralization for 48 hours to simulate acidic intraoral conditions of a caries attack. The resulting demineralization and erosion were assessed using polarization sensitive OCT (PS-OCT) and 3D digital microscopy. The images from digital microscopy demonstrated a clear delineation between laser protected zones without visual changes and zones with higher levels of demineralization and erosion. Distinct changes in the surface morphology were found within the laser treated area in accordance with the Gaussian spatial beam profile. There was significant protection from the laser in areas that were not visually altered.

For over one hundred years, x-rays have served as a cornerstone of dentistry. Dental radiographic imaging technologies have constantly improved, however, detecting occlusal lesions remains as one of the greatest challenges due to the low sensitivity of radiographs and the overlap of enamel. Once detected, occlusal lesions have penetrated far into the dentin, necessitating invasive restorative treatment. The adoption of near-infrared (NIR) systems in dentistry introduces the potential for early detection of occlusal lesions. Commercially available NIR systems for intra-oral applications currently operate near 800-nm; however, extrinsic stains may interfere with the detection of demineralization of the underlying enamel surface. Higher wavelengths such as 1300-nm render stains nearly transparent and enhances the contrast of sound enamel to demineralized enamel. This novel finding promotes minimally invasive dentistry and allows oral health professionals the ability to detect, image, track, and monitor early lesions without repeated exposure to ionizing radiation nor invasive treatment.