Daniel Fried

University of California, San Francisco, San Francisco, California, United States

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Publications (172)139.67 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Resin-based composites are used for many applications in dentistry. They are difficult to remove without damage to the underlying enamel since they adhere strongly and are color matched to the tooth. The objective of this study was to determine if an automated laser scanning system with spectral feedback could be used for selective removal of residual orthodontic composite from tooth surfaces with minimal damage to the underlying enamel. A CO2 laser operating at a wavelength of 9.3 μm with a pulse duration of 10-15 μs and a pulse repetition rate of ~200 Hz was used to selectively remove composite from the buccal surfaces of extracted teeth. A spectral feedback system utilizing a miniature spectrometer was used to control the laser scanning system. Pulpal temperature measurements were performed during composite removal to determine if there was excessive heat accumulation. Conventional and digital microscopes were used to assess the amount of enamel lost during removal. The amount of enamel lost averaged between 20 and 25 μm for irradiation intensities from 3.8 to 4.2 J/cm(2), respectively. An average maximum temperature rise of 1.9±1.5°C was recorded, with no teeth approaching the critical value of 5.5°C. The average time for composite removal from an area of 5 mm(2) was 19.3±4.1 s, fast enough for clinical feasibility. Residual composite can be rapidly removed from tooth surfaces using a CO2 laser with spectral feedback, with minimal temperature rise within the pulp and with minimal loss of sound enamel.
    Photonics & lasers in medicine. 02/2014; 3(1):37-45.
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    ABSTRACT: Objectives The aim of this study was to test the hypothesis that cross-polarization optical coherence tomography (CP-OCT) can be used to longitudinally monitor demineralization peripheral to orthodontic brackets in an extended clinical study. Methods A high-speed CP-OCT system was used to acquire 3D volumetric images of the area at the base of orthodontic brackets over a period of 12-months after placement. The reflectivity was measured at 3-month intervals for 12-months to determine if there was increased demineralization. Two teeth were monitored on twenty test subjects and the brackets were bonded using two types of adhesives This was a randomized controlled clinical study with a split mouth design such that each subject served as his or her own control. On one side, the control premolar was bonded with a bonding agent (Adper Scotchbond from 3 M ESPE, St. Paul, MN) and composite (Transbond XT from 3 M Unitek, Monrovia, CA) that lacked fluoride. On the other side, the experimental premolar was bonded with a fluoride releasing glass ionomer cement (GC Fuji Ortho LC from GC America, Alsip, IL). Results There was a small but significant increase in the calculated lesion depth and integrated reflectivity over that depth (ΔR) for both adhesive types (p < 0.0001) indicating increasing demineralization with time. There was no significant difference in the lesion depth (p = 0.22) and ΔR (p = 0.91) between the groups with the fluoride releasing glass ionomer cement and the conventional composite. Conclusions CP-OCT was able to measure a significant increase in demineralization (P < 0.0001) at the base of orthodontic brackets over a period of 12-months.
    Journal of dentistry 01/2014; · 2.00 Impact Factor
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    ABSTRACT: Early demineralization appears with high contrast at near-IR wavelengths due to a 10- to 20-fold difference in the magnitude of light scattering between sound and demineralized enamel. Water absorption in the near-IR has a significant effect on the lesion contrast and the highest contrast has been measured in spectral regions with higher water absorption. The purpose of this study was to determine how the lesion contrast changes with lesion severity and depth for different spectral regions in the near-IR and compare that range of contrast with visible reflectance and fluorescence. Forty-four human molars were used in this in vitro study. Teeth were painted with an acid-resistant varnish, leaving a 4 mm × 4 mm window on the occlusal surface of each tooth exposed for demineralization. Artificial lesions were produced in the unprotected windows after 12-48 hours exposure to a demineralizing solution at pH 4.5. Near-IR reflectance images were acquired over several near-IR spectral distributions, visible light reflectance, and fluorescence with 405-nm excitation and detection at wavelengths >500-nm. Crossed polarizers were used for reflectance measurements to reduce interference from specular reflectance. Cross polarization optical coherence tomography (CP-OCT) was used to non-destructively assess the depth and severity of demineralization in each sample window. Matching two-dimensional CP-OCT images of the lesion depth and integrated reflectivity were compared with the reflectance and fluorescence images to determine how accurately the variation in the lesion contrast represents the variation in the lesion severity. Artificial lesions appear more uniform on tooth surfaces exposed to an acid challenge at visible wavelengths than they do in the near-IR. Measurements of the lesion depth and severity using CP-OCT show that the lesion severity varies markedly across the sample windows and that the lesion contrast in the visible does not accurately reflect the large variation in the lesion severity. Reflectance measurements at certain near-IR wavelengths more accurately reflect variation in the depth and severity of the lesions. The results of the study suggest that near-IR reflectance measurements at longer wavelengths coincident with higher water absorption are better suited for imaging early caries lesions. Lasers Surg. Med. © 2013 Wiley Periodicals, Inc.
    Lasers in Surgery and Medicine 12/2013; · 2.46 Impact Factor
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    ABSTRACT: Several studies have demonstrated the potential of cross-polarization optical coherence tomography (CP-OCT) to quantify the severity of early caries lesions (tooth decay) on tooth surfaces. The purpose of this study is to show that 2D images of the lesion depth and the integrated reflectivity can be used to accurately represent the severity of early lesions. Simulated early lesions of varying severity were produced on tooth samples using simulated lesion models. Methods were developed to convert the 3D CP-OCT images of the samples to 2D images of the lesion depth and lesion integrated reflectivity. Calculated lesion depths from OCT were compared with lesion depths measured from histological sections examined using polarized light microscopy. The 2D images of the lesion depth and integrated reflectivity are well suited for visualization of early demineralization. (© 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim).
    Journal of Biophotonics 12/2013; · 3.10 Impact Factor
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    ABSTRACT: In vivo and in vitro studies have shown that high contrast images of tooth demineralization can be acquired in the near-infrared (near-IR) without the interference of stain. The purpose of this study is to compare the lesion contrast in reflectance at near-IR wavelengths coincident with high water absorption with those in the visible, the near-IR at 1,300 nm and with fluorescence measurements for early lesions in occlusal surfaces. Twenty-four human molars were used in this in vitro study. Teeth were painted with an acid-resistant varnish, leaving a 4 × 4 mm window in the occlusal surface of each tooth exposed for demineralization. Artificial lesions were produced in the exposed windows after 1- and 2-day exposure to a demineralizing solution at pH 4.5. Lesions were imaged using near-IR reflectance at three wavelengths, 1,300, 1,460, and 1,600 nm using a high definition InGaAs camera. Visible light reflectance, and fluorescence with 405 nm excitation and detection at wavelengths greater than 500 nm were also used to acquire images for comparison. Crossed polarizers were used for reflectance measurements to reduce interference from specular reflectance. The contrast of both the 1- and 2-day lesions were significantly higher (P < 0.05) for near-IR reflectance imaging at 1,460 and 1,600 nm than it was for near-IR reflectance imaging at 1,300 nm, visible reflectance imaging, and fluorescence. The markedly higher contrast at 1,460 and 1,600 nm wavelengths, coincident with higher water absorption, suggest that these wavelengths are better suited than 1,300 nm for imaging early/shallow demineralization on tooth surfaces. Lasers Surg. Med. © 2013 Wiley Periodicals, Inc.
    Lasers in Surgery and Medicine 07/2013; · 2.46 Impact Factor
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    ABSTRACT: If caries lesions are detected early enough they can be arrested by chemical intervention and dietary changes without the need for chemical intervention. Optical coherence tomography is ideally suited to monitor the changes that occur in caries lesions as a result of nonsurgical intervention, since OCT can nondestructively image the internal structure of the lesion. One of the most important changes that occurs in a lesion is preferential deposition of mineral in the outer surface zone. The deposition creates a highly mineralized and weakly scattering surface zone that is clearly visible in OCT images. Since this zone is near the highly reflective surface it is necessary to use cross-polarization OCT imaging to resolve this zone. Several CP-OCT studies have been conducted employing different remineralization models that produce lesions with varying mineral gradients. Previous studies have also demonstrated that automated algorithms can be used to assess the lesion depth and severity even with the presence of the weakly reflective surface zone. In this study we investigated the remineralization of lesions of varying severity using a pH cycling remineralization model and the change of the lesion was monitored using CP-OCT. Although the lesion depth and severity decreased after remineralization, there was still incomplete remineralization of the body of the lesion.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 03/2013; 8566.
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    ABSTRACT: Since optical coherence tomography is well suited for measuring small dimensional changes on tooth surfaces it has great potential for monitoring tooth erosion. The purpose of this study was to explore different approaches for monitoring the erosion of enamel. Application of an acid resistant varnish to protect the tooth surface from erosion has proven effective for providing a reference surface for in vitro studies but has limited potential for in vivo studies. Two approaches which can potentially be used in vivo were investigated. The first approach is to measure the remaining enamel thickness, namely the distance from the tooth surface to the dentinal-enamel junction (DEJ). The second more novel approach is to irradiate the surface with a carbon dioxide laser to create a reference layer which resists erosion. Measuring the remaining enamel thickness proved challenging since the surface roughening and subsurface demineralization that commonly occurs during the erosion process can prevent resolution of the underlying DEJ. The areas irradiated by the laser manifested lower rates of erosion compared to the non-irradiated areas and this method appears promising but it is highly dependent on the severity of the acid challenge.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 03/2013; 8566:856606.
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    ABSTRACT: In vivo and in vitro studies have shown that high contrast images of tooth demineralization can be acquired in the near-IR due to the high transparency of dental enamel. The purpose of this study is to compare the lesion contrast in reflectance at near-IR wavelengths coincident with high water absorption with those in the visible, the near-IR at 1300-nm and with fluorescence measurements for early lesions in occlusal surfaces. Twenty-four human molars were used in this in vitro study. Teeth were painted with an acid-resistant varnish, leaving a 4×4 mm window in the occlusal surface of each tooth exposed for demineralization. Artificial lesions were produced in the exposed windows after 1 & 2-day exposure to a demineralizing solution at pH 4.5. Lesions were imaged using NIR reflectance at 3 wavelengths, 1310, 1460 and 1600-nm using a high definition InGaAs camera. Visible light reflectance, and fluorescence with 405-nm excitation and detection at wavelengths greater than 500-nm were also used to acquire images for comparison. Crossed polarizers were used for reflectance measurements to reduce interference from specular reflectance. The contrast of both the 24 hr and 48 hr lesions were significantly higher (P<0.05) for NIR reflectance imaging at 1460-nm and 1600-nm than it was for NIR reflectance imaging at 1300-nm, visible reflectance imaging, and fluorescence. The results of this study suggest that NIR reflectance measurements at longer near-IR wavelengths coincident with higher water absorption are better suited for imaging early caries lesions.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 03/2013; 8566.
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    ABSTRACT: New methods are needed for the nondestructive measurement of tooth demineralization and remineralization and to monitor the progression of incipient caries lesions (tooth decay) for effective nonsurgical intervention and to evaluate the performance of anti-caries treatments such as chemical treatments or laser irradiation. Studies have shown that optical coherence tomography (OCT) has great potential to fulfill this role, since it can be used to measure the depth and severity of early lesions with an axial resolution exceeding 10-μm. It is easy to apply in vivo and it can be used to image the convoluted topography of tooth occlusal surfaces. In this paper we present early results from two clinical studies underway to measure the effect of fluoride intervention on early lesions. CP-OCT was used to monitor early lesions on enamel and root surfaces before and after intervention with fluoride varnish. The lesion depth and internal structure were resolved for all the lesions examined and some lesions had well defined surface zones of lower reflectivity that may be indicative of arrested lesions. Changes were also noted in the structure of some of the lesions after fluoride intervention.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 03/2013; 8566.
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    Hobin Kang, Cynthia L Darling, Daniel Fried
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    ABSTRACT: Previous remineralization studies employing cross polarization sensitive optical coherence tomography (CP-OCT), have been limited to the repair of artificial enamel-like lesions. In this study we attempted to remineralize existing occlusal lesions on extracted teeth. Lesions were imaged before and after exposure to an acidic remineralization regimen and the integrated reflectivity and lesion depth was calculated. Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Polarized light microscopy was also used to examine the lesions areas after sectioning the teeth. An acidic remineralization solution was used to remineralize the lesions. The integrated reflectivity significantly increased after exposure to the remineralization solution which suggests that the acidic solution caused additional demineralization as opposed to the desired remineralization.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 02/2012; 8208.
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    ABSTRACT: Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to image caries lesions in dentin, measure nondestructively the severity of dentin demineralization, and determine the efficacy of intervention with anticaries agents including fluoride and lasers. However, those studies were limited to artificial lesions on dentin and roots surfaces. The objective of this study is to determine if a cross polarization OCT system (CP-OCT) can be used to nondestructively measure a reduction in the reflectivity of natural root caries lesions after exposure to a remineralization solution. CP-OCT images of 11 teeth with existing root lesions were acquired before and after exposure to a remineralizing solution for 20 days. The integrated reflectivity was calculated after integrating to a fixed depth of 200-µm. There was a significant decrease in the integrated reflectivity after exposure to the remineralizing solution.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 02/2012; 8208.
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    ABSTRACT: A carbon dioxide laser operating at the highly absorbed wavelength of 9.3μm with a pulse duration of 10-15μs is ideally suited for caries removal and caries prevention. The enamel thermally modified by the laser has enhanced resistance to acid dissolution. This is an obvious advantage for caries prevention; however, it is often necessary to etch the enamel surface to increase adhesion to composite restorative materials and such surfaces may be more resistant to etching. The purpose of the study was to non-destructively measure the susceptibility of laser-ablated enamel surfaces to acid dissolution before and after acid-etching using Polarization Sensitive Optical Coherence Tomography (PS-OCT). PS-OCT was used to acquire images of bovine enamel surfaces after exposure to laser irradiation at ablative fluence, acid-etching, and a surface softened dissolution model. The integrated reflectivity from lesion and the lesion depth were measured using PS-OCT. Samples were also sectioned for examination by Polarized Light Microscopy (PLM). PS-OCT images showed that acid-etching greatly accelerated the formation of subsurface lesions on both laser-irradiated and non-irradiated surfaces (P<0.05). A 37.5% phosphoric acid etch removed the laser modified enamel layer after 5-10 seconds.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 02/2012; 8208.
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    ABSTRACT: New methods are needed for the nondestructive measurement of tooth demineralization and remineralization to monitor the progression of incipient caries lesions (tooth decay) for effective nonsurgical intervention and to evaluate the performance of anti-caries treatments such as chemical treatments or laser irradiation. Studies have shown that optical coherence tomography (OCT) has great potential to fulfill this role since it can be used to measure the depth and severity of early lesions with an axial resolution exceeding 10-µm, it is easy to apply in vivo and it can be used to image the convoluted topography of tooth occlusal surfaces. In this paper we present early results using a new cross-polarization OCT system introduced by Santec. This system utilizes a swept laser source and a MEMS scanner for rapid acquisition of cross polarization images. Preliminary studies show that this system is useful for measurement of the severity of demineralization on tooth surfaces and for showing the spread of occlusal lesions under the dentinal-enamel junction.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 02/2012; 8208.
  • Kenneth H Chan, Daniel Fried
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    ABSTRACT: Lasers can ablate/remove tissue in a non-contact mode of operation and a pulsed laser beam does not interfere with the ability to image the tooth surface, therefore lasers are ideally suited for integration with imaging devices for image-guided ablation. Laser energy can be rapidly and efficiently delivered to tooth surfaces using a digitally controlled laser beam scanning system for precise and selective laser ablation with minimal loss of healthy tissues. Under the appropriate irradiation conditions such laser energy can induce beneficial chemical and morphological changes in the walls of the drilled cavity that can increase resistance to further dental decay and produce surfaces with enhanced adhesive properties to restorative materials. Previous studies have shown that images acquired using near-IR transillumination, optical coherence tomography and fluorescence can be used to guide the laser for selective removal of demineralized enamel. Recent studies have shown that NIR reflectance measurements at 1470-nm can be used to obtain images of enamel demineralization with very high contrast. The purpose of this study was to demonstrate that image guided ablation of occlusal lesions can be successfully carried out using a NIR reflectance imaging system coupled with a carbon dioxide laser operating at 9.3-μm with high pulse repetition rates.
    Proceedings - Society of Photo-Optical Instrumentation Engineers 02/2012; 8208.
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    Hobin Kang, Cynthia L Darling, Daniel Fried
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    ABSTRACT: It is difficult to completely remineralize carious lesions because diffusion into the interior of the lesion is inhibited as new mineral is deposited in the outermost layers. In previous remineralization studies employing polarization sensitive optical coherence tomography (PS-OCT), two models of remineralization were employed and in both models there was preferential deposition of mineral in the outer most layer. In this study we attempted to remineralize the entire lesion using an acidic remineralization model and demonstrate that this remineralization can be monitored using PS-OCT. Artificial lesions approximately 100-150 μm in-depth were exposed to an acidic remineralization regimen and the integrated reflectivity from the lesions was measured before and after remineralization using PS-OCT. Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Although there was a high degree of remineralization, there was still incomplete remineralization of the body of the lesion. This study demonstrated that PS-OCT can be used to non-destructively measure changes in lesion structure and severity upon exposure to an acidic remineralization model. This study also demonstrated that automated algorithms can be used to assess the lesion severity even with the presence of a weakly reflective surface zone.
    Dental materials: official publication of the Academy of Dental Materials 12/2011; 28(5):488-94. · 2.88 Impact Factor
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    ABSTRACT: Enamel is highly transparent in the near-IR (NIR) at wavelengths near 1,300 nm, and stains are not visible. The purpose of this study was to use NIR transillumination and optical coherence tomography (OCT) to estimate the severity of caries lesions on occlusal surfaces both in vivo and on extracted teeth. Extracted molars with suspected occlusal lesions were examined with OCT and polarization sensitive OCT (PS-OCT), and subsequently sectioned and examined with polarized light microscopy (PLM) and transverse microradiography (TMR). Teeth in test subjects with occlusal caries lesions that were not cavitated or visible on radiographs were examined using NIR transillumination at 1,310 nm using a custom built probe attached to an indium gallium arsenide (InGaAs) camera and a linear OCT scanner. After imaging, cavities were prepared using dye staining to guide caries removal and physical impressions of the cavities were taken. The lesion severity determined from OCT and PS-OCT scans in vitro correlated with the depth determined using PLM and TMR. Occlusal caries lesions appeared in NIR images with high contrast in vivo. OCT scans showed that most of the lesions penetrated to dentin and spread laterally below the sound enamel. This study demonstrates that both NIR transillumination and OCT are promising new methods for the clinical diagnosis of occlusal caries.
    Lasers in Surgery and Medicine 11/2011; 43(10):951-9. · 2.46 Impact Factor
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    ABSTRACT: NIR imaging methods do not require ionizing radiation and have great potential for detecting caries lesions (tooth decay) on high-risk proximal and occlusal tooth surfaces and at the earliest stages of development. Previous in vitro and in vivo studies at 1300-nm demonstrated that high contrast reflectance and transillumination images could be acquired of caries lesions on tooth proximal and occlusal surfaces where most new decay is found. Water absorption varies markedly between 1200 and 1600-nm and the scattering properties of enamel and the underlying dentin have not been characterized in this region. Hyperspectral reflectance studies show lower reflectivity from sound enamel and dentin at NIR wavelengths with higher water absorption. The purpose of this imaging study was to determine which NIR wavelengths between 1200 and 1600-nm provide the highest contrast of demineralization or caries lesions for each of the different modes of NIR imaging, including transillumination of proximal and occlusal surfaces along with cross polarization reflectance measurements. A tungsten halogen lamp with several spectral filters and a Ge-enhanced CMOS focal plane array (FPA) sensitive from 400 to 1600-nm were used to acquire the images of caries lesions on extracted teeth. Artificial interproximal lesions were created on twelve tooth sections of 5 & 6-mm thickness that were used for transillumination imaging. Fifty-four extracted teeth with suspected occlusal lesions were also examined in both occlusal transillumination and reflectance imaging modes. Cavity preparations were also cut into whole teeth and filled with composite and used to compare the contrast between composite and enamel at NIR wavelengths. NIR wavelengths longer than 1400-nm are likely to have better performance for the transillumination of occlusal caries lesions while 1300-nm appears best for the transillumination of proximal surfaces. Loss of mobile water in enamel markedly reduced the transparency of the enamel at all NIR wavelengths. Significantly higher contrast was attained for reflectance measurements at wavelengths that have higher water absorption, namely 1460-nm. Wavelengths with higher water absorption also provided higher contrast of composite restorations.
    Biomedical Optics Express 10/2011; 2(10):2804-14. · 3.18 Impact Factor
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    ABSTRACT: Dental composite restorative materials are color matched to the tooth and are difficult to remove by mechanical means without excessive removal or damage to peripheral enamel and dentin. Lasers are ideally suited for selective ablation to minimize healthy tissue loss when replacing existing restorations, sealants, or removing composite adhesives such as residual composite left after debonding orthodontic brackets. In this study, a carbon dioxide laser operating at 9.3-µm with a pulse duration of 10-20-microsecond and a pulse repetition rate of ∼200 Hz was integrated with a galvanometer based scanner and used to selectively remove composite from tooth surfaces. Spectra of the plume emission were acquired after each laser pulse and used to differentiate between the ablation of dental enamel or composite. Microthermocouples were used to monitor the temperature rise in the pulp chamber during composite removal. The composite was placed on tooth buccal and occlusal surfaces and the carbon dioxide laser beam was scanned across the surface to selectively remove the composite without excessive damage to the underlying sound enamel. The residual composite and the damage to the underlying enamel was evaluated using optical microscopy. The laser was able to rapidly remove composite from tooth buccal and occlusal surfaces with minimal damage to the underlying sound enamel and without excessive heat accumulation in the tooth. This study demonstrated that composite can be selectively removed from tooth surfaces at clinically relevant rates using a CO(2) laser operating at 9.3-µm with high pulse repetition rates with minimal heat deposition and damage to the underlying enamel.
    Lasers in Surgery and Medicine 09/2011; 43(8):824-32. · 2.46 Impact Factor
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    ABSTRACT: The aim of this study was to test the hypothesis that in a short-term clinical pilot trial short-pulsed 9.6 μm CO(2)-laser irradiation significantly inhibits demineralization in vivo. Twenty-four subjects scheduled for extraction of bicuspids for orthodontic reasons (age 14.9 ± 2.2 years) were recruited. Orthodontic brackets were placed on bicuspids (Transbond XT, 3M). An area next to the bracket was irradiated with a CO(2)-laser (Pulse System Inc, Los Alamos, New Mexico), wavelength 9.6 μm, pulse duration 20 μs, pulse repetition rate 20 Hz, beam diameter 1100 μm, average fluence 4.1 ± 0.3J∕cm(2), 20 laser pulses per spot. An adjacent nonirradiated area served as control. Bicuspids were extracted after four and twelve weeks, respectively, for a quantitative assessment of demineralization by cross-sectional microhardness testing. For the 4-week arm the mean relative mineral loss ΔZ (vol% × μm) for the laser treated enamel was 402 ± 85 (mean ± SE), while the control showed significantly higher mineral loss (ΔZ 738 ± 131; P = 0.04, t-test). The difference was even larger after twelve weeks (laser arm ΔZ 135 ± 98; control 1067 ± 254; P = 0.002). The laser treatment produced 46% demineralization inhibition for the 4-week and a marked 87% inhibition for the 12-week arm. This study shows, for the first time in vivo, that the short-pulsed 9.6 μm CO(2)-laser irradiation successfully inhibits demineralization of tooth enamel in humans.
    Journal of Biomedical Optics 07/2011; 16(7):071405. · 2.88 Impact Factor
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    ABSTRACT: CO(2) lasers can be operated at high laser pulse repetition rates for the rapid and precise removal of dental decay. Excessive heat accumulation and peripheral thermal damage is a concern when using high pulse repetition rates. Peripheral thermal damage can adversely impact the mechanical strength of the irradiated tissue, particularly for dentin, and reduce the adhesion characteristics of the modified surfaces. The interpulpal temperature rise was recorded using microthermocouples situated at the roof of the pulp chamber on teeth that were occlusally ablated using a rapidly-scanned CO(2) laser operating at 9.3 μm with a pulse duration of 10 to 15 μs and repetition rate of 300 Hz over a 2 min time course. The adhesion strength of laser treated enamel and dentin surfaces was measured for various laser scanning parameters with and without post-ablation acid etching using the single-plane shear test. The mechanical strength of laser-ablated dentin surfaces were determined via the four-point bend test and compared to control samples prepared with 320 grit wet sand paper to simulate conventional preparations. Thermocouple measurements indicated that the temperature remained below ambient temperature if water-cooling was used. There was no discoloration of either dentin or enamel laser treated surfaces, the surfaces were uniformly ablated, and there were no cracks visible. Four-point bend tests yielded mean mechanical strengths of 18.2 N (s.d. = 4.6) for ablated dentin and 18.1 N (s.d. = 2.7) for control (p > 0.05). Shear tests yielded mean bond strengths approaching 30 MPa for both enamel and dentin under certain irradiation conditions. These values were slightly lower than nonirradiated acid-etched control samples. Additional studies are needed to determine if the slightly lower bond strength than the acid-etched control samples is clinically significant. These measurements demonstrate that enamel and dentin surfaces can be rapidly ablated by CO(2) lasers with minimal peripheral thermal and mechanical damage and without excessive heat accumulation.
    Journal of Biomedical Optics 07/2011; 16(7):071410. · 2.88 Impact Factor