In patients with chronic periodontitis, clinical outcomes of conventional subgingival debridement can be improved by adjunctive aPDT.

Modern ultrashort pulse lasers with scanning systems provide a huge set of parameters affecting the suitability for dental applications. The present study investigates thresholds and ablation rates of oral hard tissues and restorative materials with a view towards a clinical application system. The functional system consists of a 10 W Nd:YVO4 laser emitting pulses with a duration of 8 ps at 1,064 nm. Measurements were performed on dentin, enamel, ceramic, composite, and mammoth ivory at a repetition rate of 500 kHz. By employing a scanning system, square-shaped cavities with an edge length of 1 mm were created. Ablation threshold and rate measurements were assessed by variation of the applied fluence. Examinations were carried out employing a scanning electron microscope and optical profilometer. Irradiation time was recorded by the scanner software in order to calculate the overall ablated volume per time. First high power ablation rate measurements were performed employing a laser source with up to 50 W. Threshold values in the range of 0.45 J/cm(2) (composite) to 1.54 J/cm(2) (enamel) were observed. Differences between any two materials are statistically significant (p < 0.05). Preparation speeds up to 37.53 mm(3)/min (composite) were achieved with the 10 W laser source and differed statistically significant for any two materials (p < 0.05) with the exception of dentin and mammoth ivory (p > 0.05). By employing the 50 W laser source, increased rates up to ∼50 mm(3)/min for dentin were obtained. The results indicate that modern USPL systems provide sufficient ablation rates to be seen as a promising technology for dental applications.

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Heat generation during the removal of dental restorative materials may lead to a temperature increase and cause painful sensations or damage dental tissues. The aim of this study was to assess heat generation in dental restoration materials following laser ablation using an ultrashort pulse laser (USPL) system. A total of 225 specimens of phosphate cement (PC), ceramic (CE), and composite (C) were used, evaluating a thickness of 1 to 5 mm each. Ablation was performed with an Nd:YVO(4) laser at 1,064 nm, a pulse length of 8 ps, and a repetition rate of 500 kHz with a power of 6 W. Employing a scanner system, rectangular cavities of 1.5-mm edge length were generated. A temperature sensor was placed at the back of the specimens to record the temperature during the ablation process. All measurements were made employing a heat-conductive paste without any additional cooling or spray. Heat generation during laser ablation depended on the thickness of the restoration material (p < 0.05) with the highest values in the composite group (p < 0.05), showing an increase of up to 17 K. A time delay for temperature increase during the ablation process depending on the material thickness was observed in the PC and C group (p < 0.05) with highest values for cement (p < 0.05). Employing the USPL system for removal of restorative materials, heat generation has to be considered. Especially during laser ablation next to pulpal tissues, painful sensations might occur.

The aim of the study was to investigate the efficiency of caries removal employing an ultrashort pulsed laser (USPL) and to compare the results regarding to the ablation rate of sound enamel and dentin including surface texture. The study was performed with 59 freshly extracted carious human teeth. Two cavities with an edge length of 1 × 1 mm per tooth were created: one in the dental decay and one in sound hard tissue. For this purpose a 9-W Nd:YVO4 laser with a center wavelength of 1,064 nm and a pulse duration of 8 ps at a repetition rate of 500 kHz was used. A scanner system moved the laser beam across the surface with a scan speed of 2,000 mm/s. Ablated volume and roughness R z of the cavity ground were measured using an optical profilometer. Subsequently, the specimens were cut to undecalcified sections for histological investigations. The removal of dental decay (dentin, 14.9 mm(3)/min; enamel, 12.8 mm(3)/min) was significantly higher (p < 0.05) compared to the removal of sound tissues (dentin, 4.2 mm(3)/min; enamel, 3.8 mm(3)/min). The arithmetic means of the surface roughness R z were 8.5 μm in carious enamel, 15.43 μm in carious dentin, 4.83 μm in sound enamel and 5.52 μm in sound dentin. Light microscopic investigations did not indicate any side effects in the surrounding tissues. Regarding the ablation rate of dental decay using the USPL system, caries removal seems to be much more efficient for cavity preparation.