To date, lasers have not succeeded in replacing mechanical tools in many hard tissue applications. Slow material removal rates and unacceptable collateral damage has prevented such a successful transition. Ultrashort pulses (<10 ps) have been shown to generate little thermal or mechanical damage. Recent developments now enable such short-pulse/high-energy laser systems to operate at high pulse repetition rates (PRR's). Using proper operating parameters, ultrashort pulse lasers (USPL's) could exceed the performance of conventional tissue processing tools and yield significant material volume removal while maintaining their minimal collateral damage advantages. As such, for the first time, USPL's offer real possibility for practical replacement of the air-turbine dental drill or other mechanical means for cutting hard tissues. In this study, the subpicosecond interaction regime was investigated and compared to nanosecond ablation by using a Titanium:Sapphire Chirped Pulse Amplifier (CPA) system with 1.05-m pulses of variable duration. Both 350fs and 1-ns pulse regimes were studied. Ablation rates (AR's), ablation efficiency, and surface characteristics revealed through electron micrographs were investigated. The study characterized the interaction with a variety of hard tissue types including nail, midear bone, dentin, and enamel. With 350-fs pulses, tissue type comparison showed a remarkably similar pattern of ablation rate and surface characteristics. Negligible collateral damage and highly efficient per-pulse ablation were observed in this pulse regime. These observations should be contrasted with the 1-ns pulse ablation characteristics where strong dependence on tissue type was demonstrated and ablation efficiency was approximately an order of magnitude smaller. With efficient interaction which minimizes collateral damage, and with both cost and size of ultrashort pulse systems decreasing, the implications of this study are far-reaching for the efficient use of USPL's in several fields of medicine that currently apply traditional surgical methods.

Plasma mediated ablation of collagen gels and porcine cornea was studied at various laser pulse durations in the range of 1 ns-300 fs at 1053-nm wavelength. It was found that pulsed laser ablation of transparent and weakly absorbing gels is always mediated by plasma. On the other hand, ablation of strongly absorbing tissues is mediated by plasma in the ultrashort-pulse range only. Ablation threshold along with plasma optical breakdown threshold decreases with increasing tissue absorbance for subnanosecond pulses. In contrast, the ablation threshold was found to be practically independent of tissue linear absorption for femtosecond laser pulses. The mechanism of optical breakdown at the tissue surface was theoretically investigated. In the nanosecond range of laser pulse duration, optical breakdown proceeds via avalanche ionization initiated by heating of electrons contributed by strongly absorbing impurities at the tissue surface. In the ultrashortpulse range, optical breakdown is initiated by multiphoton ionization of the irradiated medium (six photons in case of tissue irradiated at 1053-nm wavelength), and is less sensitive to linear absorption. High-quality ablation craters with no thermal or mechanical damage to surrounding material were obtained with subpicosecond laser pulses. Experimental results suggest that subpicosecond plasma mediated ablation can be employed as a tool for precise laser microsurgery of various tissues. . His research interests are in the field of diagnostic and therapeutic applications of lasers in medicine and biology. He has published more than 70 papers and 80 conference proceedings on laser photochemistry of biomolecules, laser ablation of biological tissues, fluorescence diagnostics, and optoacoustic imaging.Dr. Oraevsky is a member of the SPIE, BIOS, LEOS, OSA, and a Fellow of the ASLMS. (M'95), for a photograph and biography, see this issue, p. 799. Luiz B. Da Silva

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