Laser-induced photoacoustic spectroscopy (LIPS) can be used to measure trace-element concentration in materials, down to parts-per-million. In this paper we investigate the use of laser-induced photoacoustic response in carious teeth detection. First, we found the Q-switched Nd:YAG laser of a wavelength of 1064 nm to produce detectable response in teeth. Then, we implemented two detection techniques using a piezoelectric transducer and Michelson Interferometer. The accurately detected response of a tooth sample by the piezoelectric transducer was analyzed using spectral analysis. However, in dentistry we do not necessarily mead an exact quantitative measurement; thus we designed a more physically realizable system that measures the acoustically-induced surface displacement using Michelson Interferometer. Monitoring this surface displacement we were able to determine the physical and optical properties of the tooth sample which could be used as a basis in diagnostics. The responses obtained by both detectors were equally confined to the categorization of a carious tooth from a normal one.

The aim of this study was two fold: (1) to investigate the nature and degree of water loss at 21°C (dehydration) and relate these findings with (2) strains produced in dentine structure during water loss and regain. The nature and degree of water loss was investigated using Nuclear-Magnetic Resonance Spectroscopy and gravimetric analysis. Digital Moire Interferometry (DMI) was used to study the patterns of strain distribution during water-loss (dehydration) and water-regain (rehydration) at 21°C. The gravimetric analysis showed that dentine exhibited a biphasic response in water-loss. An initial rapid phase followed by a gradual and steady phase. DMI showed that dehydration induced strains were formed within dentine in three phases. These experiments highlighted that the major portion of free water from dentine was lost rapidly from the surface and the dentinal tubules, as soon as they are exposed to 21°C (55% RH). DMI showed that dehydration produced strains in the dentine structure after an initial latent period. Rehydration caused almost complete reversal of the dehydration induced water-loss and strains.

We employed OCT imaging technique to study the human teeth infected with the caries lesion in fit and fissure. A time domain OCT system using a rapid-scanning optical delay line enabled high speed imaging of extracted teeth. The OCT images presented the morphological feature and caries-involved area of the dental structure with a high resolution of ~14 μm. The OCT images could be utilized to diagnose the disease, while a signal along the axial direction could provide quantitative analysis of the disease based on the reflectivity differences in the specimen. We investigated the influence of caries in human teeth with several imaging tools such as light illuminating exam, digital intra-oral radiography and electron probe micro analyzer, which provided the distributions of chemical compositions, mainly calcium and phosphate in hard tissues. The biochemical changes acquired from EPMA and the morphological features acquired from OCT in the early stage of caries were compared and analyzed to present more objectively practical index for translating the degree of caries.

Optical Coherence Tomography was used to monitor subsurface caries evolution process in vitro. Human tooth was used and bacteria were employed to induce caries lesions. Twenty-five human third molars, were used in this study. The teeth were cut longitudinally at mesio-distal direction; the surfaces were coated with nail varnish except for two squared windows (2x4 mm); at the cement-enamel junction. Artificial lesions were induced by a S. Mutans microbiological culture. The samples (N = 50) were divided into groups according to the demineralization time: 3, 5, 7, 9 and 11 days. The culture medium, was changed each 48 hours. After the demineralization process the samples were rinsed with double-deionized water and stored in a humid environment. The OCT system was implemented with average power of 96 μW in the sample arm, providing a 23 μm of axial resolution. The images were produced with lateral scans step of 10 μm. The detection system was composed by a detector, a demodulator and a computer. With the images generated by OCT it was possible to determine the lesion depth as function of sample exposition time to microbiological culture. We observed that the depth of the lesion in the root dentine increased from 70 μm to 230 μm, depending of exposure time, and follows the bacterial population growth law. This OCT system accurately depicts hard dental tissue and it was able to detect early caries in its structure, providing a powerful contactless high resolution image of lesions.

Optical methods for the detection of carious lesions, calculus and plaque have the advantage of being minimally invasive. The use of endogeneous fluorescence markers like porphyrins could simplify the application of fluorescence techniques in the dental practice. It is known that porphyrins are produced by some of the bacterial species that are present in the oral cavity. Since porphyrins have an excitation band at about 400nm they have the potential to be used as fluorescent markers of locations in the oral cavity where the production of bacteria is out of the limits of healthy regions. Further, modern and efficient GaN-based semiconductor diodes emit light in this spectral range and thus make the implementation of fluorescence sensors with excitation at this wavelength easy. Carious lesions, calculus and plaque have been measured using a self build fluorescence camera using GaN-diodes for illumination at 405nm. Further, emission spectra under this excitation were recorded. For the latter purpose freshly extracted teeth were used. It has been found that already in the case of an initial carious lesion red porphyrin-fluorescence is emitted whereas it is absent in healthy enamel. In already brown coloured carious lesions the emission bands of porphyrin are present but the observed overall fluorescence intensity is lower, probably due to the absorption of the fluorescence by the carious defect itself. In dental calculus, dental plaque and subgingival concrements porphyrin originated luminescence was found as well. Since in these cases the emission spectra differ slightly it can be concluded that they originate from different types of porphyrins and thus also from different bacteria. These results show that this fluorescence technique can be a promising method to diagnose carious lesions, calculus and plaque.

The early approximal caries lesion in enamel is observed clinically as a white spot and is difficult to detect and/or monitor with current methods available to dentists. New methods with high sensitivity and specificity are required to enable improved early dental caries diagnosis. Using unpolarized Raman spectroscopy to examine unsectioned teeth, peak intensity changes in the phosphate (PO₄^3-) vibrations (ν₂, ν₃ and ν₄) were observed between spectra of sound and carious enamel. However, there is little change in the ν₁ vibration with this approach. In contrast, when tooth sections were examined by unpolarized Raman spectroscopy, marked changes in the ν₁ peak at 959 cm^-1 were noted between healthy and carious enamel. These differences suggest that sampling orientation play a role in understanding the spectral changes. Using polarized Raman spectroscopy to examine unsectioned samples, cross polarized measurements from sound enamel exhibited significant reduction of the ν₁ peak compared with parallel polarized measurements. A similar reduction was observed with carious enamel, however, the reduction was not as prominent. By calculating the depolarization ratio of the area under the ν₁ peak, sound enamel can be clearly distinguished from demineralized regions. The spectral changes observed are attributed to changes in the structure and/or orientation of the apatite crystals as a result of the acid demineralization process.

The inner structure of teeth, i.e. the root canal anatomy, is very complex. However a good knowledge of endodontic architecture is the first step towards successful endodontic treatment. Optical coherence tomography (OCT) is a powerful technique to generate images of hard and soft tissue. Its images show dependency on the optical properties of the tissue under analysis. Changes in the scattering and absorption of tissues can be observed through the OCT images. In this work, we used optical coherence tomography to perform in vitro studies of the inner structure of the first molar of albino rats (Rattus norvegicus). Focusing on the pulp chamber and in the root canal, we compare the images generated with the OCT technique to the histology. We are analyzing the feasibility of OCT to help on the diagnostic of endodontic diseases.

New optical imaging methods are needed to determine whether caries lesions (tooth decay) are active and progressing or have become remineralized and arrested and are no longer progressing. The objective of this study was to use Polarization Sensitive Optical Coherence Tomography (PS-OCT) to image the fluoride enhanced remineralization of artificial enamel lesions. Artificial lesions were created by an acetate buffer on smooth enamel surfaces and were exposed for 20 days to a 2 ppm fluoride containing remineralization solution. PS-OCT images revealed the presence of a low scattering surface zone after the artificial lesions were remineralized. These samples displayed intact nondepolarizing surface zones when analyzed with Polarized Light Microscopy (PLM). No statistical difference in lesion depth before and after remineralization was found with both PS-OCT and PLM. The remineralized lesions showed a significant decrease in the overall integrated reflectivity compared with the demineralized lesions. Digital Microradiography confirmed the increase in mineral volume of the remineralized surface zone. This study determined that PS-OCT can image the restoration of the surface zone enamel after fluoride-enhanced remineralization of artificial in vitro dental caries.

Mucocele is an oral soft tissue cyst caused by the disturbance of saliva flow. Mucocele is widely observed in child patients and recurrence is high. The objective of this study was to clarify the effect of CO₂ laser irradiation in the case of mucocele. A CO₂ laser was used on 45 subjects, aged between 0 to 15 years, having mucocele on lip, lingual, or buccal mucosa. Our procedure in using CO₂ laser was not to vaporize the mucocele but to remove the whole mucocele mass. The border of mucocele was firstly incised by laser following defocusly ablating the root or body of mucocele separating from sorrounding tissue. As a result, mucocele was easily and completely removed without breaking the wall of mucocele. None of the cases required suturing. The results were as follows. 1. The mucocele of lip or lingual mucosa with a rich blood supply, was efficiently removed, without bleeding, giving a clear operative field during the operation. 2. The surgery itself was simple and less time-consuming. 3. After two or three weeks the wound was completely healed without almost any discomfort in all patients 4. Wound contraction and scarring were decreased or eliminated. 5. The reoccurrence of mucocele was not seen, except only in one case of lingual mucocele. In conclusion the use of CO₂ laser proved to be a very safe and effective mode for the removal of mucocele, especially in small children.

The bleaching process is been objective of many studies since the beginning of the XX century. Heat has been used to activate the hydrogen peroxide; the aesthetic results were satisfactory, but associated with this process high incidence of hypersensitivity as well as radical endodontic treatment was observed making this technique clinically hard to implemented. Nowadays the dental bleaching is one of the most wanted aesthetic procedures by the population at the dental office. With the utilization of new light sources as LASER and LED a technique to evaluate the efficiency of photo-bleaching of many pigments is necessary. This work demonstrates a new method to quantify the breakage of pigments on a cellulose matrix using a blue LED system with 1W/cm². We employed a computational analysis and digital spectroscopy. These matrixes were used because of its inert physical-chemical properties. The obtained results are within the expectative, where the groups irradiated with light presents more broken pigments that the group with no light, it was also possible to observe on this experiment that light acts decreasing the free energy of the reaction and that way speeding up the rate of bleaching.

Several lasers have been used for clinical treatment in dentistry. Among them, diode lasers are attractive because of their compactness compared with other laser sources. Near-infrared diode lasers have been practically used for cutting soft tissues. Because they penetrate deep to soft tissues, they cause sufficiently thick coagulation layer. However, they aren't suitable for removal of carious dentin because absorption by components in dentin is low. Recently, a violet diode laser with a wavelength of 405nm has been developed. It will be effective for cavity preparation because dentin contains about 20% of collagen whose absorption coefficient at a violet wavelength is larger than that at a near-infrared wavelength. In this paper, we examined cutting performance of the violet diode laser for dentin. To our knowledge, there have been no previous reports on application of a violet laser to dentin ablation. Bovine teeth were irradiated by continuous wave violet diode laser with output powers in a range from 0.4W to 2.4W. The beam diameter on the sample was about 270μm and an irradiation time was one second. We obtained the crater ablated at more than an output power of 0.8W. The depth of crater ranged from 20μm at 0.8W to 90μm at 2.4W. Furthermore, the beam spot with an output power of 1.7W was scanned at a speed of 1mm/second corresponding to movement of a dentist's hand in clinical treatment. Grooves with the depth of more than 50μm were also obtained. From these findings, the violet diode laser has good potential for cavity preparation. Therefore, the violet diode laser may become an effective tool for cavity preparation.

For the purpose of micro-selective preparation which is part of the modern dentistry four various methods were examined: ablation by Er:YAG laser radiation (free-running or Q-switching regime), preparation of tissues by ultrasonic round ball tip, and by the classical dental drilling machine using diamond round bur. In the case of Er:YAG laser application the interaction energy 40 mJ in pulse of 200 us yielding to the interaction intensity 62 kW/cm², and 20 mJ in pulse of 100 ns yielding to the interaction intensity 62 MW/cm² was used for the case of free running, and Q-switch regime, respectively. For comparisson with the classical methods the ultrasound preparation tip (Sonixflex cariex TC, D-Sonicsys micro) and dental driller together with usual preparation burrs and standard handpiece were used. For the interaction experiment the samples of extracted human teeth and ebony cut into longitudinal sections and polished were used. The thickness of the prepared samples ranged from 5 to 7 mm. The methods were compared from the point of prepared cavity shape (SEM), inner surface, and possibility of selective removal of carries. The composite filling material was used to reconstruct the cavities. The dye penetrating analysis was performed.

One perceived disadvantage of caries removal using lasers is the loss of the tactile feedback associated with the handpiece. However, alternative methods of acoustic and optical feedback become available with the laser that can be exploited to provide information about the chemical composition of the material ablated, the ablation efficiency and rate, the depth of the incision, and the surface and plume temperature during ablation. Such information can be used to increase the selectivity of ablation, avoid peripheral thermal damage and excessive heat deposition in the tooth, and provide a mechanism of robotic automation. The objective of this study was to test the hypothesis that a compact fiberoptic spectrometer could be used to differentiate between the ablation of sound and carious enamel and dentin and between dental hard tissues and composite. Sound and carious tooth surfaces along with composite restorative materials were scanned with λ=0.355, 2.79 and 9.3 μm laser pulses at irradiation intensities ranging from 0.5-100 J/cm² and spectra were acquired from λ=250-900-nm using a compact fiber-optic spectrometer. Emission spectra varied markedly with the laser wavelength and pulse duration. Optical feedback was not successful in differentiating between sound and carious enamel and dentin even with the addition of various chromophores to carious lesion areas. However, the spectral feedback was successfully used to differentiate between composites and sound enamel and dentin enabling the selective removal of composite from tooth surfaces using a computer controlled λ=9.3-μm pulsed CO₂ laser and scanning system.

TEA CO₂ lasers tuned to the strong mineral absorption of hydroxyapatite at λ =9-μm are ideally suited for the efficient ablation of dental hard tissues if the laser-pulse duration is stretched to greater than 10-μs to avoid plasma formation. CO₂ lasers are capable of operating at high repetition rates for the rapid removal of dentin and bone. The purpose of this study was to test the hypothesis that stretched λ =9.3-μm TEA CO₂ laser pulses can produce lateral incisions in dentin and bone for dental restorations and implants at repetition rates as high as 400-Hz without peripheral thermal damage. A high repetition rate, 0-500-Hz, λ =9.3-μm TEA CO₂ laser with pulse durations of 10-20-μs was used to make incisions in human dentin and porcine alveolar bone with a computer controlled scanning stage and water spray at varying irradiation intensities. The single pulse ablation rates were determined for incident fluence ranging from 1-150-J/cm². Lateral incisions 2-3-mm in length were produced in the 2-mm thick sections. Following irradiation, transverse cross-sections were examined using polarized light microscopy (PLM) and Fourier transform infrared spectro-microscopy (SR-FTIR) at the Advanced Light Source at Lawrence Berkeley National Laboratory. The single-pulse ablation rates approached 40-μm per pulse for the stretched TEA laser pulses in dentin and bone. All incisions with and without water spray yielded thermal damage zones of less than 22-μm. Thermal damage zones with water spray were less than 14-μm, even at repetition rates of 400-Hz and SR-FTIR showed no spectral changes around the periphery of the incisions. CO₂ laser pulses at λ =9.3-μm of 10-20-μs duration are well suited for the precise removal of dentin and bone for dental restorations and implants at high repetition rates without peripheral thermal damage.

TEA CO₂ lasers tuned to the strong mineral absorption of hydroxyapatite near λ=9-μm are ideally suited for the efficient ablation of dental hard tissues if the laser-pulse is stretched to greater than 5-10-μs to avoid plasma shielding phenomena. Such CO₂ lasers are capable of operating at high repetition rates for the rapid removal of dental hard tissues. An Impact 2500 TEA CO₂ laser system from GSI Lumonics (Rugby, UK) custom modified by LightMachinery (Ottawa, Canada) with a repetition rate of 0-500 Hz was used for rapid tissue removal. The single pulse ablation rates through enamel were determined for incident fluence ranging from (1-160 J/cm²). Lateral incisions using a computer controlled scanning stage and water spray were produced and the crater morphology and chemical composition were measured using optical microscopy and high-resolution synchrotron radiation infrared spectromicroscopy. The transmission through 2-meter length 300, 500, 750 and 1000-μm silica hollow waveguides was measured and 80% transmission was achieved with 40-mJ per pulse. The λ=9.3-μm laser pulses efficiently removed dental enamel at rates exceeding 15-μm per pulses with minimal heat accumulation. The residual energy remaining in tooth samples was measured to be 30-40% without water cooling, significantly lower than for longer CO₂ laser pulses. These results suggest that high repetition rate TEA CO₂ laser systems operating at λ=9.3-μm with pulse durations of 10-20-μs are ideally suited for dental application.

The formation of a hybrid layer at the dentin/resin interface is a critical point in the curative processes. New restorative materials are currently under investigation in order to improve the characteristics of this interface layer. In this paper micro-Raman spectroscopy and Environmental Scanning Electron Microscope (E-SEM) analysis have been performed to investigate the interface properties of three different restorative materials. The experimental investigation has been performed on tooth cavities prepared both by Er:YAG laser ablation and by conventional diamond bur. Laser prepared cavities were realized using 100 ms pulsed light beam with energy of 350 mJ, at a frequency of 20 Hz. The cavities were filled with three different composites: True-Vitality (Den-Mat), Enamel Plus (Micerium), Supreme (3M). The treated samples were sectioned perpendicularly to the exposed dentin surface and the morphological characterization of the samples was performed by means of E-SEM operating in wet mode. This equipment permits to obtain a high-resolution image of surface without conductive coating process. The same samples were then examined by micro-Raman spectroscopy that has already shown its validity in the study of dentin/resin interfaces.

The purpose of this study is to monitor structural response in intact teeth and teeth with structural loss using a noninvasive fiber optic microbend (FOMB) sensor. In this study a miniature fiber optic microbend sensor is fabricated and tested on intact tooth specimens, tooth specimens in which one-third crown structure was removed, tooth specimens in which access cavity was prepared and tooth specimens in which access cavity and root canal were prepared. The microbend sensor displayed a direct relationship between the applied load and the output light intensity. The rate of change in light intensity with increase in loads corresponded with the structural response of the tooth. This experiment highlights the potential of FOMB sensor technology to quantitatively monitor tooth structural loss during post endodontic restorations.

This work reports a study of load transmission, evaluation and tension dissipation on dried human skull under loading simulation of isolated contraction (SIC) of some masticatories muscles by the phase-shifting real-time holography using photorefractive Bi₁₂SiO₂₀ crystal. The four-frames phase-shifting technique and the unwrapping branch-cut technique were used to obtain the phase map and quantitative results.

Previous studies have demonstrated that Polarization Sensitive Optical Coherence Tomography (PS-OCT) can be used to image early dental caries. The primary objective of this study was to compare the measured reflectivity of natural occlusal caries lesions with the relative mineral loss measured using digital microradiography. There was excellent agreement between the increase in the integrated reflectivity in the perpendicular polarization axis of the PS-OCT system and the increase in the integrated mineral loss or lesion severity for occlusal lesions. Therefore, PS-OCT is ideally suited to image natural caries lesions in the important occlusal surfaces for the assessment of the lesion severity and activity. A secondary objective was to compare the performance of a new autocorrelator-based PS-OCT system employing a novel polarization-switching probe with our polarization-maintaining fiber based PS-OCT system, both operating at 1310-nm. The new PS-OCT system produced clean images with no artifacts and achieved high penetration depth. Yet a third objective was to determine if interproximal lesions can be imaged from the occlusal surface (from above) since interproximal lesions may only be accessible in vivo from buccal or lingual surfaces or from the occlusal surface. Simulated and natural interproximal caries lesions were imaged from the occlusal surfaces as long as there was no intervening dentin.

A thorough understanding of how polarized near-IR light propagates through sound and carious dental hard tissues is important for the development of dental optical imaging systems. New optical imaging tools for the detection and assessment of dental caries (dental decay) such as near-IR imaging and optical coherence tomography can exploit the enhanced contrast provided by polarization sensitivity. Stokes polarimetry was used to monitor the state of polarization (SOP) and degree of polarization (DOP) of incident linearly and circularly polarized light as it propagates through extracted human whole teeth, thin tooth sections and single apatite crystals. These measurements at 1310-nm suggest that the DOP is maintained through sound tooth enamel and transparent dentin and that circularly polarized light is typically depolarized more rapidly than linearly light. Polarized light is rapidly depolarized by demineralized enamel and sound and demineralized dentin. The rapid depolarization of polarized light by dental caries in the near-IR provides high contrast for caries imaging and detection.

Dental enamel manifests high transparency in the near-IR (NIR). Our previous work demonstrated that NIR light at 1310-nm is ideally suited for the transillumination of interproximal dental caries (dental decay in between teeth) and that it can also be used to image decay in the pits and fissures of the occlusal (biting) surfaces of posterior teeth where most new dental decay occurs. Early occlusal lesions cannot be detected by x-rays during the early stages of lesion development due to the overlapping topography of the crown of the tooth. Stains and non-calcified plaque are not visible in the NIR enabling better discrimination of demineralized areas. We also demonstrate that interproximal lesions can be imaged from the occlusal surface (from above). Moreover, multiple illumination and detector angles can be exploited for optimal contrast between caries and sound tissue. These measurements suggest that NIR imaging offers significant advantages over the conventional visual, tactile and radiographic caries detection methods and other optical caries detection and imaging techniques.

A violet laser with an oscillating wavelength of 405 nm has recently been developed in industry. Laser irradiation at this wavelength penetrates tissue less aggressively than Nd:YAG and diode laser irradiation at wavelengths of 810 nm, and more aggressively than irradiation by carbon dioxide laser. Further, protein is reported to absorb this 405 nm wavelength at high rates. This study was conducted to evaluate the effect of the violet laser on soft tissue in vitro. A prototype violet diode laser produced by Sumitomo Electric Industries was used. This laser irradiates with a continuous wave at a wavelength of 405 nm. Soft tissue samples were irradiated by the device at output powers in a range from 850 mW to 2400 mW as the irradiated samples were conveyed at a scanning speed of 1 mm/sec. The beam diameter was about 270 μm. The irradiated samples were observed by a stereoscopic microscope, fixed with a 10% neutral formalin aqueous solution, and histologically examined. Irradiation by the device vaporized a U-shaped section of tissue to a depth of about 350 to 900 μm. A denatured layer measuring 300 to 450 μm in width was observed under the carbonization layer. The depth of vaporization increased in proportion to the power. These results indicate that a violet laser has good potential to become an effective laser for the cutting and coagulation of soft tissue.

Micro-Raman Spectroscopy (μ-RS) provides a unique tool in medicine for a not invasive and real time analysis of biological tissue for biopsy and "in vivo" investigation. Based on the evaluation of molecular vibration frequencies, the μ-RS is able to detect the main molecular bonds of protein constituents, as the C-H and C-C ones. Changes in frequency or in the relative intensity of the vibration modes revealed by μ-RS can be related to changes of chemical bond and of protein structure induced by pathology. The μ-RS has been performed on samples of oral tissue from informed patients, affected by pemphigus vulgaris (an oral pathology) in an advanced regression state. The biopsies were thin slices (about 1mm thick) with 6mm diameter. The sample was measured through a 170 μm thick cover-glass. The experimental set-up was mainly composed by a He-Ne laser and a monochromator equipped with a Peltier cell and with a grating of 1800 grooves/mm. The laser light was focused on the sample surface by means of a long focal length 50X optical objective. The main protein bonds are clearly detectable in the considered samples and this give important information on the integrity and on the state of tissue components (lipids and proteins), and consequently on the occurrence of pathology. The potential application of this method for in vivo analysis is an invaluable alternative to biopsy and pathological examinations for many medical application as screening diagnostic, therapy progress examination, and surgical support.

This in vitro pilot study investigated the CO₂ laser effects on demineralization inhibition in sound human dental enamel. Thirty six human enamel specimens were used and randomly assigned to 6 groups, as follows: I) Control; II) 1W; III) 2W; IV) 3W; V) 4W; VI) 5W. Group I one was kept as control and others were irradiated using a pulsed CO₂ laser (λ=10.6 μm) with low crescent potencies. Fourier Transform Raman Spectroscopy was used to study the surface composition of specimens after irradiation. One specimen from each group was analyzed by Scanning Electron Microscopy and the remaining ones were submitted to an 8-day pH cycling model with use of fluoridated toothpaste twice a day. After pH-cycling, the cross-sectional microhardness was performed for mineral loss (ΔZ) quantification. The data were analyzed by ANOVA and Tuckey test (α=0.05). No changes were found either in SEM photomicrographies or RAMAN Spectra of the specimens in all groups. The ΔZ values (n=5; mean±SD) for I-VI groups were: 1741.6±725.3a; 1782.7±639.0a; 1427.2±237.0a; 1780.6±552.4a; 1385.2±602.2a; 943.1±228.1a respectively. The highest percentage of caries inhibition was found in group VI (45.8%); however the differences between ΔZ of the groups were not statistically significant. The use of CO₂ laser with low fluencies did not prevent more caries development than the use of fluoridated toothpaste, even though group VI had present good results in caries inhibition. Energy densities higher than 0.0125 J/cm² should be used to promote chemical or morphological changes on enamel surface, which are able of inhibiting mineral.

Previous studies have demonstrated that Q-switched 355-nm laser pulses can be used to remove composite sealants and restorations from tooth surfaces without significant damage to sound tooth surfaces and have also shown that 355-nm lasers pulses can also be used to selectively etch the interprismatic protein of enamel to increase the effectiveness of topical fluoride for inhibiting decay and increase the bond strength to restorative materials without acid-etching. The first aim of this study was to test the hypothesis that topical fluoride can be applied after laser irradiation before composite resin placement without significantly reducing the bond-strength. The second aim was to test the hypothesis that thermal damage to existing composite due to laser irradiation does not compromise the adhesion of newly applied composite. There was a slight but significant reduction in the magnitude of the shear-bond strength of laser-treated surfaces with and without fluoride application. There was no significant difference in the magnitude of the bond strength between laser irradiated and non-laser irradiated aged composite to newly applied composite. These results suggest that after composite removal with 355-nm laser pulses fluoride can be subsequently applied to inhibit secondary caries before placement of composite restorative materials and that 355-nm laser pulses can be used for the repair of existing restorations.

Several past studies have suggested that lasers with and without added chromophores can be used for the selective removal of dental caries from stained pit and fissures in preparation for composite sealant placement with minimal damage to sound, unstained tooth structure. Polarization sensitive optical coherence tomography (PS-OCT) is a new nondestructive imaging technology that can be used to acquire images of caries lesions in occlusal surfaces. PSOCT is ideally suited to measure the caries depth and severity before and after selective removal from occlusal surfaces. In this study, λ=355-nm laser pulses of 5-ns duration at irradiation intensities ranging from 0.5-1.3 J/cm² were scanned across tooth surfaces to selectively remove decayed enamel with and without the addition of India ink. PS-OCT images were acquired before and after removal. The laser removal was also compared to air abrasion in order to compare selectivity of these two conservative caries removal technologies.