Investigation into the optimum beam shape and fluence for selective ablation of dental calculus at lambda = 400 nm.

Background And Objectives: A frequency-doubled Ti:sapphire laser is shown to selectively ablate dental calculus. The optimal transverse shape of the laser beam, including its variability under water-cooling, is determined for selective ablation of dental calculus.

Study Design/materials And Methods: Intensity profiles under various water-cooling conditions were optically observed. The 400-nm laser was coupled into a multimode optical fiber using an f = 2.5-cm lens and light-shaping diffuser. Water-cooling was supplied coaxially around the fiber. Five human tooth samples (four with calculus and one pristine) were irradiated perpendicular to the tooth surface while the tooth was moved back and forth at 0.3 mm/second, varying between 20 and 180 iterations. The teeth were imaged before and after irradiation using light microscopy with a flashing blue light-emitting diode (LED). An environmental scanning electron microscope imaged each tooth after irradiation.

Results: High-order super-Gaussian intensity profiles are observed at the output of a fiber coiled around a 4-in. diameter drum. Super-Gaussian beams have a more-homogenous fluence distribution than Gaussian beams and have a higher energy efficiency for selective ablation. Coaxial water-cooling does not noticeably distort the intensity distribution within 1 mm from the optical fiber. In contrast, lasers focused to a Gaussian cross section (< or =50-microm diameter) without fiber propagation and cooled by a water spray are heavily distorted and may lead to variable ablation. Calculus is preferentially ablated at high fluences (> or =2 J/cm(2)); below this fluence, stalling occurs because of photo-bleaching of the calculus. Healthy dental hard tissue is not removed at fluences < or =3 J/cm(2).

Conclusion: Supplying laser light to a tooth using an optical fiber with coaxial water-cooling is determined to be the most appropriate method when selectively removing calculus with a frequency-doubled Ti:sapphire laser. Fluences over 2 J/cm(2) are required to remove calculus efficiently since photo-bleaching stalls calculus removal below that value.