Ultrashort pulse lasers for hard tissue ablation

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 (PRRs). Using proper operating parameters, ultrashort pulse lasers (USPLs) 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, USPLs 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-/spl mu/m pulses of variable duration. Both 350-fs and 1-ns pulse regimes were studied. Ablation rates (ARs), 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 USPLs in several fields of medicine that currently apply traditional surgical methods.