Rapid ablation of dental hard tissue using promoter-assisted pulsed Nd:YAG laser

Nd:YAG lasers have been used previously for selective removal of various material from teeth. To permit ablation of healthy enamel with the Nd:YAG laser, we have adopted a strategy in which micro-drops of photoabsorptive 'promoters' are placed on the enamel to enhance absorption of individual laser pulses. Ink-jet technology dispenses the micro-drops with micron- and millisecond-scale precision. Various promoters using drug and cosmetic dyes, indocyanine green, or carbon-black pigments have been studied. Typical ablation parameters are 1.064 micrometers ; 20-180 mJ per pulse; 100 microsecond(s) ; 10-30 pulses/sec; 0.2-2.0 nl drops. Recent results from the program include: (1) For a variety of promoters, a monotonic relationship obtains between absorption coefficient at 1.064 micrometers and the efficiency of ablation of enamel. (2) With different promoter volumes, the efficiency of ablation rises, plateaus, then falls with increasing volume. (3) At drilling rates of 30 pulses/sec, ablation efficiency approaches rates of 0.1 mm3/sec. LM and SEM observations show a glassy 'pebbled' crater surface indicative of hydroxyapatite that has cooled, condensed, and solidified on the crater walls. Together these results favor the view that a micro-drop promoter-assisted Nd:YAG drill can five clinically useful ablations hard dental tissue.