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**Part 4** 

**Medical Treatment of Caries** 


**Part 4** 

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**15** 

*Brazil*

**Laser Technology for Caries Removal** 

Patrícia Aparecida da Ana, Sergio Brossi Botta and Denise Maria Zezell *University of São Paulo, School of Dentistry and Nuclear and Energetic Research Institute,* 

Laser technology has been in the scope of dentistry community since Stern & Sognnaes (1964) studied laser application on dental hard tissues. Lasers have become an attractive instrument for many dental procedures including soft tissues surgery (Sperandio et al., 2011), decontamination (Benedicenti et al., 2008; Koba et al., 1998) and for assuring antiinflammatory effects (Lang-Bicuto et al., 2008). In restorative dentistry, laser has been used successfully for cavity preparation (De Moor et al., 2010; Obeidi et al., 2009), caries prevention (Namoour et al., 2011; Rechmann et al., 2011; Zezell et al., 2009), caries decontamination (Namour et al., 2011) and caries removal (Neves et al., 2011; White et al., 1993). For that, high intensity lasers are indicated, which are able to promote controlled temperature rise in a small and specific area of dental hard tissue (Ana et al., 2007). Depending on the temperature rise and the interaction of laser irradiation with dental tissues, it is possible to produce specific micro structural and/or mechanical changes related

The use of lasers for cavity preparation and caries removal is based on the ablation mechanism, in which dental hard tissue can be removed by thermal and/or mechanical effect during laser irradiation (Seka et al., 1996). This mechanism relies on the type of tissue to be irradiated, as well as the characteristics of laser equipments. The knowledge of laser wavelength, laser emission, pulse duration, pulse energy, repetition rate, beam spot size, delivery method, laser beam characteristics (Ana et al., 2006), and optical properties of the tissue, such as the refractive index, the scattering coefficient (μs), the absorption coefficient (μa), and the scattering anisotropy (Featherstone, 2000a) are necessary to assure better

For irradiation in dental hard tissues, the most frequent laser systems used are Nd:YAG λ = 1.064 µm), Argon (λ = 0.488 µm), Ho:YLF (λ = 2.065 µm), Ho:YAG (λ = 2.100 µm), Er:YAG (λ = 2.940 µm), Er,Cr:YSGG (λ = 2.780 µm), Diode (λ = 0.810 µm) and CO2 (λ = 9.300 µm or 9.600 µm or 10.600 µm). With the exception of the argon laser, these lasers emit in infrared range of electromagnetic spectrum, and a good number of equipment operates at the free running mode, with pulse durations of microseconds (µs). Considering that laser wavelength must be absorbed by enamel and dentin to assure the efficient caries removal and cavity preparation (Seka et al., 1996), the most successful laser systems for this purpose

clinical results without thermal or mechanical damages to the dental hard tissue.

**1. Introduction** 

to a correct clinical application.

Adriana Bona Matos, Cynthia Soares de Azevedo,
