Transformation of hydroxyapatite to fluorapatite by irradiation with high-energy CO2 laser.

High-energy laser irradiation has been shown to cause crystalline transformations in apatites, which may lead to the formation of tricalcium phosphates with a resulting decrease in acid resistance. Depending on the nature and energy density of laser irradiation used, however, an increase of acid resistance of dental enamel has also been reported after laser irradiation. The aim of the present study was to investigate the phase transformation of hydroxyapatite (HA) to fluorapatite (FA) in a model system that incorporates sodium fluoride (NaF) into apatite structure by using laser irradiation. A CO2 laser was used at energy densities ranging from 21 to 500 J/cm2. Synthetic HA mixed with NaF (10:1) was the target of laser irradiation. The crystalline structures were then investigated using X-ray diffraction analysis. The results showed that a phase transformation of HA to FA could be realized, and that the threshold energy density needed was 38 J/cm2. Not only is the finding crystallographically important, but it also opens new perspectives for future research regarding the development of laser technology for clinical purposes.

Healing of rat mouth mucosa after irradiation with CO2, Nd:YAG, and CO2-Nd:YAG combination lasers.

The healing process of wounds made by a combination laser was studied in 90 rats. The laser system enabled both separate and combined use of CO2 and Nd:YAG laser irradiations. The laser wounds and the control excision wounds made by alligator forceps appeared on both sides of the tongue. Specimens from the wound sites were taken immediately, 6 h, and 1, 2, 4, 7, 11, 21, 28, and 42 days after surgery. The wound-healing process was studied by macroscopic evaluation before preparing the specimens for light microscopy. Some differences were noted in the wound-healing process among the three groups into which the experimental animals were divided. Tissue coagulation damage was most extensive in the Nd:YAG laser sites, where it was observed in its full extent 4 days after surgery. Epithelial cells were seen to begin to proliferate in all the wounds 6 h after surgery. Re-epithelialization was completed by between 7 (CO2) and 21 days (Nd:YAG) at all the wound sites. The inflammatory cell infiltration was more prominent in the Nd:YAG and the CO2-Nd:YAG combination laser wounds than in the CO2 and excision wounds during healing. Tissue regeneration occurred faster with less contraction in the combination CO2-Nd:YAG wounds than in Nd:YAG wounds. The best macroscopic healing result was seen in the CO2 wound sites. The combination laser was effective both at cutting and at coagulating tissue. Combining the CO2 and Nd:YAG laser irradiation into one beam resulted in a greater incision depth than what could have been expected from using the two lasers separately.

Effects of carbon dioxide, Nd:YAG and carbon dioxide-Nd:YAG combination lasers at high energy densities on synthetic hydroxyaptite.

The aim of this study was to determine the crystalline structure and chemical alterations of synthetic hydroxyapatite after irradiation with either CO2, Nd:YAG or CO2-Nd:YAG combination lasers at high energy densities of 500-3,230 J.cm2. Further, dissolution kinetics of the lased material were analysed and compared with those of unlased apatite. Electron microscopy showed that the lased material consisted of two kinds of crystals. From the micrographs their diameters varied from 600 to 1,200 A and from 3,000 to 6,000 A, respectively. The larger crystals showed 6.9-Angström periodic lattice fringes in the transmission electron microscope. alpha-Tricalcium phosphate (TCP) was identified by X-ray diffraction. Selective-area electron diffraction identified the large crystals to consist of tricalcium phosphate while the smaller crystals were probably hydroxyapatite. Assays of dissolution kinetics showed that at these high energy densities lased material dissolved more rapidly than unlased synthetic hydroxyapatite due to the higher solubility of TCP.

Irradiation of human dental tissues with CO2-, Nd:YAG-, and CO2-Nd:YAG combination laser.

Extracted third molars were used to study the effect of Nd:YAG laser irradiation combined with CO2 laser beam on dental hard tissues. The specimens were studied with SEM after lasing and the size of the impact areas and beam penetration into enamel and dentin were planimetrically analyzed. High-energy CO2 laser (e.g. 10 s irradiation with 10 W output energy) penetrated all enamel and dentin. The simultaneous addition of Nd:YAG irradiation to the CO2 beam was found to increase the effect of CO2 laser, while Nd:YAG irradiation alone, used with equivalent energy densities, did not cause any effect on enamel surface. Thus, Nd:YAG laser was found to potentiate statistically significantly the effect of CO2 irradiation, but the morphologic alterations on dental hard tissues, such as crater formation at the beam focus site, appeared to be due to CO2 irradiation alone.