Objectives: The objective of this pilot study was to test the hypothesis that two–dimensional near-IR images of demineralization on tooth surfaces can be used to guide CO₂ laser ablation for the selective removal of artificial caries lesions from tooth surfaces.

Methods: Highly patterned artificial caries lesions were produced on 5 by 5 mm² bovine enamel samples by submerging the samples in demineralized solution for a 9-day period. Two-dimensional near-infrared (NIR) images were acquired at 1310-nm for each sample. Polarization sensitive optical coherence tomography (PS-OCT) was also used to acquire depth-resolved images of lesion areas. An imaging processing module was developed using Matlab programming language to analyze the imaging output and generate optical maps that were used to control a CO₂ laser with a wave length of 9.3-µm. Based on the optical maps, the laser was programmed to selectively remove the lesions to a uniform depth.

Results: The patterned artificial lesions were removed selectively using the optical map without damage to sound enamel areas. Post-ablation Near-IR imaging confirmed that carious lesions are removed while sound tissues are conserved.

Conclusions: This pilot study successfully demonstrated that near-IR imaging can be integrated with a CO₂ laser ablation system for the selective removal of dental caries. The next step is to test the hypothesis that various depth lesions can be removed with an iterative process of the uniform depth removal, and to verify that this approach can be applied to natural occlusal caries in the pits and fissures.

Support: NIDCR grants T-32 HDO52275-01, R01-DE14698, and R01-DE14554

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