Heat generation caused by ablation of dental hard tissues with an ultrashort pulse laser (USPL) system

Heat generation during the removal of dental hard tissues may lead to a temperature increase and cause painful sensations or damage dental tissues. The aim of this study was to assess heat generation in dental hard tissues following laser ablation using an ultrashort pulse laser (USPL) system. A total of 85 specimens of dental hard tissues were used, comprising 45 specimens of human dentine evaluating a thickness of 1, 2, and 3 mm (15 samples each) and 40 specimens of human enamel with a thickness of 1 and 2 mm (20 samples each). Ablation was performed with an Nd:YVO4 laser at 1,064 nm, a pulse duration of 9 ps, and a repetition rate of 500 kHz with an average output power of 6 W. Specimens were irradiated for 0.8 s. Employing a scanner system, rectangular cavities of 1-mm edge length were generated. A temperature sensor was placed at the back of the specimens, recording the temperature during the ablation process. All measurements were made employing a heat-conductive paste without any additional cooling or spray. Heat generation during laser ablation depended on the dental hard tissue (enamel or dentine) and the thickness of the respective tissue (p < 0.05). Highest temperature increase could be observed in the 1-mm thickness group for enamel. Evaluating the 1-mm group for dentine, a significantly lower temperature increase could be measured (p < 0.05) with lowest values in the 3-mm group (p < 0.05). A time delay for temperature increase during the ablation process depending on the material thickness was observed for both hard tissues (p < 0.05). Employing the USPL system to remove dental hard tissues, heat generation has to be considered. Especially during laser ablation next to pulpal tissues, painful sensations and potential thermal injury of pulp tissue might occur.