Photoabalation in dental hard substances and atheromatous plaques - The efficiency and selectivity criteria for surgery

The basic principals of IR photoabalation are relatively easy to understand as long as water is the predominant absorber in the target tissue (e.g. brain tissue, cornea). Dental hard substances are typical target materials for the study of biological materials with low water content (30%) Its main constituent is hydroxyapatit (50%) with maximal absorption at 9.5 μm wavelength. The photoablation efficiency, the collateral thermal damage and the resultant formation of thermally induced surface cracks were investigated. Unlike the 2.95 μm of the Er:YAG, already in use, the 9.5 μm radiation minimizes the penetration depth; as a consequence, the volume of heated material per pulse is minimal too and thus thermal cracks - a potential source of caries are avoided. Furthermore at 9.5 μm, the ablation threshold requires a minimal fluence; this is an element of selectivity, limiting photoablation to dentin and enamel, while neighboring gingiva cannot be ablated accidentally. Removal of atherosclerotic plaques for recanalization of obliterated cardiac vessels (laser angioplasty) is a minimally invasive surgical procedure of highest socioeconomic relevance. The rather inhomogeneous composition of apatit and colesterol (both absorbing at 9.5 μm) make plaques a particularly complex target material; while the ablation efficiency has to be high, the related shock wave should be minimal. The open-quote selectivity close-quote criterion of the ablation process must avoid accidental perforation of the underlying vessel walls (composed of connective tissue with high water content), a deadly complication exclamation point Experimental results with FELIX will be demonstrated. Photoacoustic spectroscopy in a recently developed non contact mode has been proved to provide various informations (on line) about the IR-photoablation process