Measurements of erbium laser-ablation efficiency in hard dental tissues under different water cooling conditions

Laser triangulation measurements of Er:YAG and Er,Cr:YSGG laser-ablated volumes in hard dental tissues are made, in order to verify the possible existence of a "hydrokinetic" effect that has been proposed as an alternative to the "subsurface water expansion" mechanism for hard-tissue laser ablation. No evidence of the hydrokinetic effect could be observed under a broad range of tested laser parameters and water cooling conditions. On the contrary, the application of water spray during laser exposure of hard dental material is observed to diminish the laser-ablation efficiency (AE) in comparison with laser exposure under the absence of water spray. Our findings are in agreement with the generally accepted principle of action for erbium laser ablation, which is based on fast subsurface expansion of laser-heated water trapped within the interstitial structure of hard dental tissues. Our measurements also show that the well-known phenomenon of ablation stalling, during a series of consecutive laser pulses, can primarily be attributed to the blocking of laser light by the loosely bound and recondensed desiccated minerals that collect on the tooth surface during and following laser ablation. In addition to the prevention of tooth bulk temperature buildup, a positive function of the water spray that is typically used with erbium dental lasers is to rehydrate these minerals, and thus sustaining the subsurface expansion ablation process. A negative side effect of using a continuous water spray is that the AE gets reduced due to the laser light being partially absorbed in the water-spray particles above the tooth and in the collected water pool on the tooth surface. Finally, no evidence of the influence of the water absorption shift on the hypothesized increase in the AE of the Er,Cr:YSGG wavelength is observed.