Smart fiber tips for dental laser applications

Abstract

Abstract During the early days of laser medicine, progress was triggered by the development of new laser types with new wavelengths or power regimes, but now applicators and application conditions have assumed this role. Specially designed distal fiber tips allow (a) to increase the quality of laser ablation, (b) to modify laser-induced tissue effects significantly, and (c) to conceive new indications that are otherwise not possible. In this paper, several newly developed and optimized applicators and fiber tips for various dental Er:YAG-laser applications are presented, including an optimized chisel-shaped tip for improved calculus removal in periodontal pockets, a fiber tip for “remote” calculus removal in tooth furcations, a contact tip for caries therapy, and two contact tips, one with increased hemostasis for oral surgery and the other one for cleaning and disinfection of implants. Most of these tips were designed and optimized using optical ray-tracing. Promising designs were realized and investigated by in vitro experiments to evaluate the ablation quality, ablation efficiency, thermal effects, and to determine the suitable laser parameters. After the successful in vitro tests the applicators and tips were used in clinical tests. The results show that all of the developed fiber tips lead to an approval of the particular application. In conclusion, from our point of view the development of applicators and special fiber tips has more impact on the progress of laser dentistry than modifications of the laser itself.