The sound of dental tissue ablation as a possible parameter for conservative dentistry

摘要

Studies in cariology have been struggling for the development of caries prevention techniques, precocious diagnoses of lesions, re-mineralization of incipient carious lesions and early restorative intervention with minimally invasive procedures. When removing caries lesion, healthy dental structure is often removed inadvertently during its final phase, for being quite difficult to precise the limits between viable and decayed dental tissues clinically. With laser technologies, a subjective clinical hint, often used to indicate when tissue ablation should be stopped is that different sounds are perceptive whether in carious (bass) or in healthy (treble) dental structure; when sound produced by ablation turned treble it would mean that healthy tissue was reached. This study aims to classify those audio differences and to turn them into objective parameters for a conservative operative dentistry with minimally invasive tissue removal when using Erbium lasers. Twenty freshly extracted human teeth were used (10 decayed and 10 sound teeth). Dentine was Erbium laser irradiated under same parameters, distance and refrigeration and a mono directional microphone was set 10 cm far from the operative area in order to capture and record the ablation produced sounds when working either on carious or healthy dentine. Ten pulses per file were then analysed in a computer software (200 analyses).It was permitted to draw similarities among the patterns in each group (decayed and healthy teeth) as well as differences between decayed and healthy produced sounds. Audio analysis came out to be a technical reliable objective parameter to determine whether laser ablated dentine substrates are decayed or sound; therefore it can be proposed as a conservative parameter, avoiding unnecessary removal of healthy dentine and restricting it to carious one.