It is challenging to identify demineralized areas of root lesions due to cervical erosion, calculus formation, andheavy staining of dentin. We have found that root caries can be imaged with extremely high contrast at shortwavelength IR (SWIR) wavelengths beyond 1500-nm. Lasers are well suited for the selective removal of carieslesions from tooth surfaces. A CO_2 laser operating at a wavelength of 9.3-μm was combined with a thuliumdopedfiber laser operating at 1880-nm for the selective removal of root caries lesions from extracted teeth.Serial SWIR reflectance images at 1880-nm were used to guide the CO_2 laser for image-guided laser ablation.Cross polarization optical coherence tomography (CP-OCT) was used to assess the initial depth of the lesionsbefore removal and assess the volume of sound and demineralized tissue removed by the CO_2 laser. With thisimage-guided approach, we believe we can achieve highly selective lesion removal and minimal damage tosurrounding sound tissues.
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