Dentin bond strength after ablation using a CO(2) laser operating at high pulse repetition rates.

Pulsed CO(2) lasers show great promise for the rapid and efficient ablation of dental hard tissues. Our objective was to demonstrate that CO(2) lasers operated at high repetition rates can be used for the rapid removal of dentin without excessive thermal damage and without compromising adhesion to restorative materials. Human dentin samples (3x3mm(2)) were rapidly ablated with a pulsed CO(2) laser operating at a wavelength of 9.3-mu m, pulse repetition rate of 300-Hz and an irradiation intensity of 18-J/cm(2). The bond strength to composite was determined by the modified single plane shear test. There were 8 test groups each containing 10 blocks: negative control (non-irradiated non-etched), positive control (non-irradiated acid-etched), and six laser treated groups (three etched and three non-etched sets). The first and second etched and non-etched sets were ablated at a speed of 25 mm/sec and 50 mm/sec with water, respectively. The third set was also ablated at 50 mm/sec without application of water during laser irradiation. Minimal thermal damage was observed on the dentin surfaces for which water cooling was applied. Bond strengths exceeded 20 MPa for laser treated surfaces that were acid-etched after ablation (25-mm/sec: 29.9-MPa, 50-mm/sec: 21.3-MPa). The water-cooled etched laser groups all produced significantly stronger bonds than the negative control (p<0.001) and a lower bond strength than the positive control (p<0.05). These measurements demonstrate that dentin surfaces can be rapidly ablated by a CO(2) lasers with minimal peripheral thermal damage. Additional studies are needed to determine if a lower bond strength than the acid-etched control samples is clinically significant where durability of these bonded restoration supersedes high bond strength.