Selective removal of esthetic composite restorations with spectral guided laser ablation.

Dental composites are used for a wide range of applications such as fillings for cavities, adhesives for orthodontic brackets, and closure of gaps (diastemas) between teeth by esthetic bonding. Anterior restorations are used to replace missing, diseased and unsightly tooth structure for both appearance and function. When these restorations must be replaced, they are difficult to remove mechanically without causing excessive removal or damage to enamel because dental composites are color matched to teeth. Previous studies have shown that CO2 lasers have high ablation selectivity and are well suited for removal of composite on occlusal surfaces while minimizing healthy tissue loss. A spectral feedback guidance system may be used to discriminate between dental composite and dental hard tissue for selective ablation of composite material. The removal of composite restorations filling diastemas is more challenging due to the esthetic concern for anterior teeth. The objective of this study is to determine if composite spanning a diastema between anterior teeth can be removed by spectral guided laser ablation at clinically relevant rates with minimal damage to peripheral healthy tissue and with higher selectivity than a high speed dental hand-piece.