Sohi Rastegar

Profiles of light, temperature, and thermal damage distributions in tissue based on measured optical properties are examined theoretically for high power diode laser (810 nm) and Nd:YAG laser 1064 nm). Generally higher absorption and effectively lower optical penetration has been experimentally observed at the wavelength of diode laser as compared to that of Nd:YAG laser. Results of this study indicate that similar thermal damage volumes are expected to be obtained by the two lasers, in general. However, for same irradiation conditions a larger volume of damage and more charring near the surface is predicted when using the diode laser on prostate tissue, and similarly for myocardial tissue. Role of blood presence throughout tissue, in terms of its optical interaction, as well as the role of a small layer of blood between the laser and the tissue is also investigated for both wavelengths.

Nd:YAG lasers have been used previously for selective removal of various material from teeth. To permit ablation of healthy enamel with the Nd:YAG laser, we have adopted a strategy in which micro-drops of photoabsorptive 'promoters' are placed on the enamel to enhance absorption of individual laser pulses. Ink-jet technology dispenses the micro-drops with micron- and millisecond-scale precision. Various promoters using drug and cosmetic dyes, indocyanine green, or carbon-black pigments have been studied. Typical ablation parameters are 1.064 micrometers ; 20-180 mJ per pulse; 100 microsecond(s) ; 10-30 pulses/sec; 0.2-2.0 nl drops. Recent results from the program include: (1) For a variety of promoters, a monotonic relationship obtains between absorption coefficient at 1.064 micrometers and the efficiency of ablation of enamel. (2) With different promoter volumes, the efficiency of ablation rises, plateaus, then falls with increasing volume. (3) At drilling rates of 30 pulses/sec, ablation efficiency approaches rates of 0.1 mm3/sec. LM and SEM observations show a glassy 'pebbled' crater surface indicative of hydroxyapatite that has cooled, condensed, and solidified on the crater walls. Together these results favor the view that a micro-drop promoter-assisted Nd:YAG drill can five clinically useful ablations hard dental tissue.

ABSTRACT Nd:YAG lasers have been used previously for selective removal of various material from teeth. To permit ablation of healthy enamel with the Nd:YAG laser, we have adopted a strategy in which micro-drops of photoabsorptive 'promoters' are placed on the enamel to enhance absorption of individual laser pulses. Ink-jet technology dispenses the micro-drops with micron- and millisecond-scale precision. Various promoters using drug and cosmetic dyes, indocyanine green, or carbon-black pigments have been studied. Typical ablation parameters are 1.064 micrometers ; 20-180 mJ per pulse; 100 microsecond(s) ; 10-30 pulses/sec; 0.2-2.0 nl drops. Recent results from the program include: (1) For a variety of promoters, a monotonic relationship obtains between absorption coefficient at 1.064 micrometers and the efficiency of ablation of enamel. (2) With different promoter volumes, the efficiency of ablation rises, plateaus, then falls with increasing volume. (3) At drilling rates of 30 pulses/sec, ablation efficiency approaches rates of 0.1 mm3/sec. LM and SEM observations show a glassy 'pebbled' crater surface indicative of hydroxyapatite that has cooled, condensed, and solidified on the crater walls. Together these results favor the view that a micro-drop promoter-assisted Nd:YAG drill can five clinically useful ablations hard dental tissue.

ABSTRACT Fluorescence spectroscopic detection and photodynamic therapy may provide an effective approach for early detection and treatment of oral cancer. Thus the development of a safe photosensitizer that could enhance the spectroscopic contrast between normal and neoplastic tissue, while allowing for selective photosensitization and treatment of pre-malignant and malignant lesions in the oral cavity, is highly desired. In this study, the pharmacokinetics and a safety of 5-aminolevulinic acid (ALA) that could induce an endogenous precursor of protoporphyrin IX and heme in the biosynthetic pathway was investigated. Two doses of ALA:25 and 75 mg/kg were administered intravenously to 4 and 3 dogs, respectively. A 'wash-out' period of 1 week between administration of each does was allowed to ensure against PpIX build-up. Using an optical multichannel analyzer, the fluorescence from the oral cavity was recorded at 3 sites: buccal mucosa, gums, and the tongue, and also from a remote site, the skin. A fiber optic probe was used to deliver excitation and collect the emitted fluorescence. Results showed that the ALA-induced fluorescence reached a peak at 2-4 hours, and returned to baseline in 24-31 hours. The dogs were stable during the course of the study, minimal vomiting was noted. In conclusion, the study showed that higher doses result in a higher peak at a later time.It was observed that different tissues have different pharmacokinetic response, the tongue and the gums have the highest peak fluorescence values, followed by the buccal mucosa and skin.

ABSTRACT Thermal therapy using various heating sources such as lasers or microwaves to destroy benign and malignant lesions has recently gained widespread acceptance. However, the accurate prediction of thermal damage in tissue according to theoretical or computer modeling is difficult and unreliable due to target variability with respect to physical properties, geometry, and blood perfusion. Thus, one of the major obstacles to application of thermal therapies has been the lack of a noninvasive, real-time method that could determine the extent and geometry of treated tissue. To evaluate the effects of laser heating on tissue, we have developed an analog-digital hybrid Doppler ultrasound system to measure the phase and amplitude of ultrasonic echoes returned from the heated tissue. The system consists of an eight-gate pulsed Doppler detector, a 16-channel 12-bit A/D converter, and a signal analysis and visualization software package. In vitro studies using canine liver showed two distinct types of modulation of the echoes along the ultrasound beam path during laser irradiation using an 810 nm diode laser. Type 1 signals showed a small and slow variation in amplitude and phase, and were attributed to tissue coagulation. Type 1 signals showed a small and slow variation in amplitude and phase, and were attributed to tissue coagulation. Type 2 signals showed large and rapid variations in amplitude and phase which usually appeared after tissue surface explosion and were indicative of tissue ablation. We hypothesize that the observed phase changes in type 1 signals are due to thermal effects within the tissue consistent with tissue expansion and contraction while the phase changes in type 2 signals are likely due to formation and motion of gas bubbles in the tissue. A further development of the Doppler ultrasound technique could lead to the generation of feedback information needed for monitoring and automatic control of thermal treatment using various heating modalities such as laser, high intensity focused ultrasound, microwaves, or radio frequency waves.