WO1999055243A1 - Apparatus for and method of laser surgery of hard tissues - Google Patents
Apparatus for and method of laser surgery of hard tissues Download PDFInfo
- Publication number
- WO1999055243A1 WO1999055243A1 PCT/US1999/008751 US9908751W WO9955243A1 WO 1999055243 A1 WO1999055243 A1 WO 1999055243A1 US 9908751 W US9908751 W US 9908751W WO 9955243 A1 WO9955243 A1 WO 9955243A1
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- WO
- WIPO (PCT)
- Prior art keywords
- outputs
- spot
- pulsation
- output
- pulsating
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
- A61C1/0046—Dental lasers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B2018/2065—Multiwave; Wavelength mixing, e.g. using four or more wavelengths
- A61B2018/207—Multiwave; Wavelength mixing, e.g. using four or more wavelengths mixing two wavelengths
Definitions
- the present invention relates to an apparatus for and further to a method of performing laser surgeries in hard biological tissues and, more particularly, to an apparatus for and method of ablating hard biological tissues characterized by low water content.
- Directing coherent radiation from a laser at a target is a well known method for precisely cutting that target by ablating or vaporizing a portion thereof.
- the dynamic nature of the target poses special problems. For example, fluids such as blood may flow into the area of the cut, obscuring that area and absorbing part of the energy that otherwise would go into ablating the target.
- U.S. Pat. application No. 08/904,249 teaches a method of laser surgery suited for soft tissues (e.g., soft dental tissue, gums), wherein two coherent radiation sources are used concurrently and coaxially for shallow ablating combined with deeper coagulation of the soft tissue, thereby preventing bleeding which otherwise interferes with ablation.
- soft tissues e.g., soft dental tissue, gums
- hard tissues such as hard dental tissues (enamel and dentine of the teeth) or bones, which are tissues characterized by low water content.
- Soft tissues contain about 70 % - 80 % water by weight, however, hard tissues, e.g., enamel and dentine in the tooth contain lower amount of water, in the range of about 2 % - 20 %.
- Ablation of biological tissues can be strongly effected using coherent radiation in the near infrared spectral range in which water has strong absorption peaks.
- Erbium YAG (Er:YAG) laser was probed for use in biological tissue ablation. Its radiation wavelength (2.94 microns) matches the strongest water absorption peak in the infrared spectral range, 3 which renders the absorption of this wavelength by water hundreds of times higher than, for example, the wavelength generated by Ho:YAG lasers.
- Er: YAG laser systems are therefore of choice for hard tissue ablation which are low in water content, since due to the high absorption of Er: YAG radiation by water effective ablation associated with reduced penetration depth and minimal thermal damage are obtained.
- the water content in dentine is typically about 20 % and in enamel it is typically about 2-10 %.
- the high absorption of Er:YAG laser radiation by water in the hard tissue of a tooth allows effective ablation of enamel and dentine.
- the penetration depth of the Er: YAG laser radiation into enamel and dentine is in the range of 3 to 7 microns. Roughly, this means that about 70 % of the incident energy is absorbed in these layers. However, at least 10 % of the Er:YAG laser energy penetrates twice as deeper.
- the deep penetrating tail of the incident radiation produces residual heat that causes strong local heating of the treated tooth.
- the local temperature at the treated area can reach hundreds of degrees Centigrade. This high temperature may cause damage to the soft tissue within the tooth which is vital for its survival. Furthermore, it vaporizes water from the tooth tissue. A decrease in the water content in the tissue reduces its absorption properties and consequently increases the penetration and residual heat effects and decreases the effectivity of ablation.
- YAG lasers Yet another problem of Er: YAG lasers is the cracking of the treated tooth tissue due to the shock waves that propagate into the tooth. Such cracks have been noted mainly while using higher radiant energies. As a result, the use of relatively low-energy pulses for safely treatment of dental hard tissues is required. This in-rurn reduces ablation efficiency.
- Er:YAG laser parameters are typically set to compromise and satisfy all of the factors herein described, resulting in low and slow ablation capabilities.
- CO2 lasers have also been attempted in hard tissue dentistry. CO2 lasers emit at 9.0 to 10.6 microns and are therefore efficiently absorbed by hydroxyapatite which is a natural constituent of hard biological tissues such at teeth and bones. However, using CO2 lasers, researchers have found that at energies sufficient for effective teeth ablation, a detrimental phenomenon of plasma generation near or at the tooth surface is experienced.
- an apparatus for and a method of ablating a target site of a hard biological tissue such as enamel, dentine and bone tissue 5
- the apparatus comprising (a) a first radiation source activatable of producing a first output having a wavelength of between 1.5 and 6.5 microns; (b) a second radiation source activatable of producing a second output having a wavelength of between 9.0 and 10.6 microns; (c) a delivering arrangement for effecting coaxiallity of the first and second outputs and for concurrently delivering the outputs to the target site; wherein the first and second outputs are selected such that concurrent delivery of the first and second outputs to the target site ablates the hard tissue at the target site.
- the method comprising the steps of (a) selecting a first radiation source activatable of producing a first output having a wavelength of between 1.5 and 6.5 microns; (b) selecting a second radiation source activatable of producing a second output having a wavelength of between 9.0 and 10.6 microns; (c) using a delivering arrangement, coaxially and concurrently delivering the first and second outputs to the target site; wherein the first and second outputs are selected such that the coaxial and concurrent delivery of the first and second outputs to the target site ablates the hard tissue at the target site.
- the first and second radiation sources are each independently a laser.
- the first radiation source is a laser selected from the group consisting of Holmium doped laser, Erbium doped laser and carbon mono- oxide laser.
- a laser selected from the group consisting of Holmium doped laser, Erbium doped laser and carbon mono- oxide laser.
- Er.YAG, Er:YSGG or Ho:YAG Preferably, Er.YAG, Er:YSGG or Ho:YAG.
- the first wavelength is selected from the group consisting of 2.06, 2.78 and 2.94 microns. 6
- the first output further has a beam cross sectional geometry at the target area selected from the group consisting of a full spot and a hulled spot.
- the spot has a size of between 0.1 millimeters and 5 millimeters, preferably, 0.2 millimeters and 1.5 millimeters.
- the full spot is selected substantially round, square or triangular.
- the full spot is top hat.
- the hulled spot is selected substantially circular, square, triangular or cross-shaped.
- the first output is pulsating.
- the pulsation is selected having pulses with very short rising/falling time in a range of less than several microseconds.
- the pulsation has a repetition rate of 1 Herz to 100 Herz.
- the pulsation is selected having a pulse duration of between several picoseconds to several milliseconds. Preferably between 50 microseconds and 800 microseconds.
- the pulsation is selected having a pulse energy of between 0.1 millijouls to 5 jouls. Preferably between 50 millijouls to 1.0 jouls. 7 According to still further features in the described preferred embodiments the pulsation is selected having a pulse energy fluence of between 5 jouls per square centimeter to 200 jouls per square centimeter.
- the delivering arrangement includes a focusing arrangement for focusing the first and second outputs on one end of an optical fiber.
- the delivering arrangement includes a telescope for focusing the first and second outputs.
- the delivering arrangement includes a delivering vehicle selected from the group consisting of a hollow waveguide, an optic fiber, an optic fiber bundle, and an articulated arm.
- the delivering arrangement includes a contact tip at a distal end thereof.
- the second radiation source is a carbon dioxide laser.
- the second wavelength is selected from the group consisting of 9.3 and 9.6 microns.
- the second output further has a beam cross sectional geometry at the target area selected from the group consisting of a full spot and a hulled spot.
- the spot has a size of between 0.1 millimeters and 5 millimeters. Preferably, between 0.2 millimeters and 1.5 millimeters. 8 According to still further features in the described preferred embodiments the full spot is selected substantially round, square or triangular.
- the hulled spot is selected substantially circular, square, triangular or cross-shaped.
- the second output is pulsating.
- the pulsation has a repetition rate of 1 Herz to 100 Herz.
- the pulsation is selected having a pulse duration of between several picoseconds to several milliseconds. Preferably between 50 microseconds to 1 millisecond. According to still further features in the described preferred embodiments the pulsation is selected having a pulse energy of between 0.1 millijouls to 5 jouls.
- the pulsation is selected having a pulse energy fluence of between 1 jouls per square centimeter to 200 jouls per square centimeter.
- the first and second outputs are both pulsating and the first and second outputs are at least partially overlapping in time.
- the first and second outputs are both pulsating and the first and second outputs are non-overlapping in time.
- the first and second outputs are both pulsating synchronously.
- the first and second outputs are both pulsating simultaneously. 9 According to still further features in the described preferred embodiments the first and second outputs are both pulsating alternately.
- the first output is absorable mostly by water in the hard tissue
- the second output is absorbable mostly by hydroxyapatite in the hard tissue
- the present invention successfully addresses the shortcomings of the presently known configurations by providing apparatus and method for ablating hard tissues such as tooth tissue with reduced heating effects.
- FIG. 1 is a schematic depiction of a laser apparatus according to the present invention
- FIG. 2 shows a comparison of the absorption coefficients of water and hydroxyapatite
- FIG. 3 shows a detailed transmission curve of hydroxyapatite
- FIG. 4 is a plot of an Er:YAG laser pulse before and after tails reshaping according to the present invention
- FIGs. 5a-d show alternative radiation delivering vehicles according to the present invention
- FIG. 6 shows a contact tip preferably employed with the delivering vehicles according to the present invention
- FIG. 7 demonstrates several possible pulse relations according to the present invention.
- FIG. 8 shows a plurality of spot shapes generated by the apparatus according to the present invention.
- the present invention is of an apparatus and method which can be used for ablating hard tissues characterized by low water content.
- the present invention can be used for dental treatment, for effectively and efficiently ablating enamel and dentine, while maintaining heat production in a treated tooth as low as possible, under damaging levels.
- FIG. 1 illustrates an apparatus according to the present invention, which is referred to hereinbelow as apparatus 20.
- apparatus 20 serves for ablating a target site 22 of a hard
- Apparatus 20 includes a first radiation source 26.
- Source 26 is activatable of producing a first output 28 having a wavelength of between 1.5 and 6.5 microns.
- Apparatus 20 further includes a second radiation source 27.
- Source 27 is activatable of producing a second output 30 having a wavelength of between 9.0 and 10.6 microns.
- Apparatus 20 further includes a delivering arrangement 32 for effecting coaxiallity of first 28 and second 30 outputs and for concurrently delivering these outputs to target site 22.
- arrangement 32 is preferably equipped with a beam combiner 23, which includes two prisms 23a and 23b, as well known in the art.
- First 28 and second 30 outputs are selected such that concurrent and coaxial delivery thereof to target site 22 ablates hard tissue 24 at target site 22.
- first 26 and second 27 radiation sources are each independently a coherent radiation source such as a laser.
- coherent radiation sources such as a laser.
- other coherent radiation sources e.g., those equipped with suitable filters may alternatively be employed.
- Lasers are presently preferred due to the high energy radiation they are capable of efficiently producing.
- first radiation source 26 is preferably a solid state laser, such as, but not limited to Holmium doped laser, e.g., Ho:YAG laser emitting at 2.06 microns, Erbium doped laser, e.g., Er:YAG laser emitting at 2.94 microns, Er:YSGG laser emitting at 2.78 microns or carbon mono-oxide (CO) laser emitting between 5 and 6.5 microns.
- Holmium doped laser e.g., Ho:YAG laser emitting at 2.06 microns
- Erbium doped laser e.g., Er:YAG laser emitting at 2.94 microns
- Er:YSGG laser emitting at 2.78 microns
- CO carbon mono-oxide
- the lower spectral range (1.5-6.5 microns) is designed to be absorbed by water in the hard tissue, whereas the upper spectral range (9.0-10.6 microns) is designed to be absorbed by hydroxyapatite in the hard tissue. 12
- the overall energy invested in the hard tissue is increased and ablating is more efficient, heating is decreased as compared with the use of, for example Er:YAG laser alone.
- the Erbium doped laser which is presently the laser of choice for the low spectral range, is set in its optimal parameters as, for example, known from the prior art, whereas the carbon dioxide laser adds ablating energy to render ablation more efficient.
- Figure 2 shows a comparison of the absorption coefficients of water and hydroxyapatite. Please note that at 2.94 (the wavelength of Er:YAG laser) the major absorption is in water, while at wavelengths of carbon dioxide lasers, hydroxyapatite is the dominant absorbent.
- first output 28 is selected pulsating, preferably at 1 Herz to 100 Herz, more preferably 1-30 Herz.
- the rising/falling of the pulse shape, especially of first output 28, should be as sharp as possible to avoid unnecessary heating.
- a usual pulse shape of free running laser is demonstrated in Figure 4. Significant parts of the pulse (the left and right tails which are shown in black) are below ablation threshold and thus contribute solely to heating of the treated tooth and to water vaporization.
- the pulsation of output 28 is preferably selected having a pulse duration of between several picoseconds to several milliseconds, more preferably, between 50 microseconds and 800 microseconds. Selecting pulse duration as described may, for example, be effected by a Q-switch, as well known in the art. 13
- the pulse duration should be compatible with the thermal relaxation time of a layer having a thickness which equals the penetration depth of the radiation.
- the penetration depths of Er YAG radiation into enamel and dentine are in the range of 3 to 7 micrometers.
- the pulsation is further selected having a pulse energy of preferably between 0.1 millijouls to 5 jouls, more preferably between 50 millijouls to
- 1.0 jouls It is preferably further selected of having a pulse energy fluence of between 5 jouls per square centimeter to 200 jouls per square centimeter.
- delivering arrangement 32 includes a focusing arrangement 34 for focusing first 28 and second 30 outputs on one end 36 of an optical fiber 38.
- delivering arrangement 32 includes a telescope, as indicated in
- Figure 1 by a pair of lenses 40, for focusing first 28 and second 30 outputs.
- delivering arrangement 32 includes a delivering vehicle 42, such as, but not limited to, a hollow waveguide 44, an optic fiber 46, an optic fiber bundle 48 or an articulated arm 50.
- a delivering vehicle 42 such as, but not limited to, a hollow waveguide 44, an optic fiber 46, an optic fiber bundle 48 or an articulated arm 50.
- a Ho: YAG laser has the advantage of producing radiation that propagates through glass or quartz, so that optical fibers made of glass or quartz may be used to conduct the radiation to the treated site.
- the radiation produced by an Er:YAG laser or by a carbon dioxide laser must be conducted to the treatment site by a hollow waveguide, or by optical fibers made of exotic materials such as, but not limited to, crystalline silver halides.
- delivering arrangement 32 includes a contact tip 52 at a 14 distal end 54 thereof, shown in Figure 1.
- Tip 52 is preferably selected conical and serves for carefully delivering outputs 28 and 30 to treated area 22 of tissue 24.
- second radiation source 27 is a carbon dioxide laser, emitting at 9.3 or 9.6 microns.
- second output 30 is pulsating, e.g. in a repetition rate of 1 Herz to 100 Herz, preferably 1 Herz to 30 Herz.
- the pulsation of second output 30 is preferably selected having a pulse duration of between several picoseconds to several milliseconds, more preferably 50 microseconds to 1 millisecond.
- the pulsation is preferably further selected having a pulse energy of between 0.1 millijouls to 5 jouls. At round spot size of 1 millimeter in diameter the pulse energy of
- the pulsation of second output 30 is preferably further selected having a pulse energy fluence of between 1 jouls per square centimeter to 200 jouls per square centimeter.
- first 28 and second 30 outputs are both pulsating.
- the pulses of first 28 and second 30 outputs are at least partially overlapping in time (compare plots a and b) or alternatively non-overlapping in time or pulsating alternately (compare plots a and d).
- first 28 and second 30 outputs are both pulsating synchronously (compare plot a to either plot b, c, or d). 15
- first 28 and second 30 outputs are both pulsating simultaneously (compare plots a and c).
- first 28 and/or second 30 outputs have a beam cross sectional geometry at target area 22 of either full spot 60 or a hulled spot 62. Regardless of its geometry, the general size of the spot is preferably selected between 0.1 millimeters and 5 millimeters.
- a full spot according to the present invention is preferably selected either substantially round 64, square 66 or triangular 68.
- a hulled spot according to the present invention is preferably selected substantially circular 70, square 72, triangular 74, cross- shaped 76 or including several sub spots 78.
- hulled spot refers to a spot that no more than 50 % of the area dictated by its periphery, as indicated, for example, by broken line 80 in Figure 8, includes radiation.
- the spots of first 28 and second outputs are co-localized and/or co-shaped.
- One ordinarily skilled in the art would know how to devise optics for obtaining the preferred beam cross sectional (spot) geometry at target area 22 as herein described.
- Ringed spots are of special interest because they increase the effectivity of drilling into the hard tissue.
- YAG lasers when ablating hard tissues is access heating, which limits ablating efficiency.
- Ablating a tissue in a ring fashion as compared to full ablation results in a similar result, since the tissue within the ring, although not irradiated is disconnected from the main tissue bulk, becomes fragile, and therefore can be easily removed. Doing so, the amount of radiation per area unit is increased, while the total amount of energy invested may be maintained unchanged. As a result, ablation is improved, while heating and water vaporization effects are minimized.
- a method of ablating a target site of a hard biological tissue, such as enamel, dentine and bone tissue includes the following steps.
- a first radiation source is selected activatable of producing a first output having a wavelength of between 1.5 and 3.6 microns.
- a second radiation source is selected activatable of producing a second output having a wavelength of between 9.0 and 10.6 microns.
- a delivering arrangement is used for coaxially and concurrently delivering the first and second outputs to the target site, wherein the first and second outputs are selected such that the coaxial and concurrent delivery of the first and second outputs to the target site ablates the hard tissue at the target site.
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU37546/99A AU742054B2 (en) | 1998-04-30 | 1999-04-21 | Apparatus for and method of laser surgery of hard tissues |
IL13935099A IL139350A0 (en) | 1998-04-30 | 1999-04-21 | Apparatus for and method of laser surgery of hard tissues |
CA002331113A CA2331113A1 (en) | 1998-04-30 | 1999-04-21 | Surgical alteration of skin tissue |
EP99919946A EP1079744A4 (en) | 1998-04-30 | 1999-04-21 | Apparatus for and method of laser surgery of hard tissues |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US6954798A | 1998-04-30 | 1998-04-30 | |
US09/069,547 | 1998-04-30 |
Publications (1)
Publication Number | Publication Date |
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WO1999055243A1 true WO1999055243A1 (en) | 1999-11-04 |
Family
ID=22089708
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1999/008751 WO1999055243A1 (en) | 1998-04-30 | 1999-04-21 | Apparatus for and method of laser surgery of hard tissues |
Country Status (5)
Country | Link |
---|---|
EP (1) | EP1079744A4 (en) |
AU (1) | AU742054B2 (en) |
CA (1) | CA2331113A1 (en) |
IL (1) | IL139350A0 (en) |
WO (1) | WO1999055243A1 (en) |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2002078585A2 (en) * | 2001-03-30 | 2002-10-10 | Carl Zeiss Meditec Ag | Device and method for the laser treatment of organic material |
EP1511438A1 (en) | 2002-06-10 | 2005-03-09 | Olaf Schäfer | Medical tools for dental treatments by means of a laser |
EP1883381A2 (en) * | 2005-05-25 | 2008-02-06 | Biolase Technology, Inc. | Electromagnetic energy emitting device with increased spot size |
US9387041B2 (en) | 2013-03-15 | 2016-07-12 | University Of North Texas | Laser-assisted machining (LAM) of hard tissues and bones |
US10188519B2 (en) | 2013-03-15 | 2019-01-29 | University Of North Texas | Laser-assisted machining (LAM) of hard tissues and bones |
US11291522B2 (en) | 2014-11-26 | 2022-04-05 | Convergent Dental, Inc. | Systems and methods to control depth of treatment in dental laser systems |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
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US5257935A (en) * | 1988-03-14 | 1993-11-02 | American Dental Laser, Inc. | Dental laser |
US5342198A (en) * | 1988-03-14 | 1994-08-30 | American Dental Technologies, Inc. | Dental laser |
US5655547A (en) * | 1996-05-15 | 1997-08-12 | Esc Medical Systems Ltd. | Method for laser surgery |
US5970983A (en) | 1996-05-15 | 1999-10-26 | Esc Medical Systems Ltd. | Method of laser surgery |
Family Cites Families (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5290274A (en) * | 1992-06-16 | 1994-03-01 | Laser Medical Technology, Inc. | Laser apparatus for medical and dental treatments |
-
1999
- 1999-04-21 WO PCT/US1999/008751 patent/WO1999055243A1/en not_active Application Discontinuation
- 1999-04-21 AU AU37546/99A patent/AU742054B2/en not_active Ceased
- 1999-04-21 IL IL13935099A patent/IL139350A0/en unknown
- 1999-04-21 CA CA002331113A patent/CA2331113A1/en not_active Abandoned
- 1999-04-21 EP EP99919946A patent/EP1079744A4/en not_active Withdrawn
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5257935A (en) * | 1988-03-14 | 1993-11-02 | American Dental Laser, Inc. | Dental laser |
US5342198A (en) * | 1988-03-14 | 1994-08-30 | American Dental Technologies, Inc. | Dental laser |
US5655547A (en) * | 1996-05-15 | 1997-08-12 | Esc Medical Systems Ltd. | Method for laser surgery |
US5970983A (en) | 1996-05-15 | 1999-10-26 | Esc Medical Systems Ltd. | Method of laser surgery |
Non-Patent Citations (1)
Title |
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See also references of EP1079744A4 |
Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2002078585A2 (en) * | 2001-03-30 | 2002-10-10 | Carl Zeiss Meditec Ag | Device and method for the laser treatment of organic material |
WO2002078585A3 (en) * | 2001-03-30 | 2003-09-12 | Zeiss Carl Meditec Ag | Device and method for the laser treatment of organic material |
EP1511438A1 (en) | 2002-06-10 | 2005-03-09 | Olaf Schäfer | Medical tools for dental treatments by means of a laser |
EP1511438B1 (en) * | 2002-06-10 | 2007-05-09 | elexxion GmbH | Medical tools for dental treatments by means of a laser |
EP1883381A2 (en) * | 2005-05-25 | 2008-02-06 | Biolase Technology, Inc. | Electromagnetic energy emitting device with increased spot size |
EP1883381A4 (en) * | 2005-05-25 | 2010-03-17 | Biolase Tech Inc | Electromagnetic energy emitting device with increased spot size |
US9387041B2 (en) | 2013-03-15 | 2016-07-12 | University Of North Texas | Laser-assisted machining (LAM) of hard tissues and bones |
US10188519B2 (en) | 2013-03-15 | 2019-01-29 | University Of North Texas | Laser-assisted machining (LAM) of hard tissues and bones |
US11291522B2 (en) | 2014-11-26 | 2022-04-05 | Convergent Dental, Inc. | Systems and methods to control depth of treatment in dental laser systems |
Also Published As
Publication number | Publication date |
---|---|
CA2331113A1 (en) | 1999-11-04 |
AU3754699A (en) | 1999-11-16 |
EP1079744A1 (en) | 2001-03-07 |
AU742054B2 (en) | 2001-12-13 |
EP1079744A4 (en) | 2006-06-28 |
IL139350A0 (en) | 2001-11-25 |
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