Er:YAG laser osteotomy: preliminary clinical and histological results of a new technique for contact-free bone surgery.

摘要

BACKGROUND: The purpose of this retrospective study was to evaluate the surgical performance, clinical usability and outcome of a new variable square pulsed (VSP) Er:YAG laser for bone cutting in oral and maxillofacial surgery. MATERIALS AND METHODS: In 40 patients an Er:YAG laser with pulse energy of 1,000 mJ, pulse duration of 300 mus and a frequency of 12 Hz was used for different intraoral osteotomies. The spot size was 0.9 mm, and the handpiece was kept at a distance of 10 mm from the bone surface. Additionally, histological analyses of the fresh osteotomy rims of lasered bone were performed. RESULTS: Er:YAG laser osteotomy revealed a remarkable cutting efficiency without any visible, negative, thermal side effects. There was no damage of adjacent soft tissue structures. However, depth control was limited to visual inspection. Histologically, a 5- to 10-microm-wide zone of a characteristic laser fingerprint appeared on the cut edges. However, there was no sign of thermal tissue damage to the underlying bone structures. CONCLUSIONS: VSP Er:YAG laser osteotomy is clinically practicable without any signs of charred tissue and wound healing disturbances. However, the lack of depth control and the necessity for careful handling are still technical limitations to be overcome.