Abstract

The purpose of this in vitro study was to investigate and compare effects of currently available laser systems at different wavelengths (XeCl excimer laser, Holmium:YAG laser, Erbium:YAG laser) on porcine articulating facets, capsule and meniscus of the temporomandibular joint via photomacroscopy, light and scanning electron microscopy. From a critical review of the relevant literature and the preliminary observations of this investigation, it appears that the Neodymium:YAG laser is inappropriate for TMJ arthroscopic surgery with regard to the huge thermal injury caused to the remaining tissue. The Holmium:YAG laser suffers from remarkable photomechanical and photothermal side effects, whereas the Erbium:YAG laser ablates temporomandibular joint tissue efficiently with minimal adjacent damage--similar to the XeCl excimer laser, without entailing the risk of potential mutagenity. To sum up, it can be concluded that there is a clinical need for laser- assisted arthroscopic surgery of the craniomandibular articulation. Nevertheless, at present none of the available laser systems meet the medical demands completely. Currently, the Erbium:YAG laser seems to be the most suitable for TMJ arthroscopic surgery.

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