Abstract

The microsecond Er:YAG pulsed laser with a wavelength of λ = 2.94 μm has been widely used in the medical field, particularly for ablating dental tissues. Since bone and dental tissues have similar compositions, consisting of mineralized and rigid structures, the Er:YAG laser represents a promising tool for laserosteotomy applications. In this study, we explored the use of the Er:YAG laser for deep bone ablation, in an attempt to optimize its performance and identify its limitations. Tissue irrigation and the laser settings were optimized independently. We propose an automated irrigation feedback system capable of recognizing the temperature of the tissue and delivering water accordingly. The irrigation system used consists of a thin 50 μm diameter water jet. The water jet was able to penetrate deep into the crater during ablation, with a laminar flow length of 15 cm, ensuring the irrigation of deeper layers unreachable by conventional spray systems. Once the irrigation was optimized, ablation was considered independently of the irrigation water. In this way, we could better understand and adjust the laser parameters to suit our needs. We obtained line cuts as deep as 21 mm without causing any visible thermal damage to the surrounding tissue. The automated experimental setup proposed here has the potential to support deeper and faster ablation in laserosteotomy applications.

Highlights

  • As in ancient times, present-day bone surgery still depends mainly on mechanical tools, such as different types of oscillating saws or burs [1,2]

  • The graph shows the results obtained after averaging over 10 measurements for each incident peak fluence, the error bars correspond to the standard deviation for each data point

  • The study of bone ablation using a microsecond erbium-dopped yttrium aluminium garnet (Er):YAG laser was performed by exploring and analyzing different aspects that contribute to optimizing the ablation process

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Summary

Introduction

Present-day bone surgery still depends mainly on mechanical tools, such as different types of oscillating saws or burs [1,2]. The bio-compatibility and degree of contamination of conventional tools pose a high risk of infection to patients. Because conventional tools are still made of metal, corrosion and wear resistance have to be evaluated and minimized. Conventional tool use limits the surgeon’s ability to achieve functional cutting shapes. Several studies have shown the value of using lasers to ablate bone, instead of mechanical tools [4,5,6,7,8,9,10]. Lasers can make contactless cuts, thereby negating any problems arising from mechanical stress. By controlling the laser with robot-assisted technology, highly precise and functional cuts become possible [11]

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