engleski

Comparison of the Er:YAG laser and a surgical drill used for osteotomy in oral surgery: an experimental study

High-energy lasers have been proposed as an alternative to conventional surgical drill in oral and maxillofacial surgery. The aims of the present study were to compare: (a) thermal changes of the bone surface, (b) time and (c) volume of the removed bone after drilling with the Er:YAG laser and a low-speed surgical drill. The bone sections were observed under light microscopy, and were histologically examined. Thirty bone blocks were prepared from porcine ribs. On each block two holes (tunnel preparations) were performed using the low-speed 1.0 mm wide surgical pilot drill and the Er:YAG laser (pulse energy: 1000mJ, pulse duration: 300μs, frequency: 20Hz). The temperature induced by the preparation techniques was measured using an infra-red camera. The removed bone volume was calculated by modified mathematical algorithm. The time required for the preparation was measured with the digital stop-watch and a time-measure instrument integrated within the computer programme. Cortical and spongious surfaces of the specimens were microscopically and histologically examined under the light microscope with a high-resolution camera. The Er:YAG laser removed significantly more bone tissue than the drill (p<0.01), in significantly less time (p<0.01). The temperature was statistically lower during the laser preparation (p<0.01). Cavities prepared with the laser were regular with clear sharp edges and knife-like cuts. In the drill group, preparations were with irregular edges full of bone fragments and fibre-like debris. Histological examination of the laser sides revealed 30μm thick altered sublayer. The tissue in the drill group was covered with smear layer without any alterations. The Er:YAG laser created preparations of regular and sharp edges, without bone fragments and debris in less time and with less generated heat. Thermal alterations in the treated surface was minimal.

laser; osteotomy; Er:YAG laser; surgical drill

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