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Harvesting of intraoral autogenous block grafts from the chin and ramus region: preliminary results with a variable square pulse Er:YAG laser - Zurich Open Repository and Archive


Stübinger, Stefan; Nuss, Katja M; Sader, Robert; von Rechenberg, Brigitte; Landes, Constantin (2008). Harvesting of intraoral autogenous block grafts from the chin and ramus region: preliminary results with a variable square pulse Er:YAG laser. Lasers in Surgery and Medicine, 40(5):312-318.

Abstract

Background and Objectives: It was the aim of this pilot study to evaluate the feasibility, benefits and limitations of a variable square pulse (VSP) Er:YAG laser for harvesting intraoral bone grafts from either the chin or ramus region.
Materials and Methods: In 12 patients (5 female, 7 male) a VSP Er:YAG laser was used to harvest bone grafts either from the ramus (3) or the symphyseal area (9). For the osteotomies, the Er:YAG laser was applied with a pulse energy of 1,000 mJ, a pulse duration of 300 microseconds, and a frequency of 12 Hz (energy density 157 J/cm2). The spot size was 0.9 mm and the handpiece was kept at a distance of about 10 mm from the bone surface.
Results: There was no visible carbonization or osseous debris on the surface of the osteotomy gap. Damage of adjacent soft tissue structures by mechanical or thermal trauma was minimal. Cutting efficiency was excellent and the overall time required for the procedure was not increased. However, due to a free manual positioning of the laser beam in the non-contact mode, it was difficult to get a well defined osteotomy line without irregularities on the surface. Slight deviations of the original angulation of the laser beam led to considerable bone loss which restricted osteotomy of ramus grafts to three cases. Depth control was limited to visual inspection.
Conclusion: The bone ablation technique using a (VSP) Er:YAG laser yielded superior clinical results without impairment of wound healing and in comparison to other laser systems, no significant time loss occurred. Yet, the missing depth control and the necessity of carefully handling the laser beam position and its angulation limit the use of a (VSP) Er:YAG laser to regions where a safe and fixed guidance of the laser beam is feasible.

Abstract

Background and Objectives: It was the aim of this pilot study to evaluate the feasibility, benefits and limitations of a variable square pulse (VSP) Er:YAG laser for harvesting intraoral bone grafts from either the chin or ramus region.
Materials and Methods: In 12 patients (5 female, 7 male) a VSP Er:YAG laser was used to harvest bone grafts either from the ramus (3) or the symphyseal area (9). For the osteotomies, the Er:YAG laser was applied with a pulse energy of 1,000 mJ, a pulse duration of 300 microseconds, and a frequency of 12 Hz (energy density 157 J/cm2). The spot size was 0.9 mm and the handpiece was kept at a distance of about 10 mm from the bone surface.
Results: There was no visible carbonization or osseous debris on the surface of the osteotomy gap. Damage of adjacent soft tissue structures by mechanical or thermal trauma was minimal. Cutting efficiency was excellent and the overall time required for the procedure was not increased. However, due to a free manual positioning of the laser beam in the non-contact mode, it was difficult to get a well defined osteotomy line without irregularities on the surface. Slight deviations of the original angulation of the laser beam led to considerable bone loss which restricted osteotomy of ramus grafts to three cases. Depth control was limited to visual inspection.
Conclusion: The bone ablation technique using a (VSP) Er:YAG laser yielded superior clinical results without impairment of wound healing and in comparison to other laser systems, no significant time loss occurred. Yet, the missing depth control and the necessity of carefully handling the laser beam position and its angulation limit the use of a (VSP) Er:YAG laser to regions where a safe and fixed guidance of the laser beam is feasible.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Equine Department
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Uncontrolled Keywords:ablation • bone • carbonization • augmentation • alveolar ridge
Language:English
Date:2008
Deposited On:23 Feb 2009 15:06
Last Modified:04 Jun 2016 07:24
Publisher:Wiley-Blackwell
ISSN:0196-8092
Publisher DOI:https://doi.org/10.1002/lsm.20639
PubMed ID:18563779

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