Primary investigations on the potential of a novel diode pumped Er:YAG laser system for bone surgery

Stock, Karl; Diebolder, Rolf; Hausladen, Florian; Wurm, Holger; Lorenz, Swetlana; Hibst, Raimund

doi:10.1117/12.2004123

Cited by 6 publications

(5 citation statements)

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“…The purposes are first to assist the disruption effect and second to prevent heating of the tissue. The influence of such a water spray on the ablation rate is given by Stock et al 21 for Er:YAG lasers and Zhang et al 22 for CO 2 lasers. The influences of bleedings, of higher flow rates and water layers above 1 mm have to be taken into account, when laser ablation is used in surgery.…”

Section: Introductionmentioning

confidence: 99%

“…For Er:YAG lasers, a drop of the ablation rate would be expected. 21 But for Nd:YAG lasers, the ablation rates for specimens submerged several millimeters under water are significantly higher than for ablation under dry conditions. 23,24 Despite the undoubted effectiveness of the Er:YAG and CO 2 lasers for hard-tissue ablation, up to now, only the Er:YAG laser entered clinical routine in dentistry.…”

Section: Introductionmentioning

confidence: 99%

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Laser cutting of bone tissue under bulk water with a pulsed ps-laser at 532 nm

et al. 2015

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Hard-tissue ablation was already investigated for a broad variety of pulsed laser systems, which cover almost the entire range of available wavelengths and pulse parameters. Most effective in hard-tissue ablation are Er:YAG and CO2 lasers, both utilizing the effect of absorption of infrared wavelengths by water and so-called explosive vaporization, when a thin water film or water–air spray is supplied. The typical flow rates and the water layer thicknesses are too low for surgical applications where bleeding occurs and wound flushing is necessary. We studied a 20 W ps-laser with 532 nm wavelength and a pulse energy of 1 mJ to effectively ablate bones that are submerged 14 mm under water. For these laser parameters, the plasma-mediated ablation mechanism is dominant. Simulations based on the blow-off model predict the cut depth and cross-sectional shape of the incision. The model is modified considering the cross section of the Gaussian beam, the incident angle, and reflections. The ablation rate amounts to 0.2 mm3/s, corresponding to an increase by at least 50% of the highest values published so far for ultrashort laser ablation of hard tissue.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laser cutting of bone tissue under bulk water with a pulsed ps-laser at 532 nm

et al. 2015

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“…Furthermore, it offers adjustable pump current as well as a variable pulse duration from 1 to 1,000 µs and offers a better beam quality which allows to couple into fibers with 200 µm core size (11,17). In prior in vitro studies we have already shown that smooth and homogeneous cuts can be achieved in both soft and hard tissue with thermally damaged zones adjustable over a wide range from about 50 µm to > 1,000 µm (18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Comparative ex vivo Investigations on the Cutting Quality of the CO2 Laser and the Diode Pumped Er:YAG Laser

Wurm

Schuler²,

Hausladen

et al. 2021

Front. Surg.

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Objectives: A sufficient histological evaluation is a key pillar in oncological treatment, especially in situations of cancer of unknown primary. CO2 laser technology is used in clinical routine of soft tissue surgery because of its cutting quality and availability. Diode pumped solid state Er(bium):YAG laser systems promise a higher cutting efficiency and minor thermal damages. The aim of this study was to compare both laser systems with respect to their suitability for cutting soft tissue.Methods: A setup was realized which enables comparable experiments with the clinical CO2 laser (AcuPulse 40ST DUO, Lumenis) and the Er:YAG laser system (DPM 40, Pantec Biosolutions AG). Fresh mucosal samples of porcine tongues were used to determine the influence of laser power and sample velocity on cutting depth and thermal damage width for both lasers. In addition, for the Er:YAG laser, the influence of the pulse repetition rate was examined additionally. For analysis, images of histological sections were taken.Results: In all experiments, the Er:YAG laser shows a significantly higher cutting depth (P < 0.0001) and less thermal damage width (P < 0.0001) than the CO2 laser. For example, at an average power of 7.7 W and a sample velocity of 5 mm/s the Er:YAG laser shows a mean cutting depth of 1.1 mm compared to the CO2 laser with 500 μm. While the Er:YAG laser shows a mean thermal damage width of 70 μm compared to 120 μm. Furthermore, the Er:YAG enables the adjustment of the cutting depth and thermal damage width by varying the irradiation parameters. A decrease of the repetition rate leads to a reduction of thermal damage. For example, a repetition rate of 100 Hz results in a thermal damage width of 46 μm compared to 87 μm at 800 Hz at an average power of 7.7 W and a cutting velocity = 5 mm/s while a homogenous cutting quality can be achieved.Conclusions: In conclusion, the results of these ex vivo experiments demonstrate significant advantages of the diode pumped Er:YAG laser system for soft tissue ablation compared to the CO2 laser, in particular regarding cutting efficiency and thermal damage width.

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“…The flash‐lamp pumped erbium solid‐state lasers presently being used for dental hard tissue ablation are poorly suited for this approach since they utilize high energy pulses and relatively low pulse repetition rates. DPSS Er:YAG lasers are now available operating with pulse repetition rates as high as 1–2 kHz and initial studies have been carried out demonstrating their utility for the ablation of dental hard tissues and bone and the removal of composite from tooth surfaces .…”

Section: Introductionmentioning

confidence: 99%

Image‐Guided Ablation of Dental Calculus From Root Surfaces Using a DPSS Er:YAG Laser

et al. 2019

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Background and Objectives Recent studies have demonstrated that near‐infrared (IR) imaging can be used to acquire high‐contrast images of root caries and calculus on the root surfaces of extracted teeth at wavelengths longer than 1450 nm. The purpose of this study was to determine if image‐guided laser ablation can be used to selectively remove calculus from tooth surfaces with minimal damage to the underlying sound cementum and dentin. Materials and Methods In this study, sequential near‐IR images at 1500–1700 nm were used to guide a diode‐pumped (DPSS) Er:YAG laser for the removal of calculus from the root surfaces of 10 extracted teeth. The selectivity of removal was assessed using digital microscopy, optical coherence tomography, and surface profilometry. Results Calculus was removed rapidly with minimal damage to the underlying sound cementum and dentin. Image‐guided ablation achieved high‐selectivity, the mean volume of calculus removal was more than 27 times higher than the mean loss of cementum. Conclusions We have demonstrated that near‐IR image‐guided laser ablation can be used for the selective removal of calculus from root surfaces ex vivo. Additionally, we have demonstrated that a diode‐pumped solid‐state Er:YAG laser is well suited for selective removal. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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Primary investigations on the potential of a novel diode pumped Er:YAG laser system for bone surgery

Cited by 6 publications

References 0 publications

Laser cutting of bone tissue under bulk water with a pulsed ps-laser at 532 nm

Laser cutting of bone tissue under bulk water with a pulsed ps-laser at 532 nm

Comparative ex vivo Investigations on the Cutting Quality of the CO2 Laser and the Diode Pumped Er:YAG Laser

Image‐Guided Ablation of Dental Calculus From Root Surfaces Using a DPSS Er:YAG Laser

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