Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-03-17, 12:41:55 | version 1.38.0
| industry surgery in humans is an atraumatic and minimally in- vasive procedure. Same conclusions were reported by Berengo M. et al.13 Er:YAG laser obtained specimens from human bone Er:YAG lasers emit infrared light with a wavelength of 2.94 µm which is absorbed predominantly by water and hydroxyapatite.14 The Er:YAG radiation is an effi- cient tool in bone surgery. In contrast with ultrasound devices, osteotomy by laser is performed in a non-contact mode. The laser tip is positioned 1–2 mm away from the target surface and there is no collateral friction damage to surrounding tissues. Under light microscopy observation, the cutting surfaces in laser obtained bone chips from our patients revealed a precise border configuration (Figs. 3 & 4) confirming previously-published state- ments based on animal models for clear and effective osteotomy achieved by thermo-mechanical laser ab- lation.1,9,10 In all laser ablated human bone samples, a mildly expressed darker amorphous layer within microns was observed superficially near to the inci- sion line (Figs. 3 & 4). Romeo and Panduric et al. reported analogous tissue characteristics found in laboratory research on porcine mandibles and ribs re- spectively.1,10 The reason for detected bone changes in all specimens in the group could be the cumulative heat deposition within the area surrounding the lased tissue.1,10 Compared to the ultrasound-obtained specimens, laser-obtained human bioptata in our study showed no smear layer or debris bone frag- ments attached to the cutting surface (Figs. 3 & 4). Those findings correlated to the results of Romeo et al. in their in vitro trial on fresh porcine mandibles and also could explained the benefits for bone healing after laser bone ablation proved by Kesler et al. in rats models.1,4 Probably the increased blood elements ad- haesion potential ensured by laser irradiation due to Kurz & bündig the absence of any smear layer enhancde the start of the remodeling process.1,10 The non-complicated postoperative period in our study confirmed that all tissue changes histologically approved on the biop- sied specimens were harmless with regard to the bone healing in humans. Conclusion The microscopic observations in the presented study showed that both the type and quality of bone transformations is attributed to the cutting mecha- nism per se. Tissue changes in human bone following in vivo laser- and ultrasound-assisted osteotomy es- tablished on the evaluated samples proved the toler- able effects of the two studied tools toward the vital human bone. The choice of adequate osteotome should be always influenced by evidence-based re- sults. The Er:YAG laser offers advantages over ultra- sound osteotomy techniques because of the non- contact intervention, with no mechanical vibration, free-of-debris cutting lines and aseptic effects. Nev- ertheless, with adequate training and experience, the surgeon is able to use this device for certain and se- lective procedures in bone surgery._ Acknowledgement: This research was funded by Medical University of Plovdiv (Grant SDP-06/2015). contact Prof. Georgi Tomov DDS, MS, PhD Associate Professor and Chair of the Department of Oral Pathology, Faculty of Dental Medicine dr.g.tomov@gmail.com Author details Im Vorfeld zum Verfassen des Artikels recherchierten die Autoren ihre Analyseergebnisse zur Zellregeneration nach Ultraschall sowie Laserosteotomie im Vergleich zu rotierenden Instrumenten. Da die bisher vorliegenden Studien zu diesen Themen nicht zwingend auf menschliche Zellen anwendbar waren, zielt der hier präsentierte Bericht auf einen histologischen Vergleich der Zellveränderungen nach In-vivo-Einschnitten in menschlichen Knochen durch Ultraschall sowie Er:YAG-Laser während der Extraktion geschädigter mandibulärer Weisheitszähne. Literature Die mikroskopischen Untersuchungen zeigten, dass sowohl Art als auch Qualität der Knochenveränderungen in starker Abhängigkeit zu den angewendeten Schneidmechanismen standen. Zellveränderungen im menschlichen Knochen in In-vivo-Laser- sowie Ultraschallosteotomie resultierten in den untersuchten Proben tolerierbare Effektive der zwei Instrumente auf das vitale humane Knochengewebe. Die Auswahl des passenden Osteotoms sollte im- mer auf evidenzbasierten Ergebnissen beruhen. Aufgrund der kontaktfreien Intervation ohne mechanische Vibration, ab lagerungsfreien Schnittkanten sowie seiner aseptischen Effekte besitze der Er:YAG-Laser deutliche Vorteile im Vergleich zur Ultraschalltechnologie. 24 laser 1 2017