A review of the physiological and histological effects of laser osteotomy

@article{RajithaGunaratne2017ARO,
  title={A review of the physiological and histological effects of laser osteotomy},
  author={G D Rajitha Gunaratne and R. J. K. Khan and Daniel Fick and Brett Robertson and Narendra B. Dahotre and Charles N. Ironside},
  journal={Journal of Medical Engineering \& Technology},
  year={2017},
  volume={41},
  pages={1 - 12}
}
Abstract Osteotomy is the surgical cutting of bone. Some obstacles to laser osteotomy have been melting, carbonisation and subsequent delayed healing. New cooled scanning techniques have resulted in effective bone cuts without the strong thermal side effects, which were observed by inappropriate irradiation techniques with continuous wave and long pulsed lasers. With these new techniques, osteotomy gaps histologically healed with new bone formation without any noticeable or minimum thermal… 
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25 Citations

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The results of this study show a non-linear relationship between cutting rates, speeds, and depths that should be critically considered for integration in robotic laser surgery.
Comparing the Bone Healing After Cold Ablation Robot‐Guided Er:YAG Laser Osteotomy and Piezoelectric Osteotomy—A Pilot Study in a Minipig Mandible
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The investigators hypothesized laser osteotomy would render acceptable bone healing based on the intraoperative findings and postoperative cut surface analysis and hypothesized the integration and miniaturization of the robot, laser, and navigation technology was applied to minipigs.
Laser in Bone Surgery
During the past half-century, laser osteotomy has been studied for a broad range of lasers, which almost covers the entire range of available laser systems in the market, from early unsuccessful…
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In situ formation of a scaffold-like structure in the laser-machined region which can be conducive during healing is revealed in the ex vivo study of laser-ablated cortical bone.
The Effect of Laser Ablation Pulse Width and Feed Speed on Necrosis and Surface Damage of Cortical Bone
Bone cutting is of importance in orthopaedic surgery but is also challenging due to its nature of brittleness—where severe mechanical and thermal damages can be introduced easily in conventional…
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TLDR
A two order of magnitude reduction in mean time to ignition and variance is shown by using the graphite topical chromophore and an increase in volumetric flow rate of the assist gas jet does show an initial increase in etch rate, but increased pressure beyond a certain point shows decreased return.
Optimization of laser osteotomy at 1064 nm using a graphite topical absorber and a nitrogen assist gas jet
: Laser ablation of bone for the purposes of osteotomy is not as well understood as ablation of homogeneous, non-biological materials such as metals and plastics. Ignition times and etch rate can…
Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician
TLDR
Too little evidence to establish lasers as an alternative to rotary instruments is suggested and piezotomes seem to be a possible new gold-standard in bone cutting due to their improved bone-healing, almost bone-lossless and precise osteotomy design, precise depth-control, softtissue protection as well as reduced intrasurgical and post-surgical morbidity.
Evaluation of bone healing following Er:YAG laser ablation in rat calvaria compared with bur drilling
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Results suggest that Er:YAG laser might accelerate early new bone formation with advantageous surface changes and cellular responses for wound healing, compared with bur‐drilling.
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References

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