Papadaki M, Doukas A, Farinelli William A, Kaban L, Troulis M
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
Int J Oral Maxillofac Surg. 2007 Dec;36(12):1193-7. doi: 10.1016/j.ijom.2007.05.019.
The general advantages of laser surgery, such as decreased bleeding and dry surgical field, reduced postoperative pain and less oedema, have led to a continuous interest in laser applications for bone cutting. The ability to cut bone with a laser beam would also be of great technical benefit in minimally invasive maxillofacial surgery (endoscopic). The Erbium:yttrium aluminum garnet (Er:YAG) laser has been demonstrated to result in minimal thermal damage of bone, precise cutting, rapid osseous healing and osteoinduction. The purpose of this study was to assess the feasibility of using Er:YAG laser to perform vertical ramus osteotomy, and to determine the most efficient energy per pulse for its completion. Two fresh pig mandibles, one pig cadaver head and one human mandible were used. A different energy per pulse (0.5, 1, 1.5 and 2J/pulse) was used for each osteotomy on the pig mandibles (n=4). Vertical ramus osteotomy was feasible with all energy settings but time decreased considerably from 28 to 5.33 min as the energy per pulse increased. The human and the pig cadaver head mandibles were osteotomized bilaterally with 2000 mJ/pulse that was the most efficient in terms of time. Bone cuts were smooth with no carbonization in all cases.
激光手术的一般优势，如出血减少、术野干燥、术后疼痛减轻和水肿减轻，使得人们对激光在骨切割方面的应用持续感兴趣。在微创颌面外科手术（内窥镜手术）中，用激光束切割骨头的能力也将具有巨大的技术优势。铒：钇铝石榴石（Er:YAG）激光已被证明能使骨的热损伤最小化、切割精确、骨愈合迅速且具有骨诱导作用。本研究的目的是评估使用Er:YAG激光进行下颌支垂直截骨术的可行性，并确定完成该手术的每个脉冲最有效的能量。使用了两块新鲜猪下颌骨、一个猪尸头和一块人类下颌骨。对猪下颌骨上的每次截骨术使用不同的每个脉冲能量（0.5、1、1.5和2焦耳/脉冲）（n = 4）。在所有能量设置下，下颌支垂直截骨术都是可行的，但随着每个脉冲能量的增加，时间从28分钟大幅减少至5.33分钟。对人类和猪尸头下颌骨双侧进行截骨术时，使用2000毫焦/脉冲，就时间而言这是最有效的。在所有情况下，骨切口都很光滑，没有碳化现象。
