Department of Oral Rehabilitation and Dental Emergencies, School of Dental Medicine, "Victor Babeş" University of Medicine and Pharmacy, Timisoara, Romania.
Semez SRL Private Practice, Trieste, Italy.
Photobiomodul Photomed Laser Surg. 2021 Jan;39(1):70-80. doi: 10.1089/photob.2020.4889. Epub 2020 Dec 17.
The aim of the study is to evaluate the possibility of preparing the implant site using the erbium:yttrium-aluminum-garnet (Er:YAG) laser scanner prototype and to reduce and/or eliminate time between primary (mechanical) stability and secondary (biological) stability, looking to the immediate occlusal loading in a single implant. A prerequisite for successful osseointegration is the establishment of direct bone-to-implant contact without interposition of nonbone or connective tissue. In recent years, the use of laser radiation was presented as an alternative/adjunctive treatment for bone tissue ablation due to vaporization of the tissues in the absence of a smear layer. The experimental protocol included six minipigs, which underwent tooth extraction, followed (after 2 months) by implant bed preparation in two methods: using a conventional bur kit and using an Er:YAG laser scanner (X runner) protocol. Four implants were placed in positions 34, 37, 44, and 47 on each animal. The animals underwent the second surgical procedure for bone sample collection (including the implant) before their sacrifice at 45-60-90-120 days. The newly formed bone was evaluated on the bone samples using histological examination and quantitative evaluations of different histological parameters based on microscopical analysis. The results that we obtained allow some interesting comparison in terms of different bone composition, depending on the method of implant site preparation and on healing periods. Moreover, it was possible to compare the bone composition, at different time stages, of implant sites prepared in the same way. Our research allowed us to demonstrate that the use of Er:YAG laser compared with traditional drill leads to the presence of a greater share of lamellar bone and a lower necrotic share in the implant site. We also showed the possibility of applying immediate occlusal loading on an animal model.
本研究旨在评估使用掺铒钇铝石榴石（Er:YAG）激光扫描仪原型制备种植体部位的可能性，并减少和/或消除初级（机械）稳定性和次级（生物）稳定性之间的时间，以期在单个种植体上实现即刻咬合负载。成功的骨整合的前提是建立直接的骨-种植体接触，而没有非骨或结缔组织的介入。近年来，由于组织的蒸发而没有淤浆层，激光辐射的使用被提出作为骨组织消融的替代/辅助治疗方法。实验方案包括六头小型猪，它们接受了拔牙，然后（2 个月后）采用两种方法制备种植床：使用传统的钻头套件和使用 Er:YAG 激光扫描仪（X runner）方案。每只动物的 34、37、44 和 47 位置放置了四个种植体。在处死动物前 45-60-90-120 天，动物接受了第二次手术以采集骨样本（包括种植体）。在骨样本上使用组织学检查和基于显微镜分析的不同组织学参数的定量评估来评估新形成的骨。我们获得的结果允许根据不同的骨组成、种植体部位制备方法和愈合期进行一些有趣的比较。此外，还可以比较以相同方式制备的种植体部位在不同时间阶段的骨组成。我们的研究表明，与传统钻头相比，使用 Er:YAG 激光会导致种植体部位存在更多的板层骨和更少的坏死骨。我们还展示了在动物模型上应用即刻咬合负载的可能性。
