Kyung-Won Baek1, Michel Dard2,3, Hans-Florian Zeilhofer1, Philippe C Cattin4, Philipp Juergens5,6. 1. Department of Biomedical Engineering, Hightech Research Center of Cranio-Maxillofacial Surgery (HFZ), University of Basel, Gewerbestrasse 14-16, Allschwil, 4123, Switzerland. 2. Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York. 3. Institut Straumann AG, Peter Merian-Weg 12, Basel, 4002, Switzerland. 4. Department of Biomedical Engineering, Center for Medical Image Analysis & Navigation, University of Basel, Gewerbestrasse 14, Allschwil, 4123, Switzerland. 5. Department of Cranio-Maxillofacial Surgery, University Hospital of Basel, Spitalstrasse 21, Basel, 4031, Switzerland. 6. MKG-Chirurgie Arabellapark Praxis für Mund-, Kiefer- und Gesichtschirurgie, Arabellastr. 17, München, 81925, Germany.
Abstract
BACKGROUND AND OBJECTIVE: To take major advantage of erbium-doped yttrium aluminium garnet (Er:YAG) lasers in osteotomy-like freedom of cutting geometries and high accuracy-the integration and miniaturization of the robot, laser, and navigation technology was tried and applied to minipigs. The investigators hypothesized laser osteotomy would render acceptable bone healing based on the intraoperative findings and postoperative cut surface analysis. STUDY DESIGN/ MATERIALS AND METHODS: We designed and implemented a comparative bone-cutting surgery in the minipig mandible with a cold ablation robot-guided Er:YAG laser osteotome (CARLO) and a piezoelectric (PZE) osteotome. The sample was composed of different patterns of defects in the mandibles of six grown-up female Goettingen minipigs. The predictor variable was Er:YAG osteotomy and PZE osteotomy. The outcome variable was the cut surface characteristics and bone healing at 4 and 8 weeks postoperatively. Descriptive and qualitative comparison was executed. RESULTS: The sample was composed of four kinds of bone defects on both sides of the mandibles of six minipigs. We observed more bleeding during the operation, open-cut surfaces, and a faster healing pattern with the laser osteotomy. There was a possible association between the intraoperative findings, postoperative cut surface analysis, and the bone healing pattern. CONCLUSIONS: The results of this study suggest that characteristic open-cut surfaces could explain favorable bone healing after laser osteotomy. Future studies will focus on the quantification of the early healing characteristics after laser osteotomy, its diverse application, and the safety feature. Lasers Surg. Med.
BACKGROUND AND OBJECTIVE: To take major advantage of erbium-doped yttrium aluminium garnet (Er:YAG) lasers in osteotomy-like freedom of cutting geometries and high accuracy-the integration and miniaturization of the robot, laser, and navigation technology was tried and applied to minipigs. The investigators hypothesized laser osteotomy would render acceptable bone healing based on the intraoperative findings and postoperative cut surface analysis. STUDY DESIGN/ MATERIALS AND METHODS: We designed and implemented a comparative bone-cutting surgery in the minipig mandible with a cold ablation robot-guided Er:YAG laser osteotome (CARLO) and a piezoelectric (PZE) osteotome. The sample was composed of different patterns of defects in the mandibles of six grown-up female Goettingen minipigs. The predictor variable was Er:YAG osteotomy and PZE osteotomy. The outcome variable was the cut surface characteristics and bone healing at 4 and 8 weeks postoperatively. Descriptive and qualitative comparison was executed. RESULTS: The sample was composed of four kinds of bone defects on both sides of the mandibles of six minipigs. We observed more bleeding during the operation, open-cut surfaces, and a faster healing pattern with the laser osteotomy. There was a possible association between the intraoperative findings, postoperative cut surface analysis, and the bone healing pattern. CONCLUSIONS: The results of this study suggest that characteristic open-cut surfaces could explain favorable bone healing after laser osteotomy. Future studies will focus on the quantification of the early healing characteristics after laser osteotomy, its diverse application, and the safety feature. Lasers Surg. Med.
Authors: Philipp Honigmann; Maximilian Hofer; Sibylle Hirsch; Marta Morawska; Magdalena Müller-Gerbl; Florian M Thieringer; Enrico Coppo Journal: Int J Med Robot Date: 2022-07-08 Impact factor: 2.483