PMID- 30645014
OWN - NLM
STAT- MEDLINE
DCOM- 20200831
LR  - 20200831
IS  - 1096-9101 (Electronic)
IS  - 0196-8092 (Linking)
VI  - 51
IP  - 6
DP  - 2019 Aug
TI  - Comparison of an Er: YAG laser osteotome versus a conventional drill for the use 
      in osteo- odonto-keratoprosthesis (OOKP).
PG  - 531-537
LID - 10.1002/lsm.23053 [doi]
AB  - OBJECTIVES: The osteo-odonto-kerato-prosthesis (OOKP) procedure is a complex, 
      multi-stage, multidisciplinary surgical intervention for the treatment of severe 
      corneal blindness. One step of the OOKP consists of creating a precise hole into 
      a tooth in which an optic cylinder is subsequently inserted; its shape must 
      ensure a perfect watertight fit. The Er: YAG laser (L) used in this study is part 
      of CARLO(R), the first laser osteotome that enables surgical planning based on 
      computed tomography data, robot guidance, and a precise execution of laser cuts 
      in teeth and bone tissue, using laser photoablation rather than conventional 
      mechanical methods. The purpose of this study was to assess whether the Er: YAG 
      laser is non-inferior compared to a conventional drill. METHODS: Thirty-two 
      bovine incisors were grounded to a thickness of 1.5 mm. In 16 teeth, a 3.5 mm 
      hole was drilled progressively into each tooth, using dental burs (B) of 
      increasing diameter that were attached to a fixed drill machine. In the other 16 
      teeth, a hole was created using an Er: YAG laser at a wavelength of 2.94 microm (Part 
      of CARLO(R)). In seven teeth of each group, the cylinder was inserted and fixated 
      with polymethylmethacrylate (PMMA) bone cement. In the remaining seven teeth of 
      each group, the cylinder was inserted without fixation material (press-fit). 
      After bonding and drying, all specimens were stored in water until force 
      measurements were recorded using a uniaxial traction machine. The force required 
      to move the optical cylinder out of the hole in the tooth was measured using an 
      Instron 3344 testing system. Scanning electron microscope (SEM) and light 
      microscope (LM) visualization of the holes created with the laser and the drill 
      were performed in two teeth (SEM)/four teeth (LM) per method. RESULTS: 
      Significant differences (P < 0.001) were found for the following parameters: B 
      PMMA versus B press-fit; B PMMA versus L press-fit; L PMMA versus B press-fit; L 
      PMMA-L press-fit. This shows that PMMA bone cement fixation is superior to 
      press-fit. No significant differences were found between B PMMA-L PMMA (P = 0.93) 
      and B press-fit-L press-fit (P = 0.83). The SEM pictures showed a smoother 
      surface using L. CONCLUSIONS: The laser cut holes were as strong as bur-drilled 
      holes, although SEM pictures showed a smoother surface of the laser cut holes. 
      Hence, laser osteotomes open the possibility to custom fit the hole exactly to 
      the width of the cylinder, which represents a potential advantage of the laser 
      over the conventional bur. Lasers Surg. Med. 51:531-537, 2019. (c) 2019 Wiley 
      Periodicals, Inc.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Berg, Britt-Isabelle
AU  - Berg BI
AD  - Department of Cranio-Maxillofacial Surgery, University Hospital Basel, 
      Switzerland.
FAU - Peyer, Michael
AU  - Peyer M
AD  - Advanced Osteotomy Tools AG (AOT), Basel, Switzerland.
FAU - Kuske, Lorenz
AU  - Kuske L
AD  - Department of Ophthalmology, University Hospital Basel, University Basel, Basel, 
      Switzerland.
FAU - Augello, Marcello
AU  - Augello M
AD  - Department of Cranio-Maxillofacial Surgery, Kantonsspital Aarau, Aarau, 
      Switzerland.
FAU - Schotzau, Andreas
AU  - Schotzau A
AD  - Department of Ophthalmology, University Hospital Basel, University Basel, Basel, 
      Switzerland.
FAU - Steineck, Markus
AU  - Steineck M
AD  - Department of Dentistry, University Basel, Basel, Switzerland.
FAU - Deibel, Waldemar
AU  - Deibel W
AD  - Advanced Osteotomy Tools AG (AOT), Basel, Switzerland.
FAU - Mathys, Daniel
AU  - Mathys D
AD  - Swiss Nanoscience Institute (SNI), Nano Imaging Lab, Basel, Bio-Pharma Centre, 
      Basel, Switzerland.
FAU - Jurgens, Philipp
AU  - Jurgens P
AD  - Department of Cranio-Maxillofacial Surgery, University Hospital Basel, 
      Switzerland.
AD  - Advanced Osteotomy Tools AG (AOT), Basel, Switzerland.
FAU - Kunz, Christoph
AU  - Kunz C
AD  - Department of Cranio-Maxillofacial Surgery, University Hospital Basel, 
      Switzerland.
FAU - Goldblum, David
AU  - Goldblum D
AD  - Department of Ophthalmology, University Hospital Basel, University Basel, Basel, 
      Switzerland.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190115
PL  - United States
TA  - Lasers Surg Med
JT  - Lasers in surgery and medicine
JID - 8007168
SB  - IM
MH  - Animals
MH  - Cattle
MH  - Incisor/*surgery/ultrastructure
MH  - Laser Therapy/*instrumentation
MH  - Lasers, Solid-State/*therapeutic use
MH  - Osteotomy/*instrumentation
MH  - Prosthesis Implantation
OTO - NOTNLM
OT  - Er: YAG laser
OT  - bone resorption
OT  - bur
OT  - corneal blindness
OT  - laser osteotomy
OT  - osteo-odonto-keratoprosthesis
OT  - scanning electron microscope
OT  - teeth
EDAT- 2019/01/16 06:00
MHDA- 2020/09/01 06:00
CRDT- 2019/01/16 06:00
PHST- 2018/12/07 00:00 [accepted]
PHST- 2019/01/16 06:00 [pubmed]
PHST- 2020/09/01 06:00 [medline]
PHST- 2019/01/16 06:00 [entrez]
AID - 10.1002/lsm.23053 [doi]
PST - ppublish
SO  - Lasers Surg Med. 2019 Aug;51(6):531-537. doi: 10.1002/lsm.23053. Epub 2019 Jan 
      15.