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A preliminary report about treatment of bisphosphonate related osteonecrosis of the jaw with Er:YAG laser ablation
Author(s) -
Stübinger Stefan,
Dissmann JanPhilipp,
Pinho Nicole Chambron,
Saldamli Belma,
Seitz Oliver,
Sader Robert
Publication year - 2009
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.20730
Subject(s) - ablation , medicine , er:yag laser , laser , soft tissue , osteonecrosis of the jaw , bisphosphonate , dentistry , mandible (arthropod mouthpart) , laser ablation , surgery , osteoporosis , optics , pathology , physics , botany , biology , genus
Background and Objectives This preliminary report describes a new laser‐assisted treatment option for the emerging complication of bisphosphonate related osteonecrosis (BON) of the jaw. Materials and Methods In eight tumour patients (three women, five men) ten bony lesions in the maxilla and mandible in the course of intravenous bisphosphonate therapy were treated with a variable square pulsed (VSP) Er:YAG laser. For the treatment, the Er:YAG laser was applied with a pulse energy of 1,000 mJ, a pulse duration of 300 microseconds, and a frequency of 12 Hz (energy density 157 J/cm 2 ). The spot size was 0.9 mm and the handpiece was kept at a distance of about 10 mm from the bone surface. The diseased bone was ablated exclusively with the Er:YAG laser by subsequently sweeping the bone surface in a well directed scanning mode. Results The surgical procedure and postoperative wound healing were without any complications and a complete soft tissue recovering was achieved within 4 weeks. During follow‐up examinations over 12 months soft tissue conditions were stable. The pulsed laser ablation caused a characteristic microstructured and craggy bone surface without a condensation or a smear layer on the laser rims. Conclusion The bone ablation technique using a VSP Er:YAG laser yielded promising clinical results without impairment of wound healing. A further analyse of the chemical, physical and pharmacological aspects of laser assisted treatment of BON lesions is necessary to get a safe and reliable treatment protocol for bisphosphonate‐related osteonecrosis of the jaw. Lasers Surg. Med. 41:26–30, 2009. © 2008 Wiley‐Liss, Inc.