Change in Temperature of Subjacent Bone During Soft Tissue Laser Ablation

I n tissues that closely approximate bone, sufficient heat may be transferred to the bone during laser surgery to cause damage and/or necrosis. To date, there have been few studies examining the temperatures elicited at the bone surface as a result of laser application to the overlying soft tissues. The purpose of this investigation was to determine, under in vitro conditions, temperature changes at the bone/soft tissue interface during laser ablation with CO 2 and Nd:YAG lasers used with and without (w/wo) air/water coolant. Experimental specimens consisted of 5 mandibles from freshly sacrificed hogs; laser treatment sites were the buccal and lingual attached gingiva of the molars and the lingual keratinized mucosa of the incisor region. CO 2 and Nd:YAG lasers were used w/wo coolant at power settings of 4 to 8 W and 5 to 9 W, respectively. Temperature changes were measured with a copper constant thermocouple contained within a 21 gauge hypodermic needle. In comparing the lasers at comparable energy densities w/wo coolant, temperature increases at the bone/soft tissue interface ranged from 8.0 to 11.1°C with the Nd:YAG and 1.4 to 2.1°C with the CO 2 . Similarly, in comparing the times required for the interface to return to baseline temperature following removal of the laser, values ranged from ~143 to 205 and ~119 to 139 seconds for the NdYAG and CO 2 , respectively. Results from this study suggest that, at energy densities equal or above those reported here, the increase in temperature at the bone surface as a result of periodontal soft tissue surgery with the NdYAG laser could be damaging, especially if the exposure is prolonged. J Periodontol 1998;69:1278–1282 .