Use of Er:YAG laser to improve osseointegration of titanium alloy implants—a comparison of bone healing

Purpose The objective of this study was to compare the osseointegration of implants in rats in sites prepared with an Er:YAG laser with osseointegration in sites prepared using a conventional drill by assessing the percentage of bone-implant contact (BIC). Materials and Methods Osteotomies were prepared with an Er:YAG laser in the tibiae of 18 rats (the test group) and drill-prepared with a 1.3-mm-wide surgical implant drill at 1,000 rpm with simultaneous saline irrigation in the tibiae of another 18 rats (the control group). Acid-etched titanium alloy implants (2 3 8 mm) were placed in the tibiae, engaging the opposite cortical plate. The Er:YAG laser was used with a regular handpiece and water irrigation (spot size, 2 mm; energy per pulse, 500 to 1,000 mJ; pulse duration, 400 ms; and energy density, 32 J/cm2). Nine animals from each group were sacrificed after 3 weeks of unloaded healing; the remainder were sacrificed after 3 months. The tissues were fixed and prepared for histologic and histomorphometric evaluation. Results Statistical analysis showed significant differences between the 2 groups at both 3 weeks and 3 months. After 3 weeks of unloaded healing, the mean BICs (±SD) were 59.48% (±21.89%) for the laser group and 12.85% (±11.13%) for the control group. Following 3 months of unloaded healing, the mean BICs (±SD) were 73.54% (±11.53%) for the laser group and 32.6% (±6.39%) for the control group. Discussion Preparation of the implant sites with the Er:YAG laser did not damage the interface; the healing patterns presented were excellent. Conclusions Based on the results of this study, it may be concluded that the Er:YAG laser may be used clinically for implant site preparation with good osseointegration results and bone healing and with a significantly higher percentage of BIC compared to those achieved with conventional methods.— Reprinted with permission of Quintessence Publishing.