A preliminary report about treatment of bisphosphonate related osteonecrosis of the jaw with Er:YAG laser ablation
Article first published online: 13 JAN 2009
Copyright © 2009 Wiley-Liss, Inc.
Lasers in Surgery and Medicine
Volume 41, Issue 1, pages 26–30, January 2009
How to Cite
Stübinger, S., Dissmann, J.-P., Pinho, N. C., Saldamli, B., Seitz, O. and Sader, R. (2009), A preliminary report about treatment of bisphosphonate related osteonecrosis of the jaw with Er:YAG laser ablation. Lasers Surg. Med., 41: 26–30. doi: 10.1002/lsm.20730
- Issue published online: 13 JAN 2009
- Article first published online: 13 JAN 2009
- Manuscript Accepted: 3 NOV 2008
- National Center of Competence in Research Computer Aided
- Image Guided Medical Interventions of the Swiss National Science Foundation, Berne, Switzerland
- diseased bone;
- oral oncology;
- laser osteotomy;
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/cm2). 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.
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.
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.