In Vitro Light and Scanning Electron Microscopic Study Involving Erbium: YAG Laser Irradiation of Temporomandibular Joint Tissue

Abstract

Laser-assisted procedures have been applied in arthroscopic surgery with varying degrees of success since the end of the 1970s. The introduction of pulsed holmium and erbium:YAG lasers in the near-infrared range seems to signify a more promising alternative in arthroscopic applications than the CO2 and Nd:YAG lasers that were propagated initially. Since a flexible transmission system for erbium:YAG lasers is still not available, commercialization and thus the clinical utilization of holmium: YAG lasers is more advanced at present. This paper introduces the results of an interdisciplinary research project. With the aid of photomacroscopic examination, light and scanning electron microscopic investigations, changes to temporomandibular joint structures were detected in vitro after irradiation with an erbium:YAG laser system. This investigation revealed that the optimum average energy density and pulse duration for the erbium:YAG laser radiation for the purpose of arthroscopic temperomandibular joint (TMJ) surgery—which means efficient etch rate and minimal adjacent injury—seem to be about 24–42 J/cm2 and 120–240 μsec, respectively.