12/3 Morphology applicator

		In vivo laser osteotomy with the CO2-laser used in the sheep tibia during Co-Me 1. Clearly visible are the ablation products flying out of the osteotomy gap. No negative thermal side effects or any charring occured during the ablation process.

Cutting vital bone by laser offers many advantages. These are above all a non-contact, blood - and vibration-reduced surgery technique, free choice of cut geometry, a small operation field, and the prevention of massive bone flour and metal abrasion. The most important prerequisites for the acceptance of a laser procedure are thereby an effective and fast bone ablation with avoidance of any thermal or thermomechanical damage of the treated tissue.

With application in bone surgery thermal damage of tissue can be minimised by the selection of a wavelength to be responsible for a high absorption in the mineralised and unmineralised bony matrix. Since calcium hydroxyapatite and water indicate the optimal absorption rate at the wavelength of the CO2-laserlight (10.6 µm), the CO2- laser is among others suitable for cutting bones.

In the context of this project a new CO2-laser with a computer-assisted scanner allowing a precise and arbitrary guidance of the laser beam, will be tested to allow new and sophisticated cut geometries. The aim is to attain newly arranged and self stabilising osteotomies not only in oral and maxillofacial surgery but also in orthopaedics and other medical disciplines. Therefore also navigation systems and robotics are tested to extend the surgical possibilities and to improve the treatment. Beneath the wavelength especially the pulse duration and the very fast pulse repetition rate of the CO2 laser are responsible for the clean and exact cut gaps which will be filled up with new bone. This could be shown by animal experiments in the sheep tibia during Co-Me 1. Further developments and tests to optimise such parameters are planned.