Correlating Hand Speeds and Tissue Charring with Soft Tissue Laser Surgical Outcomes

Asad Tanweer, Nicole Walawander and Jenna Kahn

This image shows how the IMU MotionNode device was attached to the users hand.

The IMU MotionNode device attached to the user's hand.

Undergraduate Student Project

Introduction

Imagine going to a dental office, and not having to hear the sound of a drill or leaving with the resulting numbness caused by anesthetic.  The use of lasers in dentistry have been ever so increasing but the lack of standardized literature deters many dentists from using this technology. The fear of burning and charring the tissue are evident fears that discourage dentists from using this technology. This project will serve to try and train novice laser users how to appropriately use the laser and minimize the amount of resulting charred tissue. 

Abstract

Thermal tissue damage from post-laser surgery compromises healing outcomes. This study was aimed at identifying a relationship between tissue charring and laser hand-speed that impacts quality of soft tissue laser surgery. Following operator calibration for range of motion and task (1 inch linear motion), 3 Incisions were performed with a 940 nm soft tissue diode laser (Epic Pro, Biolase) at differing hand speed monitored with digital sensors (IMU MotionNode). This unit is capable of high resolution 6 axis assessments of distance and acceleration. Digital images were collected and the amount of tissue charring (black pixels) was quantified using ImageJ software. Data was tabulated and assessed for statistical significance. We performed this pilot study at a high power (4W) to establish the methodology and study protocols. Lasers are becoming more frequently used in clinical dentistry, especially in pediatrics, for a broad array of soft tissue surgical applications. Several devices such as Diodes, Nd:YAG, Erbium and CO2 are now on the market today. Lasers enable improved quality of care due to their greater precision, photocoagulation (bloodless field), better post- surgical healing responses, and overall patient acceptance. Absorption of laser energy results in photothermal destruction (> 100C) of the tissue while adjacent areas are exposed to lower, usually photocoagulation (> 60C). The specificity of the absorption event and suitable laser parameters are essential to ensure optimal tissue responses.

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