A comparison of mass removal, thermal injury, and crater morphology of cortical bone ablation using wavelengths 2.79, 2.9, 6.1, and 6.45 µm

Laser fabrication of structural bone: surface morphology and biomineralization assessment

The current work explores the surface morphology of the laser-ablated bone using Yb-fiber coupled Nd:YAG laser (λ = 1064 nm) in continuous wave mode. As the laser-ablated region contains physiochemically modified carbonized and nonstructural region, it becomes unknown material for the body. Thus, biomineralization on such a laser-ablated region was assessed by in vitro immersion test in noncellular simulated body fluid. The presence of hydroxyapatite was detected in the precipitated mineral product using scanning electron microscopy equipped with energy dispersive spectroscopy, and X-ray diffraction analysis. The effect of varying laser parameters on distribution of surface morphology features was identified and its corresponding effect on biomineralization was studied.

Thermal Assessment of Ex Vivo Laser Ablation of Cortical Bone

As a potential osteotomy tool, laser ablation is expected to provide rapid machining of bone, while generating minimal thermal damage (carbonization) and physical attributes within the machined region conducive to healing. As these characteristics vary with laser parameters and modes of laser operation, the clinical trials and in vivo studies render it difficult to explore these aspects for optimization of the laser machining parameters. In light of this, the current work explores various thermal and microstructural aspects of laser-ablated cortical bone in ex vivo study to understand the fundamentals of laser-bone interaction using computational modeling. The study employs the Yb-fiber Nd:YAG laser (λ = 1064 nm) in the continuous wave mode to machine the femur section of bovine bone by a three-dimensional machining approach. The examination involved thermal analysis using differential scanning calorimetry and thermogravimetry, phase analysis using X-ray diffractometry, qualitative analysis using X-ray photoelectron spectroscopy, and microstructural and semiquantitative analysis using scanning electron microscopy equipped with energy-dispersive spectrometry. The mechanism of efficient bone ablation using the Nd:YAG laser was evaluated using the computational thermokinetics outcome. The use of high laser fluence (10.61 J/mm²) was observed to be efficient to reduce the residual amorphous carbon in the heat-affected zone while achieving removal of the desired volume of the bone material at a rapid rate. Minimal thermal effects were predicted through computational simulation and were validated with the experimental outcome. In addition, this work reveals the in situ formation of a scaffold-like structure in the laser-machined region which can be conducive during healing.

Influence of environmental conditions in bovine bone ablation by ultrafast laser

Ultrafast lasers are promising tools for surgical applications requiring precise tissue cutting. Shallow ablation depth and slow rate as well as collateral damage are common barriers limiting the use of laser in clinical applications. Localized cooling with water and/or air jet is known to reduce collateral thermal damage. We studied the influence of environmental conditions including air, compressed air flow, still water and water jet on ablation depth, ablation rate and surface morphology on bovine bone samples with an 800 nm femtosecond laser. At 15 J/cm² , no thermal effect was observed by electron microscopy and Raman spectroscopy. The experimental results indicate that environmental conditions play a significant role in laser ablation. The deepest cavity and highest ablation rate were achieved under the compressed air flow condition, which is attributed to debris removal during the ablation process. The shallowest ablation depth and lowest ablation rates were associated with water flushing. For surface morphology, smooth surface and the absence of microcracks were observed under air flow conditions, while rougher surfaces and minor microcracks were observed under other conditions. These results suggest that ultrafast ablation of bone can be more efficient and with better surface qualities if assisted with blowing air jet.

Integrated experimental and computational approach to laser machining of structural bone

This study describes the fundamentals of laser-bone interaction during bone machining through an integrated experimental-computational approach. Two groups of laser machining parameters identified the effects of process thermodynamics and kinetics on machining attributes at micro to macro. A continuous wave Yb-fiber Nd:YAG laser (wavelength 1070 nm) with fluences in the range of 3.18 J/mm²-8.48 J/mm² in combination of laser power (300 W-700 W) and machining speed (110 mm/s-250 mm/s) were considered for machining trials. The machining attributes were evaluated through scanning electron microscopy observations and compared with finite element based multiphysics-multicomponent computational model predicted values. For both groups of laser machining parameters, experimentally evaluated and computationally predicted depths and widths increased with increased laser energy input and computationally predicted widths remained higher than experimentally measured widths whereas computationally predicted depths were slightly higher than experimentally measured depths and reversed this trend for the laser fluence >6 J/mm². While in both groups, the machining rate increased with increased laser fluence, experimentally derived machining rate remained lower than the computationally predicted values for the laser fluences lower than ∼4.75 J/mm² for one group and ∼5.8 J/mm² for other group and reversed in this trend thereafter. The integrated experimental-computational approach identified the physical processes affecting machining attributes.

Laser cutting of bone tissue under bulk water with a pulsed ps-laser at 532 nm

Hard-tissue ablation was already investigated for a broad variety of pulsed laser systems, which cover almost the entire range of available wavelengths and pulse parameters. Most effective in hard-tissue ablation are Er:YAG and CO2 lasers, both utilizing the effect of absorption of infrared wavelengths by water and so-called explosive vaporization, when a thin water film or water–air spray is supplied. The typical flow rates and the water layer thicknesses are too low for surgical applications where bleeding occurs and wound flushing is necessary. We studied a 20 W ps-laser with 532 nm wavelength and a pulse energy of 1 mJ to effectively ablate bones that are submerged 14 mm under water. For these laser parameters, the plasma-mediated ablation mechanism is dominant. Simulations based on the blow-off model predict the cut depth and cross-sectional shape of the incision. The model is modified considering the cross section of the Gaussian beam, the incident angle, and reflections. The ablation rate amounts to 0.2  mm3/s, corresponding to an increase by at least 50% of the highest values published so far for ultrashort laser ablation of hard tissue.

Interplay of wavelength, fluence and spot-size in free-electron laser ablation of cornea

Infrared free-electron lasers ablate tissue with high efficiency and low collateral damage when tuned to the 6-microm range. This wavelength-dependence has been hypothesized to arise from a multi-step process following differential absorption by tissue water and proteins. Here, we test this hypothesis at wavelengths for which cornea has matching overall absorption, but drastically different differential absorption. We measure etch depth, collateral damage and plume images and find that the hypothesis is not confirmed. We do find larger etch depths for larger spot sizes--an effect that can lead to an apparent wavelength dependence. Plume imaging at several wavelengths and spot sizes suggests that this effect is due to increased post-pulse ablation at larger spots.