CO2 laser free-form processing of hard tissue

Drilling and surface processing of bone and tooth tissue belongs to standard medical procedures (bores and embeddings for implants, trepanation etc.). Small circular bores can be generally quickly produced with mechanical drills. However problems arise at angled drilling, the need to execute drilling procedures without damaging of sensitive soft tissue structures underneath the bone or the attempt to mill small non-circular cavities in hard tissue with high precision. We present investigations on laser hard tissue "milling", which can be advantageous for solving these problems. The processing of bone is done with a CO2 laser (10.6 mu m) with pulse durations of 50-100 mu s, combined with a PC-controlled fast galvanic laser beam scanner and a fine water-spray, which helps keeping the ablation process effective and without thermal side-effects. Laser "milling" of non-circular cavities with 1-4 mm width and about 10 mm. depth can be especially interesting for dental implantology. In ex-vivo investigations we found conditions for fast laser processing of these cavities without thermal damage and with minimised tapering. It included the exploration of different filling patterns (concentric rings, crosshatch, parallel lines, etc.), definition of maximal pulse duration, repetition rate and laser power, and optimal water spray position. The optimised results give evidence for the applicability of pulsed CO2 lasers for biologically tolerable effective processing of deep cavities in hard tissue.