Er:YAG laser ablation of bone in experimental diabetics

The aim of this study was to compare bone healing in experimental diabetics after ostectomies obtained by Er:YAG laser and bur drilling.

Twenty-eight Wistar rats weighing 250-300 g were used for this study. Diabetes was chemically induced with streptozotocin administered as a single intraperitoneal injection. Fourteen nondiabetic (normal) and 14 diabetic rats were included in the analysis. Left femur distal epiphysis of nondiabetic and diabetic rats was perforated with a surgical bone drill. Another defect with similar dimensions was created by an Er:YAG laser on the left femur of diabetic rats. An Er:YAG laser of 2940-nm wavelength with an energy density of 1.5 W was used. The rats were assigned to three experimental groups: normal bur group (control), diabetic bur group, and diabetic Er:YAG group. The rats were killed at 10 and 20 days to compare the bone healing of each group.

At 10 days of healing, the sum of histologic scores was higher in the normal bur group than in the diabetic bur and diabetic Er:YAG groups. In the present study, union, spongiosa, and bone marrow were evaluated, respectively, and there were no significant differences among the groups regarding the union and bone marrow (p > 0.05). Spongiosa bone formation was higher in the normal bur group than in the diabetic bur and diabetic Er:YAG groups (p = 0.011). There were no significant differences among the groups as to union, spongiosa, bone marrow, and sum of histologic scores (p > 0.05) at 20 days of healing.

Histologically, no difference was found between the Er:YAG and bur cavities in diabetic rats regarding bone healing. With these histological and experimental results, we believe that the 2940-nm Er:YAG laser (1.5 W) can be used confidently in the ablation of bones in diabetic cases.