Impact of the Curve Diameter and Laser Settings on Laser Fiber Fracture

To analyze the risk factors for laser fiber fractures when deflected to form a curve, including laser settings, size of the laser fiber, and the fiber bending diameter.

Single-use 272 and 365 μm fibers (Rocamed^®, Monaco) were employed along with a holmium laser (Rocamed). Five different fiber curve diameters were tested: 9, 12, 15, 18, and 20 mm. Fragmentation and dusting settings were used at a theoretical power of 7.5 W. The laser was activated for 5 minutes and the principal judgment criterion was fiber fracture. Every test for each parameter, bending diameter, and fiber size combinations was repeated 10 times.

With dusting settings, fibers broke more frequently at a curved diameter of 9 mm for both 272 and 365 μm fibers (p = 0.037 and 0.006, respectively). Using fragmentation settings, fibers broke more frequently at 12 mm for 272 μm and 15 mm for 365 μm (p = 0.007 and 0.033, respectively). Short pulse and high energy were significant risk factors for fiber fracture using the 365 μm fibers (p = 0.02), but not for the 272 μm fibers (p = 0.35). Frequency was not a risk factor for fiber rupture. Fiber diameters also seemed to be involved in the failure with a higher number of broken fibers for the 365 μm fibers, but this was not statistically significant when compared with the 272 μm fibers (p > 0.05).

Small-core fibers are more resistant than large-core fibers as lower bending diameters (<9 mm) are required to break smaller fibers. In acute angles, the use of small-core fibers, at a low energy and long-pulse (dusting) setting, will reduce the risk of fiber rupture.