Drilling of bone and tooth tissue belongs to recurrent medical procedures (screw- and pin-bores, bores for implant inserting, trepanation etc.). Small round bores can be in general quickly produced with mechanical drills. Problems arise however by angled drilling, by the necessity to fulfill the drilling without damaging of sensitive soft tissue beneath the bone, or by the attempt to mill precisely noncircular small cavities. We present investigations on laser hard tissue "milling", which can be advantageous for solving these problems.
The "milling" is done with a CO2 laser (10.6 &mgr;m) with pulse duration of 50 - 100 &mgr;s, combined with a PC-controlled galvanic beam scanner and with a fine water-spray, which helps to avoid thermal side-effects. The damaging of underlying soft tissue can be prevented through control of the optical or acoustical ablation signal. The ablation of hard tissue is accompanied with a strong glowing, which is absent during the laser beam action on soft tissue. The acoustic signals from the diverse tissue types exhibit distinct differences in the spectral composition. Also computer image analysis could be a useful tool to control the operation.
Laser "milling" of noncircular cavities with 1 - 4 mm width and about 10 mm depth is particularly interesting for dental implantology. In ex-vivo investigations we found conditions for fast laser "milling" of the cavities without thermal damage and with minimal tapering. It included exploration of different filling patterns (concentric rings, crosshatch, parallel lines and their combinations), definition of maximal pulse duration, repetition rate and laser power, optimal position of the spray. The optimized results give evidences for the applicability of the CO2 laser for biologically tolerable "milling" of deep cavities in the hard tissue.