Lasers in Medical Science

, Volume 33, Issue 7, pp 1471–1478 | Cite as

Comparative microstructural analysis of bone osteotomies after cutting by computer-assisted robot-guided laser osteotome and piezoelectric osteotome: an in vivo animal study

  • Marcello Augello
  • Waldemar Deibel
  • Katja Nuss
  • Philippe Cattin
  • Philipp Jürgens
Original Article


Most industrial laser applications utilize computer and robot assistance, for guidance, safety, repeatability, and precision. In contrast, medical applications using laser systems are mostly conducted manually. The advantages can be effective only when the system is coupled to a robotic guidance, as operating by hand does not reach the required accuracy. We currently developed the first laser osteotome which offers preoperative planning based on CT data, robot guidance, and a precise execution of the laser cuts. In an animal trial, our system was used to create a grid pattern of the same depth on the inner layer of parietal bone in 12 adult sheep. The same bone cuts were done with piezoelectric osteotome on the contralateral side. The micro-CT and histological analysis showed more new mineralized bone in the laser group compared to the piezoelectric group. As well, a cutting pattern with especially a constant osteotomy depth in the laser group was demonstrated. The here presented autonomous osteotomy tool shows not only an advantage in early bone healing stage but additionally sharp bone cuts with a very high accuracy and freely selectable design cuts.


Laser osteotomy Er:YAG laser Navigation Bone Nanotome Micro-CT 



We gratefully acknowledge Dr. Georg Schulz, Biomaterials Science Center, University of Basel, Switzerland, for performing the micro-CT scans.

Role of funding source

The animal husbandry was supported by AOT AG Switzerland.

Compliance with ethical standards

Conflict of interests

The authors declare that there is no conflict of interests regarding the publication of this paper. Ph. Cattin and P. Jürgens are co-founders of AOT AG.

Ethical approval

All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

Informed consent

Not applicable due to an animal study.


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Cranio-Maxillofacial SurgeryHospital AarauAarauSwitzerland
  2. 2.Hightech Research Centre of Cranio-Maxillofacial SurgeryUniversity of BaselAllschwilSwitzerland
  3. 3.Department of Cranio-Maxillofacial SurgeryAarauSwitzerland
  4. 4.Center for Medical Image Analysis and NavigationUniversity of BaselAllschwilSwitzerland
  5. 5.Advanced Osteotomy Tools AGBaselSwitzerland
  6. 6.Musculoskeletal Research Unit, Vetsuisse FacultyUniversity of ZurichZürichSwitzerland
  7. 7.Department of Cranio-Maxillofacial SurgeryUniversity HospitalBaselSwitzerland

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