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Over the years, developments in implant dentistry have concentrated on implant design and surface treatment of titanium,1–11 and successful osseointegration12 is now considered the minimum standard for all implants.

I case report Fig. 1_IO360 tip. (Courtesy of elexxion AG) Fig. 2_Representation of the beam profile of the IO360 tip at 1 W emission. (Courtesy of elexxion AG) Fig. 3_SEM image of sample 1, the SDS-prepared site, showing smear layer in bovine bone. _Introduction Over the years, developments in implant dentistry have concentrated on implant design and surface treatmentoftitanium,1–11 andsuccessfulosseointegra- tion12 is now considered the minimum standard for all implants. To avoid bone necrosis, preparation of the os- teotomy site is commonly achieved with a series of drills and copious water irrigation. Studies show that erbiumlaserswithwaterspraycanalsobeusedtopre- parethesite.13–17 However,littleattentionhasbeenpaid to the possibilities of laser conditioning after drill preparationoftheimplantsite. The Er:YAG laser has a wavelength of 2,940 nm. It falls within the mid-infra-red region (invisible to the human eye) and is well absorbed by water molecules andhydroxyapatite.Sincewaterisoneofthemaincon- stituents of all oral hard and soft tissues, the Er:YAG laseristhereforeusedintheablationoftooth,boneand dentalsofttissue.18–33 Er:YAG laser osteotomy and drill osteotomy have been compared in animal studies.16, 17, 34, 35 In these in- vestigations, laser osteotomy yielded comparable or better results than drill osteotomy in terms of bone healing, and some of these studies14, 16, 35 showed favourable laser results for bone-to-implant contact. Romanos et al.13 demonstrate that Er:YAG laser irradi- ationappearstostimulatethesecretionofplatelet-de- rivedgrowthfactorwhenpreparingosteotomysitesin a rat model. The study postulates that laser irradiation couldimprovethehealingofthosesites.Aleksicetal.36 demonstrate the low-level laser effect of Er:YAG laser irradiationwiththeenhancementofosteoblastprolif- eration. _Objective The authors thus instituted a study to investigate thepossibilityofusinganEr:YAGlasertoconditionan osteotomy site prepared according to a standard drillingsequence(SDS).Theyutilisedanewlydesigned tip, performed a simple in vitro experiment, and then proceeded to test the technique with two clinical cases.Theaimofthisstudywastocomparethestabil- ity values of implant placement with and without Er:YAG laser conditioning of the bone surface follow- ing an SDS. The maxillary region was chosen for both patients. A novel technique of Er:YAG laser-enhanced early implant stability Author_Dr Kenneth Luk & Dr Ryan S. K. Seto, China 28 I laser2_2012 Fig. 2 Fig. 3Fig. 1