Experimental investigation of the effect of retropulsion in sialolithotripsy with a thulium laser; [Экспериментальное исследование эффекта ретропульсии при сиалолитотрипсии тулиевым лазером]

The size of the concretion affects the effectiveness of its removal by sialoendoscopy. Comparative studies of lasers of various types in the crushing of concretions have shown that the holmium YAG laser remains the predominant intracorporeal lithotripter. However, the problem of the effect of repulsion (retropulsion) of the concretion remains unresolved. The positive results of urologists in lithotripsy with the FiberLase U2 thulium laser served as the basis for conducting their own research on salivary stones. Aim: to evaluate the effect of retropulsion when crushing sialolites with a thulium laser FiberLase U2 in various modes in vitro. Material and methods. 14 round-shaped sialoliths with a diameter of 5—6 mm were selected for the study. We have developed a model consisting of a vacutainer: a transparent glass tube with a diameter of 8 mm, cylindrical in shape, simulating the duct of the salivary gland. A FiberLase U2 laser fiber was fed through the cap of the model and a series of lithotripsies were sequentially performed in three modes of the device at maximum and minimum values of pulse energy and frequency, fragmentation was additionally investigated at average values of frequency and pulse energy of the Popcorning mode. Results: The effect of sialolith retropulsion was observed as a result of the laser pulse in all three modes of the FiberLase U2 device, however, the numerical values of the effect varied from 2 to 10 mm depending on the selected mode and its power. Air bubbles, sparks and small fragments were also formed in varying degrees of severity. Conclusion. The FiberLase U2 thulium laser is an effective means of crushing in all modes. An increase in the energy and frequency of the pulse increases the effect of retropulsion and poses a danger to tissues. Thus, the clinical study should be conducted at the minimum values of the energy and frequency of the laser pulse. © 2023 Clinical Dentistry LLC. All rights reserved.