Abstract

Laser surgery enables for very accurate, fast and clean modeling of tissue. The specific and controlled cutting and ablation of tissue, however, remains a central challenge in the field of clinical laser applications. The lack of information on what kind of tissue is being ablated at the bottom of the cut may lead to iatrogenic damage of structures that were meant to be preserved. One such example is the shaping or removal of diseased cartilaginous and bone tissue in the temporomandibular joint (TMJ). Diseases of the TMJ can induce deformation and perforation of the cartilaginous discus articularis, as well as alterations to the cartilaginous surface of the condyle or even the bone itself. This may result in restrictions of movement and pain. The aim of a surgical intervention ranges from specific ablation and shaping of diseased cartilage, bone or synovial tissues to extensive removal of TMJ structures. One approach to differentiate between these tissues is to use Laser Induced Breakdown Spectroscopy (LIBS). The ultimate goal is a LIBS guided feedback control system for surgical laser systems that enables real-time tissue identification for tissue specific ablation. In the presented study, the authors focused on the LIBS based differentiation between cartilage tissue and cortical bone tissue using an ex-vivo pig model.

© 2014 Optical Society of America

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2013 (5)

S. Weedon, N. Ahmed, and A. J. Sidebottom, “Prospective assessment of outcomes following disposable arthroscopy of the temporomandibular joint,” Br. J. Oral Maxillofac. Surg. 51(7), 625–629 (2013).
[Crossref] [PubMed]

F. Liu and A. Steinkeler, “Epidemiology, Diagnosis, and Treatment of Temporomandibular Disorders,” Dent. Clin. North Am. 57(3), 465–479 (2013).
[Crossref] [PubMed]

P. López-Jornet and F. Camacho-Alonso, “Comparison of pain and swelling after removal of oral leukoplakia with CO₂ laser and cold knife: a randomized clinical trial,” Med. Oral Patol. Oral Cir. Bucal 18(1), e38–e44 (2013).
[Crossref] [PubMed]

R. Kanawade, F. Mehari, C. Knipfer, M. Rohde, K. Tangermann-Gerk, M. Schmidt, and F. Stelzle, “Pilot study of laser induced breakdown spectroscopy for tissue differentiation by monitoring the plume created during laser surgery — An approach on a feedback Laser control mechanism,” Spectrochim. Acta, B At. Spectrosc. 87(0), 175–181 (2013).
[Crossref]

F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
[Crossref] [PubMed]

2012 (2)

F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

M. G. Koslin, A. T. Indresano, and L. G. Mercuri, “Temporomandibular joint surgery,” J. Oral Maxillofac. Surg. 70(11Suppl 3), e204–e231 (2012).
[Crossref] [PubMed]

2011 (3)

B. Spyropoulos, “50 years LASERS: in vitro diagnostics, clinical applications and perspectives,” Clin. Lab. 57(3-4), 131–142 (2011).
[PubMed]

G. Dimitroulis, “Temporomandibular joint surgery: what does it mean to the dental practitioner?” Aust. Dent. J. 56(3), 257–264 (2011).
[Crossref] [PubMed]

A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
[Crossref] [PubMed]

2009 (1)

D. A. Cremers and R. C. Chinni, “Laser-Induced Breakdown Spectroscopy - Capabilities and Limitations,” Appl. Spectrosc. Rev. 44(6), 457–506 (2009).
[Crossref]

2008 (1)

M. Strassl, V. Wieger, D. Brodoceanu, F. Beer, A. Moritz, and E. Wintner, “Ultra-short pulse laser ablation of biological hard tissue and biocompatibles,” J. Laser Micr.o Nanoengineering 3(1), 30–40 (2008).

2005 (2)

G. Dimitroulis, “The role of surgery in the management of disorders of the temporomandibular joint: a critical review of the literature. Part 2,” Int. J. Oral Maxillofac. Surg. 34(3), 231–237 (2005).
[PubMed]

G. Dimitroulis, “The role of surgery in the management of disorders of the Temporomandibular Joint: a critical review of the literature. Part 1,” Int. J. Oral Maxillofac. Surg. 34(2), 107–113 (2005).
[PubMed]

2004 (1)

A. Pourzarandian, H. Watanabe, A. Aoki, S. Ichinose, K. M. Sasaki, H. Nitta, and I. Ishikawa, “Histological and TEM examination of early stages of bone healing after Er:YAG laser irradiation,” Photomed. Laser Surg. 22(4), 342–350 (2004).
[Crossref] [PubMed]

2000 (1)

T. Menovsky, M. Van Den Bergh Weerman, and J. F. Beek, “Effect of CO(2)-Milliwatt laser on peripheral nerves: part II. A histological and functional study,” Microsurgery 20(3), 150–155 (2000).
[Crossref] [PubMed]

1999 (1)

M. L. Schoelch, N. Sekandari, J. A. Regezi, and S. Silverman., “Laser management of oral leukoplakias: a follow-up study of 70 patients,” Laryngoscope 109(6), 949–953 (1999).
[Crossref] [PubMed]

1998 (1)

G. L. Bryant, J. M. Davidson, R. H. Ossoff, C. G. Garrett, and L. Reinisch, “Histologic study of oral mucosa wound healing: a comparison of a 6.0- to 6.8-micrometer pulsed laser and a carbon dioxide laser,” Laryngoscope 108(1), 13–17 (1998).
[Crossref] [PubMed]

1997 (1)

R. Orchardson, J. M. Peacock, and C. J. Whitters, “Effect of pulsed Nd:YAG laser radiation on action potential conduction in isolated mammalian spinal nerves,” Lasers Surg. Med. 21(2), 142–148 (1997).
[Crossref] [PubMed]

1996 (1)

T. Menovsky, M. van den Bergh Weerman, and J. F. Beek, “Effect of CO2 milliwatt laser on peripheral nerves: Part I. A dose-response study,” Microsurgery 17(10), 562–567 (1996).
[Crossref] [PubMed]

1995 (1)

J. A. McNamara, D. A. Seligman, and J. P. Okeson, “Occlusion, Orthodontic treatment, and temporomandibular disorders: a review,” J. Orofac. Pain 9(1), 73–90 (1995).
[PubMed]

1994 (3)

M. F. Dolwick and G. Dimitroulis, “Is there a role for temporomandibular joint surgery?” Br. J. Oral Maxillofac. Surg. 32(5), 307–313 (1994).
[Crossref] [PubMed]

L. Gáspár, “The use of high-power lasers in oral surgery,” J. Clin. Laser Med. Surg. 12(5), 281–285 (1994).
[PubMed]

G. D. Baxter, D. M. Walsh, J. M. Allen, A. S. Lowe, and A. J. Bell, “Effects of low intensity infrared laser irradiation upon conduction in the human median nerve in vivo,” Exp. Physiol. 79(2), 227–234 (1994).
[PubMed]

1993 (1)

M. G. Koslin and J. C. Martin, “The use of the holmium laser for temporomandibular joint arthroscopic surgery,” J. Oral Maxillofac. Surg. 51(2), 122–123 (1993).
[Crossref] [PubMed]

1991 (1)

M. Ohnishi, “Arthroscopic laser surgery and suturing for temporomandibular joint disorders: technique and clinical results,” Arthroscopy 7(2), 212–220 (1991).
[Crossref] [PubMed]

1990 (1)

S. F. Dworkin, K. H. Huggins, L. LeResche, M. Von Korff, J. Howard, E. Truelove, and E. Sommers, “Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls,” J. Am. Dent. Assoc. 120(3), 273–281 (1990).
[PubMed]

1988 (1)

M. K. Basu, J. W. Frame, and P. H. Rhys Evans, “Wound healing following partial glossectomy using the CO2 laser, diathermy and scalpel: a histological study in rats,” J. Laryngol. Otol. 102(4), 322–327 (1988).
[Crossref] [PubMed]

1987 (1)

M. Luomanen, “A comparative study of healing of laser and scalpel incision wounds in rat oral mucosa,” Scand. J. Dent. Res. 95(1), 65–73 (1987).
[PubMed]

1986 (1)

H. Q. Woodard and D. R. White, “The composition of body tissues,” Br. J. Radiol. 59(708), 1209–1218 (1986).
[Crossref] [PubMed]

1984 (2)

S. E. Fisher and J. W. Frame, “The effects of the carbon dioxide surgical laser on oral tissues,” Br. J. Oral Maxillofac. Surg. 22(6), 414–425 (1984).
[Crossref] [PubMed]

J. A. Carruth, “Lasers in medicine and surgery,” J. Med. Eng. Technol. 8(4), 161–167 (1984).
[Crossref] [PubMed]

1982 (1)

J. A. Carruth, “Resection of the tongue with the carbon dioxide laser,” J. Laryngol. Otol. 96(6), 529–543 (1982).
[Crossref] [PubMed]

1979 (1)

M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, “Transoral management of localized carcinoma of the oral cavity using the CO2 laser,” Laryngoscope 89(6 Pt 1), 897–905 (1979).
[PubMed]

1978 (1)

M. Ben-Bassat, I. Kaplan, Y. Shindel, and A. Edlan, “The CO2 laser in surgery of the tongue,” Br. J. Plast. Surg. 31(2), 155–156 (1978).
[Crossref] [PubMed]

Adler, W.

F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
[Crossref] [PubMed]

F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Ahmed, N.

S. Weedon, N. Ahmed, and A. J. Sidebottom, “Prospective assessment of outcomes following disposable arthroscopy of the temporomandibular joint,” Br. J. Oral Maxillofac. Surg. 51(7), 625–629 (2013).
[Crossref] [PubMed]

Allen, J. M.

G. D. Baxter, D. M. Walsh, J. M. Allen, A. S. Lowe, and A. J. Bell, “Effects of low intensity infrared laser irradiation upon conduction in the human median nerve in vivo,” Exp. Physiol. 79(2), 227–234 (1994).
[PubMed]

Aoki, A.

A. Pourzarandian, H. Watanabe, A. Aoki, S. Ichinose, K. M. Sasaki, H. Nitta, and I. Ishikawa, “Histological and TEM examination of early stages of bone healing after Er:YAG laser irradiation,” Photomed. Laser Surg. 22(4), 342–350 (2004).
[Crossref] [PubMed]

Barman, I.

A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
[Crossref] [PubMed]

Basu, M. K.

M. K. Basu, J. W. Frame, and P. H. Rhys Evans, “Wound healing following partial glossectomy using the CO2 laser, diathermy and scalpel: a histological study in rats,” J. Laryngol. Otol. 102(4), 322–327 (1988).
[Crossref] [PubMed]

Baxter, G. D.

G. D. Baxter, D. M. Walsh, J. M. Allen, A. S. Lowe, and A. J. Bell, “Effects of low intensity infrared laser irradiation upon conduction in the human median nerve in vivo,” Exp. Physiol. 79(2), 227–234 (1994).
[PubMed]

Beek, J. F.

T. Menovsky, M. Van Den Bergh Weerman, and J. F. Beek, “Effect of CO(2)-Milliwatt laser on peripheral nerves: part II. A histological and functional study,” Microsurgery 20(3), 150–155 (2000).
[Crossref] [PubMed]

T. Menovsky, M. van den Bergh Weerman, and J. F. Beek, “Effect of CO2 milliwatt laser on peripheral nerves: Part I. A dose-response study,” Microsurgery 17(10), 562–567 (1996).
[Crossref] [PubMed]

Beer, F.

M. Strassl, V. Wieger, D. Brodoceanu, F. Beer, A. Moritz, and E. Wintner, “Ultra-short pulse laser ablation of biological hard tissue and biocompatibles,” J. Laser Micr.o Nanoengineering 3(1), 30–40 (2008).

Bell, A. J.

G. D. Baxter, D. M. Walsh, J. M. Allen, A. S. Lowe, and A. J. Bell, “Effects of low intensity infrared laser irradiation upon conduction in the human median nerve in vivo,” Exp. Physiol. 79(2), 227–234 (1994).
[PubMed]

Ben-Bassat, M.

M. Ben-Bassat, I. Kaplan, Y. Shindel, and A. Edlan, “The CO2 laser in surgery of the tongue,” Br. J. Plast. Surg. 31(2), 155–156 (1978).
[Crossref] [PubMed]

Brodoceanu, D.

M. Strassl, V. Wieger, D. Brodoceanu, F. Beer, A. Moritz, and E. Wintner, “Ultra-short pulse laser ablation of biological hard tissue and biocompatibles,” J. Laser Micr.o Nanoengineering 3(1), 30–40 (2008).

Bryant, G. L.

G. L. Bryant, J. M. Davidson, R. H. Ossoff, C. G. Garrett, and L. Reinisch, “Histologic study of oral mucosa wound healing: a comparison of a 6.0- to 6.8-micrometer pulsed laser and a carbon dioxide laser,” Laryngoscope 108(1), 13–17 (1998).
[Crossref] [PubMed]

Camacho-Alonso, F.

P. López-Jornet and F. Camacho-Alonso, “Comparison of pain and swelling after removal of oral leukoplakia with CO₂ laser and cold knife: a randomized clinical trial,” Med. Oral Patol. Oral Cir. Bucal 18(1), e38–e44 (2013).
[Crossref] [PubMed]

Carruth, J. A.

J. A. Carruth, “Lasers in medicine and surgery,” J. Med. Eng. Technol. 8(4), 161–167 (1984).
[Crossref] [PubMed]

J. A. Carruth, “Resection of the tongue with the carbon dioxide laser,” J. Laryngol. Otol. 96(6), 529–543 (1982).
[Crossref] [PubMed]

Chinni, R. C.

D. A. Cremers and R. C. Chinni, “Laser-Induced Breakdown Spectroscopy - Capabilities and Limitations,” Appl. Spectrosc. Rev. 44(6), 457–506 (2009).
[Crossref]

Cremers, D. A.

D. A. Cremers and R. C. Chinni, “Laser-Induced Breakdown Spectroscopy - Capabilities and Limitations,” Appl. Spectrosc. Rev. 44(6), 457–506 (2009).
[Crossref]

Davidson, J. M.

G. L. Bryant, J. M. Davidson, R. H. Ossoff, C. G. Garrett, and L. Reinisch, “Histologic study of oral mucosa wound healing: a comparison of a 6.0- to 6.8-micrometer pulsed laser and a carbon dioxide laser,” Laryngoscope 108(1), 13–17 (1998).
[Crossref] [PubMed]

Dimitroulis, G.

G. Dimitroulis, “Temporomandibular joint surgery: what does it mean to the dental practitioner?” Aust. Dent. J. 56(3), 257–264 (2011).
[Crossref] [PubMed]

G. Dimitroulis, “The role of surgery in the management of disorders of the temporomandibular joint: a critical review of the literature. Part 2,” Int. J. Oral Maxillofac. Surg. 34(3), 231–237 (2005).
[PubMed]

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M. F. Dolwick and G. Dimitroulis, “Is there a role for temporomandibular joint surgery?” Br. J. Oral Maxillofac. Surg. 32(5), 307–313 (1994).
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M. Ben-Bassat, I. Kaplan, Y. Shindel, and A. Edlan, “The CO2 laser in surgery of the tongue,” Br. J. Plast. Surg. 31(2), 155–156 (1978).
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M. K. Basu, J. W. Frame, and P. H. Rhys Evans, “Wound healing following partial glossectomy using the CO2 laser, diathermy and scalpel: a histological study in rats,” J. Laryngol. Otol. 102(4), 322–327 (1988).
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S. E. Fisher and J. W. Frame, “The effects of the carbon dioxide surgical laser on oral tissues,” Br. J. Oral Maxillofac. Surg. 22(6), 414–425 (1984).
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G. L. Bryant, J. M. Davidson, R. H. Ossoff, C. G. Garrett, and L. Reinisch, “Histologic study of oral mucosa wound healing: a comparison of a 6.0- to 6.8-micrometer pulsed laser and a carbon dioxide laser,” Laryngoscope 108(1), 13–17 (1998).
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M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, “Transoral management of localized carcinoma of the oral cavity using the CO2 laser,” Laryngoscope 89(6 Pt 1), 897–905 (1979).
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Howard, J.

S. F. Dworkin, K. H. Huggins, L. LeResche, M. Von Korff, J. Howard, E. Truelove, and E. Sommers, “Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls,” J. Am. Dent. Assoc. 120(3), 273–281 (1990).
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S. F. Dworkin, K. H. Huggins, L. LeResche, M. Von Korff, J. Howard, E. Truelove, and E. Sommers, “Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls,” J. Am. Dent. Assoc. 120(3), 273–281 (1990).
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M. G. Koslin, A. T. Indresano, and L. G. Mercuri, “Temporomandibular joint surgery,” J. Oral Maxillofac. Surg. 70(11Suppl 3), e204–e231 (2012).
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A. Pourzarandian, H. Watanabe, A. Aoki, S. Ichinose, K. M. Sasaki, H. Nitta, and I. Ishikawa, “Histological and TEM examination of early stages of bone healing after Er:YAG laser irradiation,” Photomed. Laser Surg. 22(4), 342–350 (2004).
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M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, “Transoral management of localized carcinoma of the oral cavity using the CO2 laser,” Laryngoscope 89(6 Pt 1), 897–905 (1979).
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R. Kanawade, F. Mehari, C. Knipfer, M. Rohde, K. Tangermann-Gerk, M. Schmidt, and F. Stelzle, “Pilot study of laser induced breakdown spectroscopy for tissue differentiation by monitoring the plume created during laser surgery — An approach on a feedback Laser control mechanism,” Spectrochim. Acta, B At. Spectrosc. 87(0), 175–181 (2013).
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R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Kaplan, I.

M. Ben-Bassat, I. Kaplan, Y. Shindel, and A. Edlan, “The CO2 laser in surgery of the tongue,” Br. J. Plast. Surg. 31(2), 155–156 (1978).
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Klämpfl, F.

R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Knipfer, C.

R. Kanawade, F. Mehari, C. Knipfer, M. Rohde, K. Tangermann-Gerk, M. Schmidt, and F. Stelzle, “Pilot study of laser induced breakdown spectroscopy for tissue differentiation by monitoring the plume created during laser surgery — An approach on a feedback Laser control mechanism,” Spectrochim. Acta, B At. Spectrosc. 87(0), 175–181 (2013).
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F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
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F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Koslin, M. G.

M. G. Koslin, A. T. Indresano, and L. G. Mercuri, “Temporomandibular joint surgery,” J. Oral Maxillofac. Surg. 70(11Suppl 3), e204–e231 (2012).
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M. G. Koslin and J. C. Martin, “The use of the holmium laser for temporomandibular joint arthroscopic surgery,” J. Oral Maxillofac. Surg. 51(2), 122–123 (1993).
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LeResche, L.

S. F. Dworkin, K. H. Huggins, L. LeResche, M. Von Korff, J. Howard, E. Truelove, and E. Sommers, “Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls,” J. Am. Dent. Assoc. 120(3), 273–281 (1990).
[PubMed]

Liu, F.

F. Liu and A. Steinkeler, “Epidemiology, Diagnosis, and Treatment of Temporomandibular Disorders,” Dent. Clin. North Am. 57(3), 465–479 (2013).
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G. D. Baxter, D. M. Walsh, J. M. Allen, A. S. Lowe, and A. J. Bell, “Effects of low intensity infrared laser irradiation upon conduction in the human median nerve in vivo,” Exp. Physiol. 79(2), 227–234 (1994).
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R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Manoj Kumar, G.

A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
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Martin, J. C.

M. G. Koslin and J. C. Martin, “The use of the holmium laser for temporomandibular joint arthroscopic surgery,” J. Oral Maxillofac. Surg. 51(2), 122–123 (1993).
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McNamara, J. A.

J. A. McNamara, D. A. Seligman, and J. P. Okeson, “Occlusion, Orthodontic treatment, and temporomandibular disorders: a review,” J. Orofac. Pain 9(1), 73–90 (1995).
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Mehari, F.

R. Kanawade, F. Mehari, C. Knipfer, M. Rohde, K. Tangermann-Gerk, M. Schmidt, and F. Stelzle, “Pilot study of laser induced breakdown spectroscopy for tissue differentiation by monitoring the plume created during laser surgery — An approach on a feedback Laser control mechanism,” Spectrochim. Acta, B At. Spectrosc. 87(0), 175–181 (2013).
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Menovsky, T.

T. Menovsky, M. Van Den Bergh Weerman, and J. F. Beek, “Effect of CO(2)-Milliwatt laser on peripheral nerves: part II. A histological and functional study,” Microsurgery 20(3), 150–155 (2000).
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T. Menovsky, M. van den Bergh Weerman, and J. F. Beek, “Effect of CO2 milliwatt laser on peripheral nerves: Part I. A dose-response study,” Microsurgery 17(10), 562–567 (1996).
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Mercuri, L. G.

M. G. Koslin, A. T. Indresano, and L. G. Mercuri, “Temporomandibular joint surgery,” J. Oral Maxillofac. Surg. 70(11Suppl 3), e204–e231 (2012).
[Crossref] [PubMed]

Moritz, A.

M. Strassl, V. Wieger, D. Brodoceanu, F. Beer, A. Moritz, and E. Wintner, “Ultra-short pulse laser ablation of biological hard tissue and biocompatibles,” J. Laser Micr.o Nanoengineering 3(1), 30–40 (2008).

Myakalwar, A. K.

A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
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Nitta, H.

A. Pourzarandian, H. Watanabe, A. Aoki, S. Ichinose, K. M. Sasaki, H. Nitta, and I. Ishikawa, “Histological and TEM examination of early stages of bone healing after Er:YAG laser irradiation,” Photomed. Laser Surg. 22(4), 342–350 (2004).
[Crossref] [PubMed]

Nkenke, E.

F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
[Crossref] [PubMed]

F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

Oetter, N.

F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
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M. Ohnishi, “Arthroscopic laser surgery and suturing for temporomandibular joint disorders: technique and clinical results,” Arthroscopy 7(2), 212–220 (1991).
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J. A. McNamara, D. A. Seligman, and J. P. Okeson, “Occlusion, Orthodontic treatment, and temporomandibular disorders: a review,” J. Orofac. Pain 9(1), 73–90 (1995).
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R. Orchardson, J. M. Peacock, and C. J. Whitters, “Effect of pulsed Nd:YAG laser radiation on action potential conduction in isolated mammalian spinal nerves,” Lasers Surg. Med. 21(2), 142–148 (1997).
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Ossoff, R. H.

G. L. Bryant, J. M. Davidson, R. H. Ossoff, C. G. Garrett, and L. Reinisch, “Histologic study of oral mucosa wound healing: a comparison of a 6.0- to 6.8-micrometer pulsed laser and a carbon dioxide laser,” Laryngoscope 108(1), 13–17 (1998).
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Peacock, J. M.

R. Orchardson, J. M. Peacock, and C. J. Whitters, “Effect of pulsed Nd:YAG laser radiation on action potential conduction in isolated mammalian spinal nerves,” Lasers Surg. Med. 21(2), 142–148 (1997).
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Pourzarandian, A.

A. Pourzarandian, H. Watanabe, A. Aoki, S. Ichinose, K. M. Sasaki, H. Nitta, and I. Ishikawa, “Histological and TEM examination of early stages of bone healing after Er:YAG laser irradiation,” Photomed. Laser Surg. 22(4), 342–350 (2004).
[Crossref] [PubMed]

Prem Kiran, P.

A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
[Crossref] [PubMed]

Regezi, J. A.

M. L. Schoelch, N. Sekandari, J. A. Regezi, and S. Silverman., “Laser management of oral leukoplakias: a follow-up study of 70 patients,” Laryngoscope 109(6), 949–953 (1999).
[Crossref] [PubMed]

Reinisch, L.

G. L. Bryant, J. M. Davidson, R. H. Ossoff, C. G. Garrett, and L. Reinisch, “Histologic study of oral mucosa wound healing: a comparison of a 6.0- to 6.8-micrometer pulsed laser and a carbon dioxide laser,” Laryngoscope 108(1), 13–17 (1998).
[Crossref] [PubMed]

Rhys Evans, P. H.

M. K. Basu, J. W. Frame, and P. H. Rhys Evans, “Wound healing following partial glossectomy using the CO2 laser, diathermy and scalpel: a histological study in rats,” J. Laryngol. Otol. 102(4), 322–327 (1988).
[Crossref] [PubMed]

Rohde, M.

R. Kanawade, F. Mehari, C. Knipfer, M. Rohde, K. Tangermann-Gerk, M. Schmidt, and F. Stelzle, “Pilot study of laser induced breakdown spectroscopy for tissue differentiation by monitoring the plume created during laser surgery — An approach on a feedback Laser control mechanism,” Spectrochim. Acta, B At. Spectrosc. 87(0), 175–181 (2013).
[Crossref]

F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
[Crossref] [PubMed]

R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Sasaki, K. M.

A. Pourzarandian, H. Watanabe, A. Aoki, S. Ichinose, K. M. Sasaki, H. Nitta, and I. Ishikawa, “Histological and TEM examination of early stages of bone healing after Er:YAG laser irradiation,” Photomed. Laser Surg. 22(4), 342–350 (2004).
[Crossref] [PubMed]

Schmidt, M.

R. Kanawade, F. Mehari, C. Knipfer, M. Rohde, K. Tangermann-Gerk, M. Schmidt, and F. Stelzle, “Pilot study of laser induced breakdown spectroscopy for tissue differentiation by monitoring the plume created during laser surgery — An approach on a feedback Laser control mechanism,” Spectrochim. Acta, B At. Spectrosc. 87(0), 175–181 (2013).
[Crossref]

F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
[Crossref] [PubMed]

F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Schoelch, M. L.

M. L. Schoelch, N. Sekandari, J. A. Regezi, and S. Silverman., “Laser management of oral leukoplakias: a follow-up study of 70 patients,” Laryngoscope 109(6), 949–953 (1999).
[Crossref] [PubMed]

Sekandari, N.

M. L. Schoelch, N. Sekandari, J. A. Regezi, and S. Silverman., “Laser management of oral leukoplakias: a follow-up study of 70 patients,” Laryngoscope 109(6), 949–953 (1999).
[Crossref] [PubMed]

Seligman, D. A.

J. A. McNamara, D. A. Seligman, and J. P. Okeson, “Occlusion, Orthodontic treatment, and temporomandibular disorders: a review,” J. Orofac. Pain 9(1), 73–90 (1995).
[PubMed]

Shapshay, S. M.

M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, “Transoral management of localized carcinoma of the oral cavity using the CO2 laser,” Laryngoscope 89(6 Pt 1), 897–905 (1979).
[PubMed]

Shindel, Y.

M. Ben-Bassat, I. Kaplan, Y. Shindel, and A. Edlan, “The CO2 laser in surgery of the tongue,” Br. J. Plast. Surg. 31(2), 155–156 (1978).
[Crossref] [PubMed]

Sidebottom, A. J.

S. Weedon, N. Ahmed, and A. J. Sidebottom, “Prospective assessment of outcomes following disposable arthroscopy of the temporomandibular joint,” Br. J. Oral Maxillofac. Surg. 51(7), 625–629 (2013).
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Silverman, S.

M. L. Schoelch, N. Sekandari, J. A. Regezi, and S. Silverman., “Laser management of oral leukoplakias: a follow-up study of 70 patients,” Laryngoscope 109(6), 949–953 (1999).
[Crossref] [PubMed]

Sommers, E.

S. F. Dworkin, K. H. Huggins, L. LeResche, M. Von Korff, J. Howard, E. Truelove, and E. Sommers, “Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls,” J. Am. Dent. Assoc. 120(3), 273–281 (1990).
[PubMed]

Spyropoulos, B.

B. Spyropoulos, “50 years LASERS: in vitro diagnostics, clinical applications and perspectives,” Clin. Lab. 57(3-4), 131–142 (2011).
[PubMed]

Sreedhar, S.

A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
[Crossref] [PubMed]

Steinkeler, A.

F. Liu and A. Steinkeler, “Epidemiology, Diagnosis, and Treatment of Temporomandibular Disorders,” Dent. Clin. North Am. 57(3), 465–479 (2013).
[Crossref] [PubMed]

Stelzle, F.

R. Kanawade, F. Mehari, C. Knipfer, M. Rohde, K. Tangermann-Gerk, M. Schmidt, and F. Stelzle, “Pilot study of laser induced breakdown spectroscopy for tissue differentiation by monitoring the plume created during laser surgery — An approach on a feedback Laser control mechanism,” Spectrochim. Acta, B At. Spectrosc. 87(0), 175–181 (2013).
[Crossref]

F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
[Crossref] [PubMed]

F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Strassl, M.

M. Strassl, V. Wieger, D. Brodoceanu, F. Beer, A. Moritz, and E. Wintner, “Ultra-short pulse laser ablation of biological hard tissue and biocompatibles,” J. Laser Micr.o Nanoengineering 3(1), 30–40 (2008).

Strong, M. S.

M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, “Transoral management of localized carcinoma of the oral cavity using the CO2 laser,” Laryngoscope 89(6 Pt 1), 897–905 (1979).
[PubMed]

Tangermann-Gerk, K.

F. Stelzle, C. Knipfer, W. Adler, M. Rohde, N. Oetter, E. Nkenke, M. Schmidt, and K. Tangermann-Gerk, “Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery,” Sensors (Basel) 13(10), 13717–13731 (2013).
[Crossref] [PubMed]

R. Kanawade, F. Mehari, C. Knipfer, M. Rohde, K. Tangermann-Gerk, M. Schmidt, and F. Stelzle, “Pilot study of laser induced breakdown spectroscopy for tissue differentiation by monitoring the plume created during laser surgery — An approach on a feedback Laser control mechanism,” Spectrochim. Acta, B At. Spectrosc. 87(0), 175–181 (2013).
[Crossref]

F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

Terwey, I.

F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

Tewari, S. P.

A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
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Truelove, E.

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T. Menovsky, M. Van Den Bergh Weerman, and J. F. Beek, “Effect of CO(2)-Milliwatt laser on peripheral nerves: part II. A histological and functional study,” Microsurgery 20(3), 150–155 (2000).
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M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, “Transoral management of localized carcinoma of the oral cavity using the CO2 laser,” Laryngoscope 89(6 Pt 1), 897–905 (1979).
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A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
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S. F. Dworkin, K. H. Huggins, L. LeResche, M. Von Korff, J. Howard, E. Truelove, and E. Sommers, “Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls,” J. Am. Dent. Assoc. 120(3), 273–281 (1990).
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G. D. Baxter, D. M. Walsh, J. M. Allen, A. S. Lowe, and A. J. Bell, “Effects of low intensity infrared laser irradiation upon conduction in the human median nerve in vivo,” Exp. Physiol. 79(2), 227–234 (1994).
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M. Strassl, V. Wieger, D. Brodoceanu, F. Beer, A. Moritz, and E. Wintner, “Ultra-short pulse laser ablation of biological hard tissue and biocompatibles,” J. Laser Micr.o Nanoengineering 3(1), 30–40 (2008).

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D. A. Cremers and R. C. Chinni, “Laser-Induced Breakdown Spectroscopy - Capabilities and Limitations,” Appl. Spectrosc. Rev. 44(6), 457–506 (2009).
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S. Weedon, N. Ahmed, and A. J. Sidebottom, “Prospective assessment of outcomes following disposable arthroscopy of the temporomandibular joint,” Br. J. Oral Maxillofac. Surg. 51(7), 625–629 (2013).
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[PubMed]

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G. Dimitroulis, “The role of surgery in the management of disorders of the temporomandibular joint: a critical review of the literature. Part 2,” Int. J. Oral Maxillofac. Surg. 34(3), 231–237 (2005).
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G. Dimitroulis, “The role of surgery in the management of disorders of the Temporomandibular Joint: a critical review of the literature. Part 1,” Int. J. Oral Maxillofac. Surg. 34(2), 107–113 (2005).
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F. Stelzle, I. Terwey, C. Knipfer, W. Adler, K. Tangermann-Gerk, E. Nkenke, and M. Schmidt, “The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study,” J. Transl. Med.  10, 123 (2012).

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M. L. Schoelch, N. Sekandari, J. A. Regezi, and S. Silverman., “Laser management of oral leukoplakias: a follow-up study of 70 patients,” Laryngoscope 109(6), 949–953 (1999).
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M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, “Transoral management of localized carcinoma of the oral cavity using the CO2 laser,” Laryngoscope 89(6 Pt 1), 897–905 (1979).
[PubMed]

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R. Orchardson, J. M. Peacock, and C. J. Whitters, “Effect of pulsed Nd:YAG laser radiation on action potential conduction in isolated mammalian spinal nerves,” Lasers Surg. Med. 21(2), 142–148 (1997).
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P. López-Jornet and F. Camacho-Alonso, “Comparison of pain and swelling after removal of oral leukoplakia with CO₂ laser and cold knife: a randomized clinical trial,” Med. Oral Patol. Oral Cir. Bucal 18(1), e38–e44 (2013).
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Microsurgery (2)

T. Menovsky, M. van den Bergh Weerman, and J. F. Beek, “Effect of CO2 milliwatt laser on peripheral nerves: Part I. A dose-response study,” Microsurgery 17(10), 562–567 (1996).
[Crossref] [PubMed]

T. Menovsky, M. Van Den Bergh Weerman, and J. F. Beek, “Effect of CO(2)-Milliwatt laser on peripheral nerves: part II. A histological and functional study,” Microsurgery 20(3), 150–155 (2000).
[Crossref] [PubMed]

Photomed. Laser Surg. (1)

A. Pourzarandian, H. Watanabe, A. Aoki, S. Ichinose, K. M. Sasaki, H. Nitta, and I. Ishikawa, “Histological and TEM examination of early stages of bone healing after Er:YAG laser irradiation,” Photomed. Laser Surg. 22(4), 342–350 (2004).
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Talanta (1)

A. K. Myakalwar, S. Sreedhar, I. Barman, N. C. Dingari, S. Venugopal Rao, P. Prem Kiran, S. P. Tewari, and G. Manoj Kumar, “Laser-induced breakdown spectroscopy-based investigation and classification of pharmaceutical tablets using multivariate chemometric analysis,” Talanta 87(0), 53–59 (2011).
[Crossref] [PubMed]

Other (5)

O. Samek, M. Liska, J. Kaiser, V. Krzyzanek, D. C. S. Beddows, A. Belenkevitch, G. W. Morris, and H. H. Telle, “Laser ablation for mineral analysis in the human body: integration of LIFS with LIBS,” Biomedical Sensors, Fibers, and Optical Delivery Systems pp. 263–271, SPIE, Stockholm, Sweden (1999).

A. Kramida, Y. Ralchenko, and J. Reader, “Team (2012). NIST Atomic Spectra Database (ver. 5.0),” National Institute of Standards and Technology, Gaithersburg, MD (Available at: http://physics .nist.gov/asd)

R. Kanawade, F. Mahari, F. Klämpfl, M. Rohde, C. Knipfer, K. Tangermann-Gerk, W. Adler, M. Schmidt, and F. Stelzle, “Qualitative tissue differentiation by analysing the intensity ratios of atomic emission lines using laser induced breakdown spectroscopy (LIBS): prospects for a feedback mechanism for surgical laser systems,” J. Biophotonics 1-9 (2013).

D. L. J. R. Dr David A. Cremers, Handbook of Laser-Induced Breakdown Spectroscopy (Wiley, 2006)

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Figures (5)

Fig. 1
Fig. 1 Schematic of the LIBS setup used.
Fig. 2
Fig. 2 (A) Mean LIBS spectra of cartilage of animal #1. (B) Mean LIBS spectra of cortical bone of animal #1.
Fig. 3
Fig. 3 Intensity ratio values of cartilage and cortical bone calculated from three pairs of atomic emission lines. (Black) Ca(422.67) to Na(588.99), (Red) Na(588.99) to K(766.48) and (Blue) Ca(616.21) to K(766.48)).
Fig. 4
Fig. 4 (A) PCA of animal #1 - #5. (B) Projection of animal #6 on PCs of animal #1 - #5.
Fig. 5
Fig. 5 ROC curve of animal #6.

Tables (4)

Tables Icon

Table 1 Portion of variance covered by the PCs on the total variance of the LIBS spectra.

Tables Icon

Table 2 Confusion Matrices of the classification result of cartilage and cortical bone of six animals.

Tables Icon

Table 3 Area under the ROC (AUC) curve values of cartilage and cortical bone classification of 6 animals.

Tables Icon

Table 4 Sensitivity and specificity values of 6 animals.

Metrics