## 4 Discussion  
In the present study, the suitability of laser use for soft-tissue incision for implant placement and the in vivo stability of the femtosecond laser-treated implant were evaluated by applying two types of implants to the tibias of New Zealand White rabbits. A conventional method using a scalpel was selected as a control for laser incision, and an SLA implant was used as a control for the femtosecond laser-treated implant. Healing of the incision site was monitored for 2 weeks, and radiologic and histologic evaluations of the implants were conducted at 4 and 6 weeks post-implantation. Throughout the experiment, animals wore neck collars to protect the surgical area postoperatively and were observed to be in good health, with no adverse effects on water or food intake. Visual evaluation of the incision sites indicated that laser incisions had somewhat unfavorable healing compared to scalpel incisions. Thus, while a scalpel may be more suitable for general tissue incisions, a laser might be advantageous in surgeries involving significant bleeding due to its hemostatic properties. In the evaluation of implant efficacy, ISQ values for the femtosecond laser-treated surfaces and SLA-treated surfaces were similar immediately post-implantation, indicating initial stability; the values further stabilized at 4 and 6 weeks. Micro-CT and tissue analyses revealed comparable levels of osseointegration between the femtosecond laser-treated and SLA-treated implants. Notably, the tissue BIC results showed slightly higher values for the femtosecond laser-treated implants, suggesting potential advantages for initial implant fixation. However, there was a somewhat elevated inflammatory cell infiltration at 4 weeks in the FEMTO group, warranting further investigation. Previous studies [24] have shown that titanium surfaces treated with a femtosecond laser exhibit smaller contact angles and greater hydrophilicity than SLA-treated surfaces, which could enhance the osseointegration process [25]. Additionally, femtosecond laser-treated surfaces form distinct micro- and nanostructures, promoting higher rates of cell growth and protein adsorption [26; 27; 22; 28]. The superiority of femtosecond laser-treated implant surfaces has also been demonstrated in other studies. [PERSON] et al. [29] compared polished control samples, femtosecond laser-treated implants, and SLA-treated implants in the tibias of New Zealand rabbits over 8 weeks. The femtosecond laser-treated implants showed higher physical bonding forces and more new bone formation than the SLA-treated implants. However, in the present study, no significant differences were observed between the femtosecond laser-treated and SLA-treated implants, possibly due to the higher inflammatory response seen at 4 weeks post-surgery in the FEMTO group. The experiment conducted by these authors has limitations for direct comparison with my study due to the inclusion of other elements for implant surface treatment. Several studies comparing diode laser incisions with scalpel incisions reported better hemostasis with diode laser incisions and better healing with scalpel incisions [30; 31; 32], which is consistent with our findings. Therefore, lasers could be considered for extensive surgical areas or areas with a high risk of bleeding, while scalpel use may be preferable in aesthetic areas requiring rapid healing and minimal scarring. Figure 9: Tissue-slide analysis: (**a**) bone-implant contact; (**b**) new bone area. Data shown are mean \(\pm\) standard deviation, two-way analysis of variance. FEMTO, femtosecond laser; SLA, SLA, sandblasted, large-grit, acid-etched; W, week. The present study demonstrated that femtosecond laser-treated implants have comparable osseointegration capabilities to SLA-treated implants in vivo. Previous research [28] has shown that both femtosecond laser-treated and SLA-treated implants achieve superior Ra and Sa values than machined surfaces.