A comparative study of wound healing following incision with a scalpel, diode laser or Er,Cr:YSGG laser in guinea pig oral mucosa: A histological and immunohistochemical analysis.
OBJECTIVE
This study compared wound healing following incisions with either a scalpel, a diode laser or an Er,Cr:YSGG laser in guinea pig oral mucosa.


METHODS
Three types of wound were made randomly with either a stainless-steel scalpel, a diode laser or an Er,Cr:YSGG laser in the buccal mucosa of 24 guinea pigs. Five guinea pigs were sacrificed on each of Days 1, 3, 5 and 7 post-surgery. Four guinea pigs were sacrificed on Day 14 post-surgery. Biopsy samples from each oral mucosa wound were examined using light microscopy and the expression of tumor necrosis factor (TNF)-alpha and transforming growth factor (TGF)-beta1 was determined by immunohistochemical staining. The expression of TNF-alpha and TGF-beta1 was evaluated by calculating the percentage of positively stained cells and immunostaining intensity was evaluated using a scale ranging from 0 to 3.


RESULTS
Infiltration of inflammatory cells decreased rapidly at Day 5 post-surgery in all three groups of animals. The highest level of TNF-alpha expression was found at Day 1 post-surgery for the diode laser wounds. The intensity of TNF-alpha immunostaining was highest at Day 3 post-surgery and lowest at Day 7 post-surgery for all three groups of animals. For the scalpel wounds, a lower level of TGF-beta1 expression was seen until Day 3 post-surgery and a higher level from Day 7 post-surgery compared to laser wounds. The intensity of TGF-beta1 immunostaining was highest at Day 1 post-surgery for the diode laser wounds.


CONCLUSIONS
The diode laser is considered a good cutting device for oral mucosa; however, more tissue damage occurs than with the use of a scalpel or an Er,Cr:YSGG laser. Larger studies will be needed before fully endorsing the widespread use of the diode laser.
Practice in Tower Dental Clinic, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Jae-Yong
JY
Jin
Sang-Hwa
SH
Lee
Hyun-Joong
HJ
Yoon
D000818:Animals; D006168:Guinea Pigs; D007124:Immunoenzyme Techniques; D007249:Inflammation / Q000378:metabolism; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D009061:Mouth Mucosa / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000295:instrumentation*; D011897:Random Allocation; D053773:Transforming Growth Factor beta1 / Q000096:biosynthesis; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis; D014945:Wound Healing / Q000502:physiology
D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha