A comparative histological and immunohistochemical study of wound healing following incision with a scalpel, CO2 laser or Er,Cr:YSGG laser in the Guinea pig oral mucosa

Purpose. This study was undertaken to compare wound healing following incisions with either a scalpel, CO2 laser or Er,Cr:YSGG laser in Guinea pig oral mucosa. Materials and methods. Three types of wounds were randomly introduced with either a stainless steel scalpel, CO2 laser or Er, Cr:YSGG laser in the buccal mucosa of each of 22 Guinea pigs. Four Guinea pigs were sacrificed on day 1, day 3 and day 5 post-surgery. Five Guinea pigs were sacrificed on day 7 and day 14 post-surgery. Biopsy samples from each oral mucosa wound were examined and the expression of TNF-alpha and TGF-beta 1 was determined by immunohistochemical staining. Results. At day 3 post-surgery, the histological pattern of the healing process was similar in the scalpel and Er,Cr:YSGG laser wounds and there were more ulcerations present in the CO2 laser wounds than in the scalpel and Er, Cr:YSGG laser wounds. The level of TNF-a expression was twice in the laser wounds that in the scalpel wounds. A higher level of TGF-beta 1 expression was seen at day 7 post-surgery and a lower level at day 14 post-surgery in the CO2 laser wounds than in the scalpel and Er, Cr:YSGG laser wounds. Conclusions. The Er, Cr:YSGG laser has many advantages for oral surgery due to a low inflammatory response and minimal damage of the tissue. Although a CO2 laser has better hemostatic ability, its use causes greater tissue damage than a scalpel and Er,Cr:YSGG laser. However, further larger studies would be needed before fully endorsing its widespread use.