Space-making effect for new bone formation by suppressing scar contraction of mucosal epithelium of rat tooth extraction wound using diode laser and CO2 laser treatment

CO2 Laser for Esthetic Healing of Injuries and Surgical Wounds with Small Parenchymal Defects in Oral Soft Tissues

A number of studies have recently demonstrated the effectiveness of CO2 laser irradiation for the repair and regeneration of scar tissue from injuries or surgical wounds. However, such studies of the oral mucosa are highly limited. Previous studies using CO2 laser irradiation have indicated that two factors contribute to esthetic healing, namely, artificial scabs, which are a coagulated and carbonized blood layer formed on the wound surface, and photobiomodulation therapy (PBMT) for suppressing wound scarring and promoting wound healing. This review outlines basic research and clinical studies of esthetic healing with the use of a CO2 laser for both artificial scab formation by high-intensity laser therapy and PBMT in the treatment of injuries and surgical wounds with small parenchymal defects in oral soft tissues. The results showed that the wound surface was covered by an artificial scab, enabling the accumulation of blood and the perfusion necessary for tissue regeneration and repair. Subsequent PBMT also downregulated the expression of transformation growth factor-b1, which is involved in tissue scarring, and decreased the appearance of myofibroblasts. Taken together, artificial scabs and PBMT using CO2 lasers contribute to the suppression of scarring in the tissue repair process, leading to favorable esthetic and functional outcomes of wound healing.

Effects of Photobiomodulation Therapy on Hard Tissue Healing in Rat Tooth Extraction Sockets

Objective: To investigate the effects of photobiomodulation therapy (PBMT) on hard tissue healing in rat maxillary first molar extraction sockets. Methods: A total of 20 male Wistar rats were used in the study. The right extraction sockets were irradiated with a Ga-Al-As laser (500 mW, 980 nm) for 51.7 J/cm2 every 24 h for 7 days, while the left sockets served as controls. Rats were sacrificed on days 3, 7, 14, and 28 after tooth extraction, and microcomputed tomography (CT) analysis, histopathological evaluation, and enzyme-linked immunosorbent assay (ELISA) were conducted at different time points. Results: Micro-CT analysis showed that the percentage of bone volume/tissue volume (TV) and bone mineral density were significantly higher in the experimental group compared to the control group on day 28 (p < 0.05). Histopathological evaluation revealed that PBMT promoted new bone formation and accelerated bone remodeling. ELISA demonstrated a significant increase in alkaline phosphatase expression in the laser sides on days 7 and 14 (p < 0.05). Conclusions: One application postextraction followed by seven consecutive daily applications of PBMT can effectively promote hard tissue healing in rat maxillary first molar extraction sockets.

Evaluation of the Effectiveness of the Carbon Dioxide (CO2) Laser in Minor Oral Surgery: A Systematic Review

Introduction: Lasers in oral surgery have been extensively studied in recent years. Laser treatment is now a well-known technology that is frequently employed on oral soft tissues. The carbon dioxide (CO2) laser was one of the first soft tissue removal lasers. Because of the strong affinity of the CO2 laser to water, it is best used for removing, vaporizing, and coagulating these tissues. In minor oral surgery, CO2 laser therapy has shown advantages. Therefore, this study examined the CO2 laser use in minor oral soft tissue surgery. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were followed in this study. A question for research encompassing the inclusion criteria for the participants, intervention, comparison, outcome, and study design (PICOS) was formulated. The search queries were entered into the PubMed/Medline, Scopus, and Embase databases. Consideration was given to publications published between January 1, 2018 and March 15, 2023. Results: The research included 37 studies after narrowing search results, eliminating duplicate titles, and conducting an eligibility review (three animal studies, seven case reports, three case series, and twenty-four clinical studies). CO2 lasers alone or in combination with other therapies successfully treated oral potentially malignant disorders (OPMDs), oral tumors, oral fibrous-epithelial lesions, gingival melanin hyperpigmentation, pyogenic granuloma, socket preservation, mucocele, high labial frenulum attachment, and so on. CO2 lasers reduced intra- and postoperative complications and adverse effects, improved postoperative functional results, ablated tissues with precision, and minimized disease recurrence and malignant transformation. Conclusion: Our study found that the CO2 laser in oral minor surgeries is successful, but further randomized clinical trials and multicenter studies are recommended to compare CO2 laser surgery to other treatments.