Optimizing Oral Soft Tissue Healing: A Comparative Evaluation of 450 NM and 976 NM Diode Lasers with Adjunctive Hyaluronic Acid and Low-Level Laser Therapy. Histological and Immunohistochemical Study

Document Type : Original Article

Authors

1 Oral and Maxillofacial Surgery Specialist, Private Practice, Cairo, Egypt

2 Professor of Medical Applications of laser, National institute of Laser Enhanced Sciences (NILES), Cairo University

3 Lecturer of Medical Applications of laser, National institute of Laser Enhanced Sciences (NILES), Cairo University

Abstract

Introduction: Optimizing oral wound healing remains a critical aspect of oral surgery. While diode lasers have been widely utilized for incisions, their impact on wound healing can be influenced by adjunctive therapies.
Aim of the Work: This study aimed to compare the healing efficacy of 450 nm and 976 nm diode laser incisions and to evaluate the potential benefits of hyaluronic acid (HA) injections and low-level laser therapy (LLLT) as adjuncts.
Materials and Methods: Thirty Wistar Albino rats were randomly assigned to five groups (n=6 per group). Group 1 is a negative control without any intervention at all. Group 2 underwent incision using a 450 nm diode laser, and Group 3 using a 976 nm diode laser, both without adjunctive treatment. Group 4 received a 450 nm diode laser incision, followed by LLT & HA injection and weekly LLLT (650 nm). Group 5 underwent a 976 nm diode laser incision with LLT & HA injection and weekly LLLT. Biopsies were collected at baseline, post-operative days 3 and 7. Wound healing was evaluated through hematoxylin and eosin (H&E) staining, Masson’s trichrome staining for collagen deposition, and immunohistochemical analysis of CD34 for angiogenesis.
Results: Histological analysis revealed enhanced wound healing in Groups 4 and 5 compared to Groups 2 and 3. The combination of HA and LLLT significantly increased collagen deposition, improved tissue organization, and enhanced angiogenesis, as evidenced by higher CD34 expression. Notably, Group 4 (450 nm + HA + LLLT) demonstrated the most favorable healing outcomes at both time points, with greater fibroblast proliferation and neovascularization.
Conclusion: The addition of HA and LLLT to diode laser incisions accelerates oral wound healing by promoting collagen synthesis and angiogenesis. Among the tested wavelengths, the 450 nm diode laser combined with HA and LLLT demonstrated superior healing potential. These findings suggest a promising strategy for enhancing repair in surgery.

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