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手术刀、CO2 激光和 Er,Cr:YSGG 激光切割对豚鼠口腔黏膜愈合影响的组织学和免疫组织化学比较研究。

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.

机构信息

Department of Oral and Maxillofacial Surgery, Yeouido St. Mary’s Hospital, Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Acta Odontol Scand. 2012 Dec;70(6):448-54. doi: 10.3109/00016357.2011.635598. Epub 2011 Dec 12.

Abstract

PURPOSE

This study was undertaken to compare wound healing following incisions with either a scalpel, CO(2) 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, CO(2) 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-α and TGF-ß1 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 CO(2) laser wounds than in the scalpel and Er,Cr:YSGG laser wounds. The level of TNF-α expression was twice in the laser wounds that in the scalpel wounds. A higher level of TGF-β1 expression was seen at day 7 post-surgery and a lower level at day 14 post-surgery in the CO(2) 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 CO(2) 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.

摘要

目的

本研究旨在比较手术刀、CO2 激光和 Er,Cr:YSGG 激光切割对豚鼠口腔黏膜愈合的影响。

材料和方法

将三种类型的伤口随机用不锈钢手术刀、CO2 激光或 Er,Cr:YSGG 激光切割于 22 只豚鼠的颊黏膜。4 只豚鼠分别于术后第 1、3 和 5 天处死,5 只豚鼠于术后第 7 和 14 天处死。对每个口腔黏膜伤口进行活检,通过免疫组织化学染色法检测 TNF-α 和 TGF-β1 的表达。

结果

术后第 3 天,手术刀和 Er,Cr:YSGG 激光伤口的愈合过程组织学模式相似,CO2 激光伤口的溃疡程度比手术刀和 Er,Cr:YSGG 激光伤口更严重。激光伤口的 TNF-α 表达水平是手术刀伤口的两倍。术后第 7 天,CO2 激光伤口 TGF-β1 的表达水平较高,术后第 14 天则较低,低于手术刀和 Er,Cr:YSGG 激光伤口。

结论

由于炎症反应低、组织损伤小,Er,Cr:YSGG 激光在口腔手术中有许多优势。虽然 CO2 激光具有更好的止血能力,但与手术刀和 Er,Cr:YSGG 激光相比,其使用会造成更大的组织损伤。然而,在充分支持其广泛应用之前,还需要进行更多更大规模的研究。

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