Painless formation of an aesthetic scar on the oral mucosa using laser wound soldering: an experimental study

Introduction. The number of surgical interventions in the oral cavity is steadily increasing, as dental diseases are among the most common health conditions today. Consequently, the choice of suturing techniques during surgical procedures is directly linked to the quality of dental care. One promising approach is laser tissue soldering, which enables rapid and airtight tissue bonding under sterile wound conditions, leading to faster healing and reduced scar formation.

Objective. To enhance the effectiveness of surgical treatment in dental patients by experimentally developing a laser tissue soldering technique for the oral mucosa using laser radiation and a biocompatible soldering material.

Materials and methods. The experimental study was conducted on 16 chinchilla breed laboratory rabbits. Linear wounds were created on the oral mucosa using a scalpel and then sutured. The animals were divided into two study groups: 1) the wounds were sutured using Prolene 5.0 thread; 2) the wound edges were joined using the laser tissue soldering technique, employing a 970 nm wavelength laser device and a biocompatible solder composed of bovine serum albumin, indocyanine green, single-walled carbon nanotubes, type I collagen, and Prolene 5.0 thread. Postoperative assessments included pain intensity, swelling severity, and the degree of hyperemia coloration at the surgical site on days 1, 3, and 5, using a scoring system.

Results. In vivo experimental studies demonstrated that laser tissue soldering with laser radiation and biocompatible solder provided superior wound regeneration. Postoperatively, pain and swelling were minimal, hyperemia was not pronounced, and no cases of suture dehiscence or tissue necrosis were observed. The laser-formed suture site exhibited early epithelialization, and the resulting scar was extremely thin and nearly indistinguishable from the surrounding tissue.

Conclusion. The use of laser radiation in combination with biocompatible solder represents a promising technique for wound closure in the oral cavity, as it enables painless acceleration of postoperative regenerative processes with minimal risk of hypertrophic scar formation.

1. Evseev M.A. Surgical suture: the evolution of thread and needle. Clinical experience of the Twenties. 2012; 4 (16):59-62.

2. Semenov G.M., Petrishin V.L., Kovshova M.B. Surgical staining. The 3rd is decreasing. I’ve Been Through St. Petersburg: Peter. 2012: 256. ISBN 978-5-496-00023-9.

3. Робустова Т.Г. Хирургическая стоматология. 4-е изд. Москва: Медицина. 2010: 622. Robustova T.G. Surgical dentistry. 4th ed. Moscow: Medicine. 2010: 622.

4. La Rosa GRM., Scapellato S., Cicciu M., Pedulla E. Antimicrobial Activity of Antibacterial Sutures in Oral Surgery: A Scoping Review. International Dental Journal. 2024: 6539(24):00052-2. https://doi.org/10.1016/j.identj.2024.01.029

5. Faris A., Khalid L., Hashim M., Yaghi S., Magde T., Bouresly W., Hamdoon Z., Uthman AT., Marei H., Al-Rawi N. Characteristics of Suture Materials Used in Oral Surgery: Systematic Review. Int Dent J. 2022:72(3):278-287. https://doi.org/10.1016/j.identj.2022.02.005.

6. Ryabkin D.I., Suchkova V.V., Gerasimenko A.Yu. Prediction of tensile strength of laser welds of biological fabrics by machine learning methods. Medical equipment. 2023:2(338):26–29.

7. Peterson AW., Halter M., Tona A., Plant AL. High resolution surface plasmon resonance imaging of single cells. BMC Cell Biology. 2014:15(35):2–14. doi:10.1186/1471-2121-15-35. PMC 4289309. PMID 25441447.

8. Makedonova Yu.A., Afanasyeva O.Yu., Alexandrov A.V., Kabytova M.V., Chaplieva E.M. The possibilities of using medical gel for plastic perforation of the maxillary sinus. Cathedral-Department. Dental education. 2023:(85):62–65.

9. Sigal Z.M., Babushkin F.G., Nikiforova A.N., Kapustin B.B. Surgical sutures. The training manual. Izhevsk. 2009:136.

10. Akopov A.L., Artyukh D.Yu., Molnar T.F. History of mechanical brace surgical suture (literature review). Bulletin of Surgery named after I.I. Grekov. 2020:179(6):81–88.

11. Glinnik A.A., Avlas S.D., Stebunov S.S., Rummo O.O., Germanovich V.I. Bariatric surgery in morbid obesity. Surgery news. 2021:29(6):662–670.

12. Ashurkov I.P., Krylova D.A., Belkin V.O., Yatsenko A.G., Tarasenko S.V. Results of the use of collagen matrix in soft tissue management in the field of dental implants in the frontal maxilla. Problems of dentistry. 2023:19(4):69–76.

13. Sudarsan P.K.S., Lata J., Kajla P., Sooch S.P.S., Prashar S. Comparative study between the efficacy of conventional plain vicryl and antibacterial vicryl containing triclosan. International Journal of Advanced Research. 2023:11(07):241–250. https://dx.doi.org/10.21474/IJAR01/17225.

14. Kim H., Hwang K., Yun S. Catgut and its Use in Plastic Surgery. Journal of craniofacial surgery. 2020:31(3): 876-878. https://doi.org/10.1097/SCS.0000000000006149.

15. Parmar G.S., Ghodke B., Meena A.K. Releasable Suture versus Autologous Blood for Pterygium Surgery using Conjunctival Autografts. J Ophthalmic Vis Res. 2020:15(1):32-37. https://doi.org/10.18502/jovr.v15i1.5938.

16. Muth D.R., Wolf A., Kreutzer T., Shajari M., Vounotrypidis E., Priglinger S., Mayer W.J. Safety and Efficacy of Current Sclera Fixation Methods for Intraocular Lenses and Literature Overview. Klinische Monatsblatter fur Augenheilkunde. 2021:238(08): 868–874. https://doi.org/10.1055/a-1333-3199.

17. Mohammad S., Hanstein R., Lo Y., Levy I. Validating a Low-Fidelity Model for Microsurgical Anastomosis Training. JBJS Open Access. 16;6(3):e20.00148. https://doi.org/10.2106/JBJS.OA.20.00148.

18. Tuchin V.V. Biomedical optics fiber research and laser technology. А monograph. Moscow. A Man of Very Media Hips. 2021:495. ISBN 978-5-4497-0568-6.

19. Hsu V.M., Aldahan A.S., Tsatalis J.P., Perper M., Nouri K. Efficacy of Nd:YAG laser therapy for the treatment of verrucae: a literature review. Lasers in Medical Science. 2017:32(5):1207–1211. https://doi.org/10.1007/s10103-017-2219-5.

20. Nadhreen A.A., Alamoudi N.M., Elkhodary H.M. Low-level laser therapy in dentistry: Extra-oral applications. Nigerian Journal of Clinical Practice. 2019:22(10):1313-1318. https://doi.org/10.4103/njcp.njcp_53_19.

21. Li-Da H., Zhen L., Yu P., MuhammadIqbal S., Yu-Feng Z., Li L. A review on biodegradable materials for cardiovascular stent application. Frontiers of Materials Science. 2016:10(3): 238–259. https://doi.org/10.1007/s11706-016-0344-x.

22. Matteini P., Ratto F., Rossi F., de Angelis M., Cavigli L., Pini R. Hybrid nanocomposite films for laser-activated tissue bonding. Journal of Biophotonics. 2012:5(11–12):868–877. https://doi.org/10.1002/jbio.201200115.

23. Ark M., Cosman P.H., Boughton P., Dunstan C.R. Photochemical Tissue Bonding (PTB) methods for sutureless tissue adhesion. International Journal of Adhesion and Adhesives. 2016:71:87–98. https://doi.org/10.1016/j.ijadhadh.2016.08.006.

24. Gerasimenko A.Y., Morozova E.A., Ryabkin D.I., Fayzullin A., Tarasenko S.V., Molodykh V.V., Pyankov E.S., Savelyev M.S., Sorokina E.A., Rogalsky A.Y., Shekhter A., Telyshev D.V. The study of the interaction mechanism between bovine serum albumin and single-walled carbon nanotubes depending on their diameter and concentration in solid nanocomposites by vibrational spectroscopy. Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy. 2020:227:117682. https://doi.org/10.3390/bioengineering9060238.

25. Barry R.M. Book Review: Biomedical Photonics Handbook. Journal of Biomedical Optics. 2003:9(5):1864. https://doi.org/10.1117/1.1776177.

26. Tarasenko, S.V., Blagushina N.A. Histological assessment of the use of bioresorbable collagen membranes in the closure of wound defects of the oral mucosa in an experiment. Vyatka Medical Bulletin. 2022:1:(73):67–75.

27. Keating S.C., Thomas A.A., Flecknell P.A., Leach M.C. Evaluation of EMLA cream for preventing pain during tattooing of rabbits: Changes in physiological, behavioural and facial expression responses. PLOS ONE. 2012:7(9):e44437. doi:10.1371/journal.pone.0044437.

28. Kramer E.A., Rentschler M.E. Energy-Based Tissue Fusion for Sutureless Closure: Applications, Mechanisms, and Potential for Functional Recovery. Annual Review of Biomedical Engineering. 2018:20:1–20. https://doi.org/10.1146/annurev-bioeng-071516-044702.

29. Pabittei D.R., de Boon W., Heger M., van Golen R.F., Balm R., Legemate D.A., de Mol BA. Laser-assisted vessel welding: state of the art and future outlook. J Clin Transl Res. 2015:30;1(2):1–18. https://doi.org/10.1146/annurev-bioeng-071516-044702.

30. Ashbell I., Agam N., Katzir A., Basov S., Platkov M., Avital I., Nisky I., Netz U. Laser tissue soldering of the gastrointestinal tract: a systematic review LTS of the gastrointestinal tract. Heliyon. 2023; 9(5): e16018. https://doi.org/10.1016/j.heliyon.2023.e16018.

31. Gemonov V.V., Lavrova E.N., Falin L.I. Histology and embryology of the organs of the oral cavity and teeth. Moscow: GEOTAR-Media. 2019:320.ISBN 978-5-9704-5180-9.

32. Berkovitz B.K., Hoiiand G.R., Moxam B.J. Oral Anatomy, Histology and Embryology. St Louis: Mosby. 2009:416.

33. Alexandrov M.T. Laser clinical biophotometry (theory, experiment, practice). M.

34. Technosphere, 2008:584. ISBN 978-5-94836-148-1.

35. Bagramov R.I., Alexandrov M.T., Sergeev Yu.N. Lasers in dentistry, maxillofacial surgery and reconstructive plastic surgery. M. Technosphere. 2010:576. ISBN 978-5-94836-148-2.

36. Minaev V.P., Zhilin K.M. Modern laser devices for surgery and power therapy based on semiconductor and fiber lasers: recommendations for selection and application: Scientific and Technical Association «IRE-Polyus». Moscow: I.V. Balabanov. 2009:47. ISBN 978-5-91563-037-9. pp. 5–11.

37. Risovanny S.I., Risovannaya O.N., Masychev V.I. Laser dentistry. Krasnodar: Kuban-Book. 2005:74-124

38. Tarasenko S.V., Tsarev V.N., Garipov R.D., Dyachkova E.Yu., Repina S.I. Microbiological justification and effectiveness of the use of erbium and neodymium lasers in patients with inflammatory periodontal diseases and peri-implantation tissues. Clinical dentistry. 2019:4 (92):41-45.