Clinical and Histological Comparison of Healing by Steel Scalpel, Diode Laser, and Radiofrequency in Palatal Wound: An Animal Study

Abstract

Background: Wound healing following periodontal soft tissue procedures can differ owing to different techniques, the feasibility of  which can be determined through detailed macroscopic and microscopic observations.

Aims: This study aimed to clinically and  histologically evaluate palatal wound healing in rats by secondary intention after excision using a steel scalpel, diode laser, and  radiofrequency.

Materials and Methods: An excision was made in the edentulous anterior maxilla of 42 4-month-old male Wistar rats  weighing 289–428 g. Part of the connective tissue was left in the surgical area to observe the dynamics of secondary intention wound  healing. Three experimental groups were established: the steel scalpel, an 810-nm diode laser at a power output of 1.5 W in continuous  mode, and a monopolar radiofrequency in a fully rectified waveform at 15 W. Clinical and histological analyses were performed on days 2,  4, and 7. Hemostasis, changes in body weight, defect size, epithelial gap, and inflammatory infiltration were evaluated.

Results: The  epithelial gap closed completely in all groups on day 7. Bleeding occurred significantly more in the scalpel group (P < 0.001). No  significant changes were observed in body weight between the groups. Macroscopically, the mean wound area decreased over time in all  groups. Wound healing was significantly slower in the laser group on day 2 and in the radiofrequency group on days 4 and 7 (P < 0.001).  Microscopically, the laser created the cleanest wound area, with minimal inflammatory infiltration and no thermal injury. More damage  occurred in the connective tissue of the radiofrequency group. Wound healing was observed on day 7 in all groups.

Conclusions: Palatal  wound healing with secondary intention yielded different outcomes in a rat model when different techniques were used. However,  almost complete healing was observed in all wounds, which highlights the importance of the soft tissue left in the surgical area. Wound  healing in periodontal soft tissue procedures is not compromised by different techniques, as long as the clinician has sufficient  knowledge and experience.