Histological Effects of an Innovative 445 Nm Blue Laser During Oral Soft Tissue Biopsy

Abstract

Continuously evolving laser devices can be used in various fields; they are an alternative to the traditional cold blade surgery to perform biopsies of oral soft tissues. The aspect focused on in this paper is the possibility to use the 445 nm diode laser (Eltech K-Laser srl, Treviso, Italy) in complete safety, by evaluating its thermal effects during microscopy. A histological evaluation of the alteration of the peri-incisional edges on 10 samples was realized. All excisional biopsies were related to clinically unsuspected lesions and performed by the same expert operator. The surgical procedure was performed with the same laser parameters and the same pathologist evaluated the thermal effect on the samples. An average value of the detected tissue alteration was calculated; the average damage of the epithelium was 650.93 μm, while in the connective tissue it was 468.07 μm. In all the cases a clear diagnosis was possible, and no clinical complications were observed; so, the 445 nm diode laser proved to be a device that can be safely used for biopsies of clinically unsuspicious lesions. Due to the small number of cases, this in vivo preliminary experience needs to be extended.

<i>In vivo</i> clinical and histological thermal effect of a 445 nm diode laser on oral soft tissues during a biopsy

“…Compared to the mean thermal effect of the first 10 specimens in this study, the mean of all 38 specimens is lower, and this trend may be attributable to the learning curve required for new devices, even when used by a skilled operator [10]. This aspect confirms the need to use laser devices correctly, with the right intraoperative parameters, and with correct fiber movements, to limit tissue carbonization.…”

Assessment of Effects of Laser Light Combining Three Wavelengths (450, 520 and 640 nm) on Temperature Increase and Depth of Tissue Lesions in an Ex Vivo Study

“…Studies on the 445 nm diode laser (2.5 W, CW, 3100 J/cm 2 ; Eltech K-Laser srl, Treviso, Italy), used during the biopsy of soft tissues within the oral cavity, showed the mean scope of thermal damage to the epithelium reaching a depth of 650.43 µm (± 311.96 µm) and damage to the subepithelial connective tissue reaching a depth of 468.23 µm (± 264.23 µm) [ 33 ]. In all samples, but one, the total thickness of thermal damage did not exceed 1 mm.…”

Laser in Dentistry During COVID-19 Pandemic: A Brief Review of Literature

“…CO 2 lasers (10 600 nm) are the best option for the ablation of extremely hydrated lesions such as fibrous lesions; however, for highly vascularized lesions or tissues, diode (445 nm, 810 nm, and 980 nm) and Nd:YAG (1064 nm) lasers can reduce the chance of hemorrhage due to their strong coagulation functions (15,16). Via photothermal and photomechanical/photoacoustical mechanisms, the Er:YAG and Er,Cr:YSGG lasers induce bubble dynamics, a fragmentation process, and tissue ablation (17).…”