Clinical and histological comparison of incisions in animal tissue made with scalpel, carbon dioxide laser, diode laser, Nd:YAG and Er,Cr:YSGG laser

Objective: To test the null hypothesis that the incision properties of four different lasers: carbon dioxide, diode, Nd:YAG, and Er,Cr:YSGG are comparable clinically and histologically to each other, and the stainless steel scalpel blade incision.;Materials and Method: 30 incisions were made in fresh pig mandibles, in the keratinized oral mucosa, with the stainless steel scalpel blade, and the four lasers tested, 6 incisions for each treatment. The four lasers parameters were set according to each laser manufacturers' instructions for the soft tissue incision. Histological examination (H&E stain) assessed depth of incision, width of incision, lateral coagulation, depth of coagulation, and time to complete each incision. One-way ANOVA approach with a Bonferroni or Scheffe posttest analysis for the P value, with the P value set at <0.05 was used to analyze data.;Results: The scalpel incision induced no lateral or deep coagulation. The Nd:YAG laser exhibited the most lateral and deep coagulation, as well as the most width of incision. The Er,Cr:YSGG laser and the carbon dioxide lasers differed statistically in their depth of incision, having lesser depth, from the diode and the Nd:YAG lasers. The incision time was the least with the scalpel, and the Nd:YAG laser took the most time to incise the soft tissue.;Conclusion: The findings support choosing lasers over the scalpel for the soft tissue incision if hemostasis and coagulation is clinically desired in the chosen procedure. The use of the stainless steel scalpel blade incision is more favorable than any type of laser if primary closure of the soft tissue is needed. Lasers time for incision in the soft tissue takes longer than the scalpel due to laser-tissue interaction effects of lasers.;Keywords: oral soft tissue incision with lasers, stainless steel scalpel blade, carbon dioxide laser, diode laser, Nd:YAG laser, Er,Cr:YSGG laser, ablation, necrosis, thermal damage, coagulation zones. vi.