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Histopathological and biomechanical changes in soft palate in response to non-ablative 9.3-μm CO2 laser irradiation: an in vivo study

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Abstract

The purpose of this study was to investigate in vivo the biomechanical and morphological changes in soft palates of Wistar rats from non-ablative irradiation with a 9.3-μm CO2 laser. A blinded, randomized, controlled study was designed with 45 Wistar rats categorized into treated and control sets. The treated set was exposed to 9.3-μm CO2 laser irradiation at an average power of 1.0 W and a single pulse fluence of 0.16 J/cm2 scanned using an automated system at a repetition rate of 315 Hz in a patterned area covering 0.4 cm2 in 6 s. The tissue of each animal was excised and divided into two halves. One-half was sectioned for histopathology, and the other half was used to measure tissue stiffness, which was reported as the effective Young’s modulus. Measurements for both sets were taken at three time points: days 1, 21, and 35. There were no significant adverse events or changes in the behavior of the rats over the duration of the study. The treated set exhibited an order of magnitude increase in stiffness relative to the controls, which was maintained over the three time points. Histopathology showed a moderate contraction/disruption of the lamina propria collagen observed at day 1 and collagen accumulation observed at days 21 and 35 in the tissue remodeling phase. Non-ablative 9.3-μm CO2 laser irradiation can safely increase oral mucosal stiffness and can be used as an effective treatment to reduce tissue vibrations that are associated with snoring.

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References

  1. Wang Z, Rebeiz EE, Shapshay SM (2002) Laser soft palate stiffening: an alternative to uvulopalatopharyngoplasty. Lasers Surg Med 30(1):40–43 http://www.ncbi.nlm.nih.gov/pubmed/11857602. Accessed February 20, 2019

    Article  CAS  Google Scholar 

  2. Kirsch KM, Zelickson BD, Zachary CB, Tope WD (1998) Ultrastructure of collagen thermally denatured by microsecond domain pulsed carbon dioxide laser. Arch Dermatol 134(10):1255–1259. https://doi.org/10.1001/archderm.134.10.1255

    Article  CAS  PubMed  Google Scholar 

  3. Fitzpatrick RE, Rostan EF, Marchell N (2000) Collagen tightening induced by carbon dioxide laser versus erbium: YAG laser. Lasers Surg Med 27(5):395–403. https://doi.org/10.1002/1096-9101(2000)27:5<395::AID-LSM1000>3.0.CO;2-4

    Article  CAS  PubMed  Google Scholar 

  4. da Cunha MG, Paravic FD, Machado CA (2015) Histological changes of collagen types after different modalities of dermal remodeling treatment: a literature review. Surg Cosmet Dermatol 7(4):285–291. https://doi.org/10.5935/scd1984-8773.2015741

    Article  Google Scholar 

  5. Ross EV, Yashar SS, Naseef GS et al (1999) A pilot study of in vivo immediate tissue contraction with CO2 skin laser resurfacing in a live farm pig. Dermatologic Surg 25(11):851–856. https://doi.org/10.1046/j.1524-4725.1999.99091.x

    Article  CAS  Google Scholar 

  6. Von Den Hoff JW, Maltha JC, Kuijpers-Jagtman AM (2006) Palatal wound healing: the effects of scarring on growth. In: Cleft Lip and Palate. Springer Berlin Heidelberg, Berlin, pp 301–313. https://doi.org/10.1007/3-540-30020-1_20

    Chapter  Google Scholar 

  7. Krysztof Miracki ZV (2013) Nonsurgical minimally invasive Er:YAG laser snoring treatment. J Laser Heal Acad 1(1):36–41

    Google Scholar 

  8. Sippus J (2015) NightLase procedure – laser snoring and sleep apnea reduction treatment. J Laser Heal Acad 2015(1):S06

    Google Scholar 

  9. Cetinkaya EA, Turker M, Kiraz K, Gulkesen HK (2016) Er: Yag laser treatment of simple snorers in an outpatient setting. Orl. 78(2):70–76. https://doi.org/10.1159/000443510

    Article  PubMed  Google Scholar 

  10. Green J, Weiss A, Stern A (2011) Lasers and radiofrequency devices in dentistry. Dent Clin N Am 55(3):585–597. https://doi.org/10.1016/j.cden.2011.02.017

    Article  PubMed  Google Scholar 

  11. Fantarella D, Kotlow L (2014) The 9.3-μm CO 2 dental laser: technical development and early clinical experiences. J Laser Dent J Laser Dent 2222(11):10–27

    Google Scholar 

  12. Berger G, Finltelsteln Y, Oplnr D (1999) Histopathologic changes of the soft palate after laser-assisted uvulopalatoplasty. Arch Otolaryngol Head Neck Surg 125(7):786–790. https://doi.org/10.1001/archotol.125.7.786

    Article  CAS  PubMed  Google Scholar 

  13. Berger G, Finkelstein Y, Stein G, Ophir D (2001) Laser-assisted uvulopalatoplasty for snoring: medium- to long-term subjective and objective analysis. Arch Otolaryngol Head Neck Surg 127(4):412–417. https://doi.org/10.1001/archotol.127.4.412

    Article  CAS  PubMed  Google Scholar 

  14. Lalabonova H, Ilieva EM (2013) Clinical evaluation of the healing process of oral soft tissue surgical wounds stimulated by low-level laser therapy. J IMAB - Annu Proceeding 19(2):279–281. https://doi.org/10.5272/jimab.2013192.279

    Article  Google Scholar 

  15. Poyrazoǧlu E, Doǧru S, Saat B, Güngör A, Çekin E, Cincik H (2006) Histologic effects of injection snoreplasty and radiofrequency in the rat soft palate. Otolaryngol Head Neck Surg 135(4):561–564. https://doi.org/10.1016/j.otohns.2006.05.008

    Article  PubMed  Google Scholar 

  16. Fung Y (2013) Biomechanics: mechanical properties of living tissues. Springer Science & Business Media, New York

    Google Scholar 

  17. Song AS, Najjar AM, Diller KR (2014) Thermally induced apoptosis, necrosis, and heat shock protein expression in 3D culture. https://doi.org/10.1115/1.4027272

  18. Akhtar R, Schwarzer N, Sherratt MJ et al (2009) Nanoindentation of histological specimens: mapping the elastic properties of soft tissues. J Mater Res 24(03):638–646. https://doi.org/10.1557/jmr.2009.0130

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Qian L, Zhao H (2018) Nanoindentation of soft biological materials. Micromachines. 9(12):654. https://doi.org/10.3390/mi9120654

    Article  PubMed Central  Google Scholar 

  20. McKee CT, Last JA, Russell P, Murphy CJ (2011) Indentation versus tensile measurements of Young’s modulus for soft biological tissues. Tissue Eng Part B Rev 17(3):155–164. https://doi.org/10.1089/ten.TEB.2010.0520

    Article  PubMed  PubMed Central  Google Scholar 

  21. Seckel BR, Younai S, Wang KK (1998) Skin tightening effects of the ultrapulse CO2 laser. Plast Reconstr Surg 102(3):872–877. https://doi.org/10.1097/00006534-199809030-00040

    Article  CAS  PubMed  Google Scholar 

  22. Sasaki GH (2010) Quantification of human abdominal tissue tightening and contraction after component treatments with 1064-nm/1320-nm laser-assisted lipolysis: clinical implications. Aesthetic Surg J 30(2):239–245. https://doi.org/10.1177/1090820X10369373

    Article  Google Scholar 

  23. Svahnström K (2013) Er : YAG laser treatment of sleep-disordered breathing. J laser Health Acad 2013(2):13–16

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Acknowledgments

Dr. Xin Brown of Boston University provided access to the device used in the biomechanics portion of this study and helped to train the authors on the use of nanoindentation. She also provided some idea of the initial indentation parameters that might work for this method on soft tissues. Dr. Gregory Rybacki of Toxikon, Inc., provided the histopathology analysis of the oral mucosa.

Funding

This study was funded by Convergent Dental.

Author information

Authors and Affiliations

  1. Convergent Dental, Needham, MA, USA

    Ali H. Badreddine, Stephen Couitt & Charles Kerbage

Authors
  1. Ali H. Badreddine
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  2. Stephen Couitt
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  3. Charles Kerbage
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Corresponding author

Correspondence to Ali H. Badreddine.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study did not unnecessarily duplicate previous testing and that there were no non-animal alternatives acceptable for the evaluation of the test article as defined by the protocol. No evidence of pain and distress was reported to the Veterinarian or Study Director. Toxikon strictly adhered to the following standards in maintaining the animal care and use program:

United States Department of Agriculture (USDA), Animal and Plant Health Inspection Service, 9 CFR Ch. 1, Subchapter A-Animal Welfare.

“Guide for the Care and Use of Laboratory Animals,” National Research Council, 2011.

Office for Laboratory Animal Welfare (OLAW), “Public Health Service Policy on Humane Care and Use of Laboratory Animals,” Health Research Extension Act of 1985 (Public Law 99–158 November 20, 1985), Revised 2015.

ISO 109932, 2006, Biological Evaluation of Medical Devices Part 2: Animal Welfare Requirements.

AAALAC International accreditation.

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Badreddine, A.H., Couitt, S. & Kerbage, C. Histopathological and biomechanical changes in soft palate in response to non-ablative 9.3-μm CO2 laser irradiation: an in vivo study. Lasers Med Sci 36, 413–420 (2021). https://doi.org/10.1007/s10103-020-03087-y

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  • DOI: https://doi.org/10.1007/s10103-020-03087-y

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