Effects of Intraoperative Laser Photobiomodulation on Osteogenic Differentiation of Human Jaw Bone Explants Harvested During Cyst Surgery

Background: Surgical removal of jaw cysts frequently results in bone defects that may compromise healing and delay functional rehabilitation. Laser photobiomodulation (PBM) has been proposed as a minimally invasive adjuvant capable of enhancing osteogenic activity; however, translational evidence based on freshly harvested human jaw bone tissue remains limited. Objective: To investigate the effects of intraoperative laser photobiomodulation on osteogenic differentiation and cellular viability in human bone explants obtained during cystectomy, using a paired experimental design. Materials and Methods: This translational experimental study included 20 patients undergoing surgical treatment for medium to large maxillary or mandibular cysts. From each patient, paired bone explants were harvested intraoperatively, with one explant exposed to diode laser photobiomodulation and the contralateral explant serving as an untreated control. Explants were cultured under standardized conditions and assessed for osteogenic differentiation using morphometric analysis, immunofluorescence staining for alkaline phosphatase (ALPL) and osteocalcin (OCN), and confocal microscopy. Cell viability was evaluated using a live/dead fluorescence assay. Results: Biologically viable osteogenic cultures were obtained from 8 patients and included in the final paired analysis. In the majority of responsive cases, laser-treated explants demonstrated an increased number of osteoblast-like cellular structures, greater osteoblastic surface area occupancy, and enhanced expression of ALPL and OCN compared with paired controls. No evidence of laser-induced cytotoxicity was observed. Conclusions: Intraoperative laser photobiomodulation enhanced osteogenic activity in human jaw bone explants in a subset of cases, supporting its potential role as a biologically active adjuvant in maxillofacial cyst surgery. Inter-individual variability highlights the need for further optimization of irradiation protocols and larger controlled studies to identify predictive factors for clinical responsiveness.