Effects of Intraoperative Photobiomodulation on Osteogenic Differentiation of Human Jaw Bone Explants Harvested During Cyst Surgery: A Paired Ex Vivo Translational Experimental Study

Background: Surgical removal of jaw cysts results in bone defects that may compromise regeneration. Photobiomodulation (PBM) has been proposed as a minimally invasive adjunct capable of influencing osteogenic activity, but translational evidence using freshly harvested human jawbone tissue remains limited. Objective: To evaluate the effects of intraoperative PBM on osteogenic differentiation and cellular viability in human jaw bone explants obtained during cystectomy. Materials and Methods: This paired translational ex vivo experimental study enrolled 40 patients undergoing surgical treatment for medium to large cystic lesions of the maxilla or mandible. From each patient, paired bone explants were harvested intraoperatively, with one explant exposed to diode PBM and the other serving as a control. Explants were cultured under standardized conditions and assessed using morphometric analysis, immunofluorescence staining for alkaline phosphatase (ALPL) and osteocalcin (OCN), confocal microscopy, and quantitative live/dead viability assays. Viable osteogenic cultures suitable for paired analysis were obtained in 34 patients and constituted the final analytic cohort. Results: PBM-treated explants showed higher numbers of osteoblast-like cellular structures and greater osteogenic surface area occupancy than paired controls. Immunofluorescence demonstrated increased ALPL and OCN expression in laser-treated samples. Quantitative viability analysis showed comparable cell survival between groups, with no evidence of laser-induced cytotoxicity. Inter-individual variability in osteogenic response was observed. Conclusions: In this exploratory paired ex vivo model, intraoperative PBM was associated with enhanced osteogenic activity in human jaw bone explants. These findings are limited to surrogate cellular outcomes and require confirmation through studies incorporating quantitative mineralization and clinical healing parameters.