Effects of pulsed electromagnetic field on oral mucosal wound healing

Oral mucosal sores limit daily activities at school, work, and home, resulting in millions of lost educational and working hours worldwide each year. At the same time, these diseases have psychosocial effects and often significantly reduce the quality of life. In addition to traditional medicine, magnetotherapy is also accepted by 21st century medicine as alternative methods that promise the healing of various health problems. Today, magnetotherapy offers a non-invasive, safe and easy method for pain and inflammation management. Although there are many treatments to accelerate wound healing in the oral mucosa, the effects of pulsed electromagnetic field (PEMF), which is a non-invasive application, have not been examined. In this study, we aimed to reveal the effects of PEMF on the mucosal wounds created on the palate of rats. In our study, 32 Wistar Albino male rats were distributed randomly and equally to the groups and 4 experimental groups were formed, with 8 rats in each group. Rats in groups 1 and 3 were created with only an oral mucosal wound, PEMF was not applied, and were sacrificed at the end of the 4th day and 7th day, respectively. Following the creation of an oral mucosal wound, PEMF was applied to groups 2 and 4 for a total of 2 hours a day, at 12-hour intervals, at the same time of the day during the experiment, and the rats were sacrificed at the end of the 4th and 7th days, respectively. Excised wound areas were examined histopathologically, immunohistochemically and genetically. Inflammatory cell infiltration, granulation tissue formation and epithelialization were scored. Histopathological scoring was evaluated as none - mild - moderate - severe (0, 1 positive, 2 positive, 3 positive). Cytokeratin expressions were scored. Endothelial Nitric Oxide Synthase (eNos), platelet derived growth factor (PDGF), fibroblast growth factor (FGF), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF) expressions were measured. As a result of the examinations, significantly reduced wound areas were detected in the PEMF applied groups compared to the wound-only groups on the 4th and 7th days (p = 0.002, p = 0.042, respectively). Both on day 4 and day 7, granulation tissue scores (p = 0.005, p = 0.010, respectively), epithelialization scores (p = 0.012, p = 0.004, respectively), cytokeratin scores (p<0.001, p = 0.013, respectively), EGF expression (p < 0.001, p = 0.010, respectively), FGF expression (p = 0.004, p = 0.014, respectively), PDGF expression (p = 0.002, p = 0.040, respectively) and VEGF expression. (p = 0.008, p = 0.009, respectively) was observed to be significantly higher. Again on both days, it was observed that the inflammatory cell infiltration score (p = 0.003, p = 0.008, respectively) and eNos expression (p < 0.001, p = 0.037, respectively) were significantly lower in the groups that received PEMF application compared to the wound-only groups. In our study, it was found that PEMF application increased the expression of growth factors such as EGF, PDGF, VEGF, FGF around the wound in rat oral mucosal wounds. PEMF application has been histopathologically shown to increase granulation tissue formation and epithelialization, and macroscopically a reduction in the wound area has been demonstrated. We believe that this promising experimental study, which shows that the non-invasive, non-toxic, low-cost PEMF application can be used as a treatment method for oral mucosal wounds, may shed light on various future studies. This study should be supported by future studies.