Effect of Low-level Laser Therapy on Palatal Wound Healing
Condition: Palatal Wound
MeSH terms: Wounds and Injuries
Study type: Interventional
Phase: Phase 4

Summary: 
      The aim of the present study was to evaluate the influence of LLLT on the recovery of the
      palatine donor site wounds after harvest connective tissue graft.
    

Detailed description: 
      This was a prospective, parallel and controlled clinical trial. The population evaluated in
      this study was selected at Science and Technology Institute - ICT - São José dos Campos,
      College of Dentistry

      The selected patients were randomly allocated (by a computer generated list) into:

        -  Group 1 (Test, n=16): Periodontal surgery for root coverage through connective tissue
           graft and LLLT on donor site.

        -  Group 2 (Control, n=16): Periodontal surgery for root coverage through connective tissue
           graft and LLLT SHAM on donor site.

      Surgical procedure was performed by one surgeon. The gingival recession defects were treated
      by connective tissue graft technique. A connective tissue graft was removed from palate
      mucosa following Bruno technique. Briefly, a first incision on the palate was performed
      perpendicularly to the long axis of the teeth, 2 to 3 mm apical to the gingival margin. The
      mesiodistal length of the incision was determined by the length of the graft required to
      cover the recession. Since the selected recessions were in maxillary canines and premolars,
      the length of the graft vary minimally (10-12mm). The second incision was made parallel to
      the first one, 1-2mm apically, and parallel to the long axis of the teeth in order to
      separate the subepithelium connective tissue from the epithelial layer. The incision is
      carried far enough apically to provide a 7mm height of connective tissue to cover the denuded
      root surface. Afterwards, another incision parallel to the long axis of the teeth, starting
      from the first incision was performed to separate the subepithelium connective tissue from
      the periosteum. Then, the connective tissue graft was removed from the palate as
      atraumatically as possible. Single sutures were made on the palate (4-0 silk) and the graft
      was sutured on the receptor site

      Clinical parameters were assessed at baseline and 7, 14, 45, 60 and 90 days post-operatively

      Statistical Analysis The null hypothesis considered in the study was the absence of
      difference in the clinical parameters between the different groups. For data analysis, the
      statistical program was used. The demographic and clinical data were compared between the
      groups using Student's t-test. The data were first analyzed for homogeneity using the
      Shapiro-Wilk test, which indicated non-normal distribution. . Those presenting Shapiro-Wilk p
      values < 0.05 were analyzed using a Friedman test (for intragroup comparisons) and
      Mann-Whitney tests (for intergroup comparisons). For remaining wound area, tissue
      colorimetry, tissue thickness, and post-operative discomfort parameter analysis, Two Way
      Repeated Measures ANOVA was performed for intra and intergroup analysis. T-test was used for
      intergroup comparison of number of analgesics taken. Presence or absence of scar was measured
      by Q-square test. For all tests significance level of 5% was used.
    

Intervention name(s): LLLT
Intervention type(s): Procedure
Intervention description(s): The patients allocated for the test group received the following protocol for laser application: Five (5) points of irradiation were performed. The irradiation was performed with a ASGaAl diode laser that continuously emitted a wavelength of 660 nm. 30 mW was used for 20 seconds, and the total applied energy density (fluence) was 15 J/cm2 (3 J/cm2 per point and an application time of 4 seconds per point). The applications were performed using punctual contact (to reduce reflection) with the tip perpendicular to the gingival tissue. Laser therapy was initiated in the immediate postoperative period (just after sutures) and was followed by seven more applications performed every other day, with a total of 8 laser applications. The power of the equipment was calibrated prior to each application. The patients allocated to the control group received sham irradiation. For this, black rubber protection was placed at the tip of the laser device, which did not allow the light to reach the tissue
Other intervention name(s): Low-level laser therapy (LLLT) after Coronally advanced falp and connective tissue graft technique to treat gingival recessions on the donor site
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Gingival recessions