Comparison of Two Different Low-level Laser Intensity Protocols on the Healing of Palatal Wounds
Condition: Palatal Wound
MeSH terms: Wounds and Injuries
Study type: Interventional

Summary: 
      The aim of this study was to compare two intensities of LLLT on wound healing process of the
      donor palatine area after CTG removal.
    

Detailed description: 
      This is a prospective, parallel and controlled clinical trial. The population evaluated in
      the study was selected at Science and Technology Institute - ICT- São José dos Campos,
      College of Dentistry.

      Patients were assigned to one of the three treatment groups:

        -  Group 60 (Test, n=18): Periodontal surgery for root coverage through connective tissue
           graft and LLLT application on donor site using a 60 J/cm² dose.

        -  Group 30 (Test, n=18): Periodontal surgery for root coverage through connective tissue
           graft and LLLT application on donor site using a 30 J/cm² dose.

        -  Group Sham (Control, n= 18): Periodontal surgery for root coverage through connective
           tissue graft and LLLT SHAM on donor site.

      All surgeries were performed by the same expert periodontist (MPS). Before the surgical
      procedure, all patients were enlightened about the causes and consequences of gingival
      recession and prevention techniques. Factors related to the origin of gingival recession,
      such as toothbrush trauma and inflammation caused by biofilm, were controlled through
      instruction on standardized brushing technique to avoid the influence of other hygiene
      methods capable of promoting trauma on soft tissues. Standardized dental floss and
      toothbrushes were given to patients. The surgical technique adopted in the recession defects
      was the trapezoidal-type of CAF and the connective tissue graft was removed from palate
      mucosa . 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 mesial-distal length of the
      incision was determined by the length of the graft required to cover the recession. Because
      the selected recessions were in maxillary canines and premolars, the lengths of the graft
      varied minimally (10-12mm). The second incision was made parallel to the first one (1-2 mm
      apically and parallel to the long axis of the teeth) to separate the subepithelium connective
      tissue from the epithelial layer. The incision is carried far enough apically to provide a 7-
      mm height of connective tissue to cover the denuded root surface. Afterward, 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.

      The evaluated parameters were wound remaining area (WRA), scar and tissue colorimetry (TC),
      tissue thickness (TT) and postoperative discomfort (D), evaluated at baseline and 7, 14, 45,
      60, and 90 days after surgery.

      Statistical Analysis: All data were expressed as mean ± standard deviation or expressed in
      percentages during the descriptive phase. Data were analyzed according to distribution by the
      Shapiro-Wilk test. For the remaining wound area, tissue colorimetry, tissue thickness, and
      postoperative discomfort parameter analysis, two way repeated measures ANOVA was performed
      for intra- and intergroup analysis. T test was used for intergroup comparison of the number
      of analgesics taken. The presence or absence of scars was measured by Q-square test.
      Statistical analysis was performed using Sigma Plot 12.0. In all tests a significance level
      of 0.05 was chosen.
    

Intervention name(s): Low Level Laser Therapy; GaAlAs laser
Intervention type(s): Procedure; Device
Intervention description(s): Low Level Laser Therapy on the palatal donor site of connective tissue graft.; Utilization of GaAlAs laser to irradiation on the palatal donor site.
Other intervention name(s): Laser stimulation; Low level GaAlAs laser
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Connective tissue graft; Gingival recession; Low level laser therapy