Diode Laser for Harvesting Gingival Graft
Condition: Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      Aims: The aim of present randomized controlled clinical study was to evaluate whether the
      additional use of diode laser would facilitate the donor surgery, improve the palatal wound
      healing and reduce post-operative morbidity after the coronally advanced flap (CAF) with
      connective tissue (CTG) grafts.

      Methods: Fifty-two patients with isolated recessions were treated. The CTG resulted from the
      de-epithelialization of a free gingival graft (FGG) with blade (control group) or diode laser
      (DL) (test group). The DL was used to de-epithelialize the outer part of the FGG and
      photo-biostimulate the palatal wound area. Post-operative morbidity was evaluated by using
      Oral health related Quality of life (QoL), smile related QoL and visual analogue
      scale-discomfort (VAS). Root coverage outcomes were also evaluated 6 months after operation.
    

Detailed description: 
      The procedure of connective tissue harvesting from the palate is often characterized by the
      challenge of obtaining the largest volume of tissue possible on one side while minimizing
      post-operative pain and reducing the risk of complications on the other.The present clinical
      study evaluated whether the additional use of diode laser would facilitate the donor surgery,
      improve the palatal wound healing and reduce post-operative morbidity after the bilaminar
      periodontal plastic surgery procedure for the treatment of isolated single gingival recession
      defects with no loss of interdental clinical attachment.

      In the test sites, an aluminum, gallium, and arsenide diode laser (wavelength 810 nm and
      power of 1W) was applied in continuous mode. In the control group,a free (epithelialized)
      gingival graft was harvested by two horizontal and two vertical incisions defining the area.
      The post operative course of the patients were evaluated by visual analogical scale and the
      oral health impact profile
    

Intervention name(s): diode laser group; scalpel control group
Intervention type(s): Device; Procedure
Intervention description(s): the laser tip was used to remove all visible epithelium in the outer side of the defined graft area. The treatment was performed from the coronal to the apical aspect in parallel paths, and care was taken to avoid any laser contact to the palatal bone and periosteum by aiming the laser beam at a 450 angle to the palatal soft-tissue. The resultant layer on the surface was totally removed with knife and moist gauze. Then, the graft was harvested from the de-epithelized area with a 15c blade.; In the control group tissue was obtained by two horizontal and two vertical incisions defining the area to be harvested. The blade was oriented perpendicular to the bone along the coronal horizontal incision and once an adequate soft tissue thickness was obtained; it was rotated in order to be parallel to the superficial surface. The thickness of the graft was maintained uniform while proceeding apically with the blade until the FGG was harvested. The palatal wound was protected with equine-derived collagen maintained by compressive sling 5-0 sutures
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: free gingival graft; diode laser; donor site; mucogingival surgery