Low-intensity Laser Therapy in the Treatment of Gingival Recession
Condition: Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      The purpose of this study was to evaluate the 6-month outcomes of applying low-intensity
      laser therapy associated with connective tissue grafts to treat gingival recession.
    

Detailed description: 
      This was a prospective, parallel and controlled clinical trial. The population evaluated in
      this study was selected at ICT - São José dos Campos, College of Dentistry.

      The selected patients were randomly allocated (by a computer generated list) into:

      Group CTG (n = 20) - patients who received connective tissue graft to treat gingival
      recession Group CTG+LILT (n = 20) - patients who received connective tissue graft associated
      with 8 applications of low-intensity laser therapy to treat gingival recession.

      The surgeries, as well as all postoperative follow-up, were performed at the dental clinic of
      ICT- UNESP. Surgical areas were anesthetized (2% mepivacaine with 1:100,000 epinephrine). Two
      horizontal incisions were made at right angles to the adjacent interdental papillae, at the
      level of the CEJ, without interfering with the gingival margins of neighboring teeth. Two
      oblique vertical incisions were extended beyond the mucogingival junction, and a trapezoidal
      mucoperiosteal flap was raised up to the mucogingival junction. After this point, a
      split-thickness flap was extended apically, releasing the tension and favoring coronal
      positioning of the flap. The exposed root surface was gently scaled and planed to remove any
      possible irregularities. Afterward, a thin and small connective tissue graft was harvested
      from the palate using a scalpel with parallel blades (1.0 mm away from each other). The graft
      was sutured# using single sutures in the papillae, over the root surface, in such a way that
      covered the CEJ and the recession. Then, the flap was coronally positioned and sutured to
      completely cover the graft The patients allocated for the test group received the following
      protocol for laser application: Five (5) points of irradiation were performed, as depicted in
      Figure 1. The irradiation was performed with a GaAlAs** 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)

      Clinical parameters were assessed at baseline and 3 and 6 months 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 (Sigmaplot). 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). Patients' esthetics and discomfort
      measures using VAS were analyzed by T-tests. The frequency of sites that were scored as very
      good or excellent in each group by QCE analysis, the frequency of complete root coverage,
      BOP, and the presence or absence of plaque at the site were compared using χ2 tests.
      Intergroup RES comparisons were performed with a T-test. A significance level of 0.05 was
      adopted.
    

Intervention name(s): Connective tissue graft
Intervention type(s): Procedure
Intervention description(s): Periodontal surgical technique to treat gingival recessions
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment