Er,Cr:YSGG Laser For Recipient Bed Bio-modification And Connective Tissue Harvesting in Treatment of Gingival Recession

Study Overview
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Brief Summary
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A clinical and radiographic evaluation of using Erbium, Chromium, Scandium, Gallium and Garnet (Er,Cr:YSGG) laser in recipient site bio-modification and de-epithelialized connective tissue graft harvesting compared to conventional scalpel surgical technique in the treatment of class I and II Miller gingival recession.

Detailed Description
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Twenty four patients suffering from isolated Class I and II Miller gingival recession defects in anterior esthetic region were enrolled in this study. They were randomly assigned into three groups; de-epithelialized connective tissue graft harvesting technique or; conditioning the exposed root surfaces with Er,Cr:YSGG laser before connective tissue coverage using scalpel blade harvested de-epithelialized connective tissue graft harvesting technique, or; conditioning the exposed root surfaces with the Er,Cr:YSGG laser before Er,Cr:YSGG laser harvested connective tissue using de-epithelialized technique. Clinical and radiographic parameters were recorded at baseline and at 3, 6 and 9 months postoperatively.

Official Title
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The Use Of Er,Cr:YSGG Laser For Recipient Bed Bio-modification And De-epithelialized Palatal Graft Harvesting In The Treatment of Gingival Recession Defects -(Randomized Clinical Trial)

Conditions
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Gingival Recession, Localized

Intervention / Treatment
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* Device: laser root surface conditioning & laser DGG harvesting
* Device: laser root surface conditioning & blade DGG harvesting
* Procedure: blade DGG harvesting


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Single class I, II Miller gingival recession defects (≥ 2mm in depth), presence of identifiable buccal cemento-enamel junction (CEJ) and presence of a step ≤ 1 mm at CEJ. Controlled periodontal disease Full-mouth plaque score of <10%; full-mouth gingival score of <15% Patients available for 9 months follow-up period. Exclusion Criteria: Smokers. Pregnant and lactating females. Taking medications known to interfere with periodontal tissue health or healing. Previous periodontal surgery on the involved sites. Non-vital teeth. Molar teeth. Recession defects associated with caries or restoration. Occlusal interferences. Taking anti-inflammatory drugs or antibiotics in the past 6 months.

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 58 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: L-DGG/LRB<br>laser root surface conditioning & laser DGG harvesting | Device: laser root surface conditioning & laser DGG harvesting<br>* laser root surface bio-modification (single application) and placement of harvested de-epithelialized gingival graft (DGG) followed by coronal repositioned flap for gingival recession Miller's I, II defect coverage<br>* Other names: erbium, chromium:YSGG laser;|
| Experimental: B-DGG/LRB<br>laser root surface conditioning & blade DGG harvesting | Device: laser root surface conditioning & blade DGG harvesting<br>* laser root surface bio-modification (single application) and scalpel blade harvesting of de-epithelialized palatal graft (Zucchelli et al. 2010) and coronal repositioned flap for gingival recession Miller's I, II defect coverage<br>* Other names: erbium, chromium:YSGG laser;|
| Active Comparator: B-DGG<br>blade DGG harvesting | Procedure: blade DGG harvesting<br>* De-epithelialized palatal graft harvested using scalpel blade (Zucchelli et al. 2010) and coronal repositioned flap for gingival recession defect coverage<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Recession depth | measured from the gingival margin to the cemento-enamel junction at the mid-buccal aspect of the tooth using William's graduated periodontal probe to the nearest mm | baseline-3-6-9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain assessment at the donor site | Visual Analogue Scale | 7 days | 
| number of analgesic pills consumed per day | counting number of analgesic pills per day | 7 days | 
| Recession width | distance between mesial and distal gingival margin of the tooth recorded on a horizontal line tangential at the CEJ to the nearest mm | baseline-3-6-9 months | 
| Gingival thickness | determined 2mm apical to the gingival margin using standardised CBCT | baseline and at 9 months | 
| Height of keratinized tissue width | measured form the mid-buccal aspect of the gingival margin to the mucogingival line | baseline and at 9 months | 
| Clinical attachment loss | measured from the CEJ to the bottom of the periodontal pocket to the nearest mm. | baseline-3-6-9 months | 
| Probing pocket depth | measured from the gingival margin to the base of the periodontal pocket to the nearest mm | baseline-3-6-9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Er,Cr:YSGG laser, connective tissue graft, root coverage, mucogingival surgery, gingival recession