Gingival Recession Clinical Trial
Official title:
Connective Tissue Graft Associated or Not With Low Intensity Laser Therapy: A Randomized Clinical Trial
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.
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.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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