Gingival Recession, Localized
Conditions
Keywords
Er,Cr:YSGG laser, connective tissue graft, root coverage, mucogingival surgery, gingival recession
Brief summary
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
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.
Interventions
DEVICElaser root surface conditioning & laser DGG harvesting
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
DEVICElaser root surface conditioning & blade DGG harvesting
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
PROCEDUREblade DGG harvesting
De-epithelialized palatal graft harvested using scalpel blade (Zucchelli et al. 2010) and coronal repositioned flap for gingival recession defect coverage
Sponsors
Ain Shams University
Misr International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Masking of investigator and participants was not applicable due to surgical procedure and use of laser either for root surface bio-modification or during connective tissue harvesting. The blinded outcome assessor performed the clinical measurements at each selected defect site during the study period. She was not involved in any other part of the study protocol.
Eligibility
Sex/Gender
ALL
Age
21 Years to 58 Years
Healthy volunteers
Yes
Inclusion criteria
1. 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. 2. Controlled periodontal disease 3. Full-mouth plaque score of \<10%; full-mouth gingival score of \<15% 4. Patients available for 9 months follow-up period.
Exclusion criteria
1. Smokers. 2. Pregnant and lactating females. 3. Taking medications known to interfere with periodontal tissue health or healing. 4. Previous periodontal surgery on the involved sites. 5. Non-vital teeth. 6. Molar teeth. 7. Recession defects associated with caries or restoration. 8. Occlusal interferences. 9. Taking anti-inflammatory drugs or antibiotics in the past 6 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Recession depth | baseline-3-6-9 months | 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 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| number of analgesic pills consumed per day | 7 days | counting number of analgesic pills per day |
| Recession width | baseline-3-6-9 months | distance between mesial and distal gingival margin of the tooth recorded on a horizontal line tangential at the CEJ to the nearest mm |
| Gingival thickness | baseline and at 9 months | determined 2mm apical to the gingival margin using standardised CBCT |
| Pain assessment at the donor site | 7 days | Visual Analogue Scale |
| Clinical attachment loss | baseline-3-6-9 months | measured from the CEJ to the bottom of the periodontal pocket to the nearest mm. |
| Probing pocket depth | baseline-3-6-9 months | measured from the gingival margin to the base of the periodontal pocket to the nearest mm |
| Height of keratinized tissue width | baseline and at 9 months | measured form the mid-buccal aspect of the gingival margin to the mucogingival line |
Countries
Egypt
Outcome results
None listed