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The concept of laser deepithelialization to retard epithelial migration has enabled new attachment formation in periodontal pockets. Based on this hypothesis, that laser deepithelialization during root coverage procedures will enhance clinical outcome, a split mouth randomized controlled clinical trial was planned to compare the clinical outcome of Coronally advanced flap (CAF) + subepithelial connective tissue graft (SCTG) alone and in combination with laser de-epithelialization in the treatment of gingival recession.
Successful treatment of recession defects to obtain new attachment and prevent repair by long junctional epithelium continues to present a serious therapeutic challenge. The concept of laser deepithelialization to retard epithelial migration has enabled new attachment formation in periodontal pockets. Based on this hypothesis, that laser deepithelialization during root coverage procedures will enhance clinical outcome, a split mouth randomized controlled clinical trial was planned to compare the clinical outcome of Coronally advanced flap (CAF) + subepithelial connective tissue graft (SCTG) alone and in combination with laser de-epithelialization in the treatment of gingival recession.
METHOD:
In a split-mouth study, 20 patients presenting at least one pair of bilaterally symmetrical Miller's Class I and Class II buccal gingival recessions will be selected. Control site will receive coronally advanced flap with connective tissue graft and test site will receive laser deepithelialization as an adjunct to coronally advanced flap with connective tissue graft. Gingival recession depth (GRD), Gingival recession width (GRW), Probing depth (PD), Clinical attachment level (CAL), Keratinized tissue width (KTW), Plaque index (PI), Gingival index (GI), Gingival bleeding index (GBI) will be measured at baseline, 6 weeks, 3 months and 6 months after treatment. The root coverage outcomes were also assessed by photogrammetric analysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CAF+ SCTG+ laser depithelialisation | Active Comparator | CAF + SCTG and Diode (GaAlAs) laser with a wavelength of 820 nm and a power of 1.5 watt in a continuous mode was applied to remove the sulcular epithelium. |
|
| CAF+SCTG+ sham laser depithelialisation | Sham Comparator | CAF+ SCTG+ sham LASER deepithelialisation was applied to remove the sulcular epithelium. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LASER deepithelialization | Device | the selected participants were assigned in test and control. Under LA full thickness flap was reflected until the mucogingival junction and recipient area was prepared. The connective tissue graft harvested from palate was placed on the root surface and secured with 5-0 absorbable sutures. Diode (GaAlAs) laser with a wavelength of 820 nm and a power of 1.5 watt in a continuous mode was applied to remove the sulcular epithelium. The connective tissue graft was placed on the root surface at the level of the CEJ and then secured with 5-0 absorbable sutures in both test and control sites using sling suture.. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of root coverage (PRC) | 6 months | |
| Complete root coverage | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Reductions in recession depth (Rec Red) | 6 months | |
| Gingival recession width (GRW) | 6 months | |
| Probing depth (PD) |
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Inclusion Criteria:• Miller's Class I and II recession defects involving maxillary or mandibular canines or premolars.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Joann Pauline George, MDS | Contact | 09448541637 | drjoannpaulinegeorge@gmail.com | |
| ankita jha, BDS | Contact | 9663597700 | ankita_0901@yahoo.co.in |
| Name | Affiliation | Role |
|---|---|---|
| Joann Pauline George, MDS | krishnadevaraya college of dental sciences | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dr Joann Pauline George | Recruiting | Bangalore | Karnataka | 562157 | India |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22754897 | Background | Nevins ML, Camelo M, Schupbach P, Kim SW, Kim DM, Nevins M. Human clinical and histologic evaluation of laser-assisted new attachment procedure. Int J Periodontics Restorative Dent. 2012 Oct;32(5):497-507. |
| Label | URL |
|---|---|
| reference article | View source |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Aug 1, 2017 | |
| Reset | Jan 31, 2018 | |
| Release | Sep 1, 2020 | |
| Reset | Sep 24, 2020 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Aug 1, 2017 | Jan 31, 2018 | |||
| Sep 1, 2020 |
| ID | Term |
|---|---|
| D005889 | Gingival Recession |
| ID | Term |
|---|---|
| D005882 | Gingival Diseases |
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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|
| Sham LASER deepithelialization | Device | the selected participants were assigned in test and control. Under LA full thickness flap was reflected until the mucogingival junction and recipient area was prepared. The connective tissue graft harvested from palate was placed on the root surface and secured with 5-0 absorbable sutures. sham LASER deepithelialisation was applied to the sulcular epithelium. The connective tissue graft was placed on the root surface at the level of the CEJ and then secured with 5-0 absorbable sutures in both test and control sites using sling suture.. |
|
| 6 months |
| Clinical attachment level (CAL) | 6 months |
| Keratinized tissue width (KTW) | 6 months |
| Sep 24, 2020 |
| D055093 |
| Periodontal Atrophy |