Evaluation of Root Coverage by Connective Graft and Different Root Conditioning Adjunctive Therapies

Effects of Photobiomodulation and Antimicrobial Photodynamic Therapy Associated With Subepithelial Connective Tissue Graft on the Root Coverage of Multiple Gingival Recessions: A Randomized Controlled Clinical Trial.

The aim of this study was to evaluate the effect of two different treatment agents used in conjunction with subepithelial connective graft technique on root coverage outcomes in multiple recession defects. Half of patients will receive root treatment with antimicrobial photodynamic therapy and the other half will receive photobiomodulation therapy by laser on surgery site.

Antimicrobial photodynamic therapy has been widely used in Periodontics to obtain reduction of periodontopathogenic bacteria with absence of systemic side effects and minimal bacterial resistance. Also, it has properties of root demineralization and exposure of collagen fibers. These properties may enhance root coverage in procedures of subepithelial connective graft. Laser photobiomodulation has the potential to increase healing and repair, this can generate gains in the root coverage and dental hypersensitivity.

Inclusion Criteria:

• Multiple Gingival recession - two or more Miller's class I or II (2 to 5 mm of height)
• Indication of root coverage by dentin hypersensitivity or esthetic.
• Minimum palate thickness (1,5mm)
• Visible Enamel cement junction (JCE) on the teeth to be treated and pulp vitality
• Patients without signs of periodontal disease activity and with plaque index and bleeding on probing throughout ≤20%;

Exclusion Criteria:

• Use of drugs that affect periodontal tissues (eg: anticonvulsants, calcium channel blockers, cyclosporine, bisphosphonates, hormone-based contraceptives, steroids)
• Smokers
• Pregnancy
• Diabetics
• History of head and neck radiotherapy
• Teeth with mobility
• Malpositioned teeth
• History of periodontal surgery at the area on the last 12 months
• Patients with orthodontic therapy in progression