Effect of Er,Cr (YSGG Laser Root Conditioning on the Success of Root
Coverage with Subepithelial Connective Tissue Graft): A Randomized
Clinical Trial with a 6-Month Follow-Up

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Abstract

Objectives:

Finding predictable approaches for root surface biomodification is an important challenge in the treatment of gingival recession. This study sought to assess the root coverage percentage by subepithelial connective tissue graft (SCTG) following root surface conditioning with erbium, chromium: yttrium scandium gallium garnet (Er,Cr:YSGG) laser.

Materials and Methods:

In this split-mouth, randomized clinical trial, 30 teeth with Miller’s Class I and II gingival recession were treated with SCTG (the Langer and Langer technique) with (case group) or without (control group) root surface conditioning with Er,Cr:YSGG laser (wavelength=2780 nm, power=0.75 W, H mode, repetition rate=20 Hz). Recession depth (RD), recession width (RW), clinical attachment level (CAL), and probing depth (PD) were assessed at the baseline (one week before surgery) and at 2 and 6 months postoperatively. The amount of root coverage was quantified in the two groups. Data were analyzed using Friedman test and Wilcoxon signed-rank test.

Results:

No significant difference was noted between the case and control groups in any parameter (P>0.05). Significant improvement occurred in all the measured parameters in the two groups after surgery (P<0.05). The mean root coverage at the end of the study period was 87% and 80% in the case and control groups, respectively (P=0.244), and complete root coverage was achieved in 66% and 60% of the samples in the case and control groups, respectively.

Conclusions:

Root surface conditioning by Er,Cr:YSGG laser improved the mean root coverage and the percentage of complete root coverage. However, these changes were not statistically significant.

Related collections

Most cited references 43

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Subepithelial connective tissue graft technique for root coverage.

B Langer, L. Langer (1985)

This article describes the use of the subepithelial connective tissue graft as a donor source for root coverage. The success of these grafts has been attributed to the double-blood supply at the recipient site from the underlying connective tissue base and the overlying recipient flap. Four cases have been illustrated to demonstrate the versatility of this procedure for areas of single or multiple root coverage especially in the maxillary arch, coverage of existing crown margins and areas requiring a combination of ridge augmentation and root coverage. An increase of 2 to 6 mm of root coverage has been achieved in 56 cases over 4 years with minimal sulcus depth and no recurrence of recession. The donor site is a closed wound which produces less postoperative discomfort.

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Record: found
Abstract: found
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The etiology and prevalence of gingival recession.

Moawia M Kassab, Robert E Cohen (2003)

Gingival recession in its localized or generalized form is an undesirable condition resulting in root exposure. The result often is not esthetic and may lead to sensitivity and root caries. Exposed root surfaces also are prone to abrasion. The purpose of this article is to describe the prevalence, etiology and factors associated with gingival recession. The authors reviewed cross-sectional epidemiologic studies of gingival recession and found that they correlated the prevalence of recession to trauma, sex, malpositioned teeth, inflammation and tobacco consumption. The recent surveys they reviewed revealed that 88 percent of people 65 years of age and older and 50 percent of people 18 to 64 years of age have one or more sites with recession. The presence and extent of gingival recession also increased with age. More than 50 percent of the population has one or more sites with gingival recession of 1 mm or more. The prevalence of gingival recession was found in patients with both good and poor oral hygiene. It has been proposed that recession is multifactorial, with one type being associated with anatomical factors and another type with physiological or pathological factors. Recession has been found more frequently on buccal surfaces than on other aspects of the teeth. Dentists should be knowledgeable about the etiology, prevalence and associating factors of gingival recession, as well as treatment options, so that appropriate treatment modalities can be offered to patients. Treatments for gingival recession include gingival grafting, guided tissue regeneration and orthodontic therapy. Such treatments typically result in esthetic improvement, elimination of sensitivity and a decreased risk of developing root caries.

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Postoperative complications following gingival augmentation procedures.

Petros Damoulis, Jamie Griffin, David W. Cheung … (2006)

Postoperative pain, swelling, and bleeding are the most common complications following soft tissue grafting procedures; however, detailed documentation is sparse in the literature. The aims of this prospective study were as follows: 1) to compare the frequency of complication occurrence after free soft tissue grafting (FSTG) or subepithelial connective tissue grafting (SCTG) procedures; 2) to evaluate the use of an acellular dermal matrix (ADM) as the donor tissue alternative to an FSTG or SCTG; and 3) to identify possible predictors for these complications. Seventy-five FSTG and 256 SCTG procedures were performed in 228 patients by a single operator. In five free soft tissue and 84 bilaminar graft procedures, an ADM was used instead of autogenous tissue. Variables such as the duration and location of procedures, smoking history, gender, and age were recorded. Patients were asked to fill out a questionnaire 1 week after the surgeries regarding postoperative pain, swelling, and bleeding. Data were analyzed using the chi2 test and logistic regression analysis. Odds ratios were calculated for moderate and severe adverse outcomes grouped together. The duration of surgical procedures was highly correlated with pain or swelling post-surgically (P = 0.001). Current smokers were three times more likely to experience post-surgical swelling (P = 0.01). Patients who underwent FSTG procedures were three times more likely to develop post-surgical pain (P = 0.002) or bleeding (P = 0.03) compared to those who received SCTG procedures. When an ADM was applied instead of autogenous tissue, the probability of swelling or bleeding was significantly reduced (odds ratio [OR] = 0.46, P = 0.02 and OR = 0.3, P = 0.001, respectively). Long surgical procedures and smoking may increase the severity and frequency of certain post-surgical complications after gingival augmentation procedures. FSTG procedures incur a higher likelihood for postoperative pain or bleeding than SCTG procedures, whereas the application of an ADM may significantly reduce the probability of swelling and bleeding.

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Author and article information

Journal

Journal ID (nlm-ta): J Dent (Tehran)

Journal ID (iso-abbrev): J Dent (Tehran)

Journal ID (publisher-id): JOD

Journal ID (pmc): JOD

Title: Journal of Dentistry (Tehran, Iran)

Publisher: Tehran University of Medical Sciences

ISSN (Print): 1735-2150

ISSN (Electronic): 2008-2185

Publication date (Print): July 2018

Volume: 15

Issue: 4

Pages: 230-239

Affiliations

[1 ] Assistant Professor, Department of Periodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran

[2 ] Associate Professor, Department of Periodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran

[3 ] Postgraduate Student, Department of Periodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran

[4 ] Assistant Professor, Department of Biostatistics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran

Author notes

Corresponding author: A. Hooshyarfard, Department of Periodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran Dr.A.Hooshyarfard@ 123456gmail.com

Article

Publisher ID: jod-15-230

PMC ID: 6218461

SO-VID: 7ab61b3f-1ffb-4066-8b8e-9711399b4ccc

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 15 January 2018

Date accepted : 11 June 2018

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Effect of Er,Cr (YSGG Laser Root Conditioning on the Success of Root Coverage with Subepithelial Connective Tissue Graft): A Randomized Clinical Trial with a 6-Month Follow-Up

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