Semilunar Coronally Advanced Flap with or without Low Level Laser Therapy in Treatment of Human Maxillary Multiple Adjacent Facial Gingival Recessions: A Clinical Study

Abstract

Semilunar coronally advanced flap (SCAF) and its modifications or adjuncts have been proposed in the literature for root coverage. Low level laser therapy (LLLT) has been shown to enhance wound healing. The aim of this split-mouth randomized controlled clinical trial was to assess the effects of LLLT application with respect to root coverage after SCAF procedure for the treatment of human maxillary multiple adjacent facial gingival recessions. Ten subjects with bilateral multiple adjacent maxillary facial gingival recession defects (Miller I and II) were included in this study (20 in test, 20 in control group). A diode laser (810 nm) at 0.3 watts was applied to test sites during and 1 week after surgery for 10 seconds. Comparisons of the surgical sites were made with clinical measurements. Statistically significant differences were observed between test and control sites in the change in gingival recession depth, gingival recession width, clinical attachment level, and width of the keratinized tissue measurements after 6 months (p = 0.003, p = 0.001, p = 0.006, and p =< 0.001, respectively). The test group presented significantly greater complete root coverage (N = 18/20, 90%) compared with the control group (N = 6/20, 30%) at 6 months post-operatively. Within the confines of this study, the results depicted that a Low Level Laser Technique application may enhance the predictability of SCAF procedure. Further long-term studies with more sample sizes are needed for a stronger evidence base. Gingival recessions are commonly encountered in dentistry and pose an esthetic concern. Minimal gingival recessions can be treated by a Semilunar Coronally Advanced Flap (SCAF), but the predictability and stability of the outcomes are quiet questionable. In the present report, a Low Level Laser Technique (LLLT) application adjunct to SCAF depicted a significant improvement in the predictability and stability of root coverage outcomes (for a period of 6 months) compared with as achieved by SCAF alone. From this report, it can be stated that LLLT may be effectively used in a day to day practice for enhancing the root coverage outcomes of SCAF.