Free gingival graft adjunct with low-level laser therapy: a randomized placebo-controlled parallel group study
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This study aimed to evaluate the effect of low-level laser therapy (LLLT) in terms of enhancing wound healing, reducing free gingival graft (FGG) shrinkage and postoperative pain.
Materials and methods
Thirty patients were randomly assigned to receive either FGG + LLLT (test, n = 15) or FGG + plasebo LLLT (control, n = 15). In the test group, a diode laser (810 nm, 0.1 W, energy density 6 J/cm2) was applied immediately after surgery and 1, 3, 7, and 14 days later. Measurements of the graft surface areas of the groups were made with an image-analyzing software at baseline and first, third, and sixth months. Complete wound epithelialization and visual analogue scale (VAS) for pain score were evaluated after surgery.
Shrinkage of the graft was statistically higher in the control than the test group at third and sixth months (p < 0.05). In terms of epithelization of the graft area, the test and control groups did not show any significant difference during the 28-day period (p > 0.05). Besides this, statistically significant differences were observed for VAS pain score and the number of analgesic used (p < 0.05).
The use of an 810-nm diode laser provided additional benefits to FGG in terms of less shrinkage of the graft dimensions and postoperative pain.
Low-level laser therapy reduced the shrinkage of free gingival graft’s surface area after 6 months and enhanced postoperative pain relief.
KeywordsFree gingival graft Low-level laser therapy Shrinkage Visual analogue scale
The authors would like to thank research assistant Mehmet Cihan Sengun (MCS) (Abant Izzet Baysal University, Faculty of Dentistry, Department of Periodontology) for his assistance in laser biostimulation.
Dr. Gunpinar designed the study, supervised all aspects of the research, interpreted the results, and drafted the manuscript. Dr. Yildiz performed all the surgical operations and clinical measurements.
This study was supported by Abant Izzet Baysal University Scientific Research Center in Bolu, Turkey (Project number 2016.06.05.1114).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in full accordance of the decision of the Ethics Committee of the Abant Izzet Baysal University Medical Faculty (acceptance number 2016/49) with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 4.Wilson RD (1983) Marginal tissue recession in general dental practice: a preliminary study. Int J Periodontics Restor Dent 3(1):40–53Google Scholar
- 17.de Medeiros ML, Araujo-Filho I, da Silva EM, de Sousa Queiroz WS, Soares CD, de Carvalho MG, Maciel MA (2017) Effect of low-level laser therapy on angiogenesis and matrix metalloproteinase-2 immunoexpression in wound repair. Lasers Med Sci 32(1):35–43. https://doi.org/10.1007/s10103-016-2080-y CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Boschi ES, Leite CE, Saciura VC, Caberlon E, Lunardelli A, Bitencourt S, Melo DA, Oliveira JR (2008) Anti-inflammatory effects of low-level laser therapy (660 nm) in the early phase in carrageenan-induced pleurisy in rat. Lasers Surg Med 40(7):500–508. https://doi.org/10.1002/lsm.20658 CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Aliasl J, Khoshzaban F, Barikbin B, Naseri M, Kamalinejad M, Emadi F, Razzaghi Z, Talei D, Yousefi M, Aliasl F, Barati M, Mohseni-Moghaddam P, Hasheminejad SA, Esmailzad Nami H (2014) Comparing the healing effects of Arnebia euchroma ointment with petrolatum on the ulcers caused by fractional CO2 laser: a single-blinded clinical trial. Iran Red Crescent Med J 16(10):e16239. https://doi.org/10.5812/ircmj.16239 CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Dias SB, Fonseca MV, Dos Santos NC, Mathias IF, Martinho FC, Junior MS, Jardini MA, Santamaria MP (2015) Effect of GaAIAs low-level laser therapy on the healing of human palate mucosa after connective tissue graft harvesting: randomized clinical trial. Lasers Med Sci 30(6):1695–1702. https://doi.org/10.1007/s10103-014-1685-2 CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Heidari M, Paknejad M, Jamali R, Nokhbatolfoghahaei H, Fekrazad R, Moslemi N (2017) Effect of laser photobiomodulation on wound healing and postoperative pain following free gingival graft: a split-mouth triple-blind randomized controlled clinical trial. J Photochem Photobiol B 172:109–114. https://doi.org/10.1016/j.jphotobiol.2017.05.022 CrossRefGoogle Scholar
- 31.Sanz-Moliner JD, Nart J, Cohen RE, Ciancio SG (2013) The effect of an 810-nm diode laser on postoperative pain and tissue response after modified Widman flap surgery: a pilot study in humans. J Periodontol 84(2):152–158. https://doi.org/10.1902/jop.2012.110660 CrossRefPubMedPubMedCentralGoogle Scholar
- 32.Aras MH, Gungormus M (2010) Placebo-controlled randomized clinical trial of the effect two different low-level laser therapies (LLLT)—intraoral and extraoral—on trismus and facial swelling following surgical extraction of the lower third molar. Lasers Med Sci 25(5):641–645. https://doi.org/10.1007/s10103-009-0684-1 CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Eroglu CN, Keskin Tunc S (2016) Effectiveness of single session of low-level laser therapy with a 940 nm wavelength diode laser on pain, swelling, and trismus after impacted third molar surgery. Photomed Laser Surg 34(9):406–410. https://doi.org/10.1089/pho.2016.4101 CrossRefPubMedPubMedCentralGoogle Scholar
- 35.Ozturan S, Durukan SA, Ozcelik O, Seydaoglu G, Haytac MC (2011) Coronally advanced flap adjunct with low intensity laser therapy: a randomized controlled clinical pilot study. J Clin Periodontol 38(11):1055–1062. https://doi.org/10.1111/j.1600-051X.2011.01774.x CrossRefPubMedPubMedCentralGoogle Scholar
- 38.Santamaria MP, Fernandes-Dias SB, Araujo CF, Lucas da Silva Neves F, Mathias IF, Rebelato Bechara Andere NM, Neves Jardini MA (2017) 2-year assessment of tissue biostimulation with low-level laser on the outcomes of connective tissue graft in the treatment of single gingival recession: a randomized clinical trial. Journal of Periodontology 88 (4):320–328. doi: https://doi.org/10.1902/jop.2016.160391 CrossRefPubMedCentralGoogle Scholar