Skip to main content
Top
Published in: Lasers in Medical Science 4/2018

01-05-2018 | Review Article

Effectiveness of laser adjunctive therapy for surgical treatment of gingival recession with flap graft techniques: a systematic review and meta-analysis

Authors: Jing Yan, Jie Zhang, Qian Zhang, Xinlu Zhang, Kui Ji

Published in: Lasers in Medical Science | Issue 4/2018

Login to get access

Abstract

Various flap graft techniques in the treatment of gingival recession have already been reported in the literatures for root coverage. Laser therapy has effects of ablative, hemostatic, and decontamination. Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) to compare the efficacy of flap surgery combined with laser with surgery alone for treating gingival recession. The studies were searched from PubMed, Embase, Web of science, and the Cochrane Central Register of Controlled Trials by two reviewers up to August 2017. The quality of RCTs was assessed by Cochrane Handbook. Data were extracted from studies and analyzed by Review Manager 5.3. 95% confidence interval (CI) and risk ratio (RR) were calculated for dichotomous data. Seven RCTs with 173 patients and 296 teeth were included in the meta-analysis. We found no statistically significant differences between two groups in GRD (gingival recession depth) (P = 0.21), GRW (gingival recession width) (P = 0.92), RES (root esthetic score) (P = 0.21), and CRC (complete root coverage) (P = 0.09). Statistically significant differences were found between two groups in the WKT (width of keratinized tissue) (P < 0.0001) and 1-year follow-up of PD (probing depth) (P = 0.03) and CAL (clinical attachment level) (P < 0.00001). The meta-analysis found that surgery with laser therapy provided clinical advantages in terms of WKT and 1-year follow-up of PD and CAL. However, flap graft associated with laser did not offer additional benefit to root coverage and esthetics in treating gingival recession. More long-term studies are required to assess these parameters.
Literature
1.
go back to reference Kassab MM, Cohen RE (2003) The etiology and prevalence of gingival recession. J Am Dent Assoc 134(2):220–225CrossRefPubMed Kassab MM, Cohen RE (2003) The etiology and prevalence of gingival recession. J Am Dent Assoc 134(2):220–225CrossRefPubMed
2.
go back to reference Smith RG (1997) Gingival recession. Reappraisal of an enigmatic condition and a new index for monitoring. J Clin Periodontol 24(3):201–205CrossRefPubMed Smith RG (1997) Gingival recession. Reappraisal of an enigmatic condition and a new index for monitoring. J Clin Periodontol 24(3):201–205CrossRefPubMed
4.
go back to reference Carnio J, Neiva RF (2014) Mineral trioxide aggregate and subepithelial connective tissue graft for treatment of iatrogenic gingival recession: long-term results. Int J Periodontics Restorative Dent 34(1):71–77CrossRefPubMed Carnio J, Neiva RF (2014) Mineral trioxide aggregate and subepithelial connective tissue graft for treatment of iatrogenic gingival recession: long-term results. Int J Periodontics Restorative Dent 34(1):71–77CrossRefPubMed
5.
go back to reference Cairo F et al (2016) Clinical efficacy of coronally advanced flap with or without connective tissue graft for the treatment of multiple adjacent gingival recessions in the aesthetic area: a randomized controlled clinical trial. J Clin Periodontol 43(10):849–856CrossRefPubMed Cairo F et al (2016) Clinical efficacy of coronally advanced flap with or without connective tissue graft for the treatment of multiple adjacent gingival recessions in the aesthetic area: a randomized controlled clinical trial. J Clin Periodontol 43(10):849–856CrossRefPubMed
6.
go back to reference Santos FR et al (2017) Comparison of conventional and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin. Clin Cosmet Investig Dent 9:7–11CrossRefPubMedPubMedCentral Santos FR et al (2017) Comparison of conventional and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin. Clin Cosmet Investig Dent 9:7–11CrossRefPubMedPubMedCentral
7.
go back to reference Yilmaz E et al (2014) Laser-assisted laterally positioned flap operation: a randomized controlled clinical trial. Photomed Laser Surg 32(2):67–74CrossRefPubMed Yilmaz E et al (2014) Laser-assisted laterally positioned flap operation: a randomized controlled clinical trial. Photomed Laser Surg 32(2):67–74CrossRefPubMed
8.
go back to reference Srinivas BV et al (2015) Treatment of gingival recession using free gingival graft with fibrin fibronectin sealing system: a novel approach. J Pharm Bioallied Sci 7(Suppl 2):S734–S739CrossRefPubMedPubMedCentral Srinivas BV et al (2015) Treatment of gingival recession using free gingival graft with fibrin fibronectin sealing system: a novel approach. J Pharm Bioallied Sci 7(Suppl 2):S734–S739CrossRefPubMedPubMedCentral
9.
go back to reference Cheng Y et al (2016) Efficacy of adjunctive laser in non-surgical periodontal treatment: a systematic review and meta-analysis. Lasers Med Sci 31(1):151–163CrossRefPubMed Cheng Y et al (2016) Efficacy of adjunctive laser in non-surgical periodontal treatment: a systematic review and meta-analysis. Lasers Med Sci 31(1):151–163CrossRefPubMed
10.
go back to reference Dilsiz A, Aydin T, Emrem G (2010) Effects of the combined desensitizing dentifrice and diode laser therapy in the treatment of desensitization of teeth with gingival recession. Photomed Laser Surg 28(Suppl 2):S69–S74PubMed Dilsiz A, Aydin T, Emrem G (2010) Effects of the combined desensitizing dentifrice and diode laser therapy in the treatment of desensitization of teeth with gingival recession. Photomed Laser Surg 28(Suppl 2):S69–S74PubMed
11.
go back to reference Singh N, Uppoor A, Naik D (2015) Semilunar coronally advanced flap with or without low level laser therapy in treatment of human maxillary multiple adjacent facial gingival recessions: a clinical study. J Esthet Restor Dent 27(6):355–366CrossRefPubMed Singh N, Uppoor A, Naik D (2015) Semilunar coronally advanced flap with or without low level laser therapy in treatment of human maxillary multiple adjacent facial gingival recessions: a clinical study. J Esthet Restor Dent 27(6):355–366CrossRefPubMed
12.
go back to reference Medrado AR et al (2003) Influence of low level laser therapy on wound healing and its biological action upon myofibroblasts. Lasers Surg Med 32(3):239–244CrossRefPubMed Medrado AR et al (2003) Influence of low level laser therapy on wound healing and its biological action upon myofibroblasts. Lasers Surg Med 32(3):239–244CrossRefPubMed
13.
go back to reference AlGhamdi KM, Kumar A, Moussa NA (2012) Low-level laser therapy: a useful technique for enhancing the proliferation of various cultured cells. Lasers Med Sci 27(1):237–249CrossRefPubMed AlGhamdi KM, Kumar A, Moussa NA (2012) Low-level laser therapy: a useful technique for enhancing the proliferation of various cultured cells. Lasers Med Sci 27(1):237–249CrossRefPubMed
14.
go back to reference Tuby H, Maltz L, Oron U (2006) Modulations of VEGF and iNOS in the rat heart by low level laser therapy are associated with cardioprotection and enhanced angiogenesis. Lasers Surg Med 38(7):682–688CrossRefPubMed Tuby H, Maltz L, Oron U (2006) Modulations of VEGF and iNOS in the rat heart by low level laser therapy are associated with cardioprotection and enhanced angiogenesis. Lasers Surg Med 38(7):682–688CrossRefPubMed
15.
go back to reference Ozcelik O et al (2008) Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study. J Clin Periodontol 35(3):250–254CrossRefPubMed Ozcelik O et al (2008) Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study. J Clin Periodontol 35(3):250–254CrossRefPubMed
16.
go back to reference Sanz-Moliner JD et al (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):152–158CrossRefPubMed Sanz-Moliner JD et al (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):152–158CrossRefPubMed
17.
go back to reference Dilsiz A et al (2010) Root surface biomodification with Nd:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts. Photomed Laser Surg 28(3):337–343CrossRefPubMedPubMedCentral Dilsiz A et al (2010) Root surface biomodification with Nd:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts. Photomed Laser Surg 28(3):337–343CrossRefPubMedPubMedCentral
18.
go back to reference Dilsiz A, Aydin T, Yavuz MS (2010) Root surface biomodification with an Er:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts. Photomed Laser Surg 28(4):511–517CrossRefPubMedPubMedCentral Dilsiz A, Aydin T, Yavuz MS (2010) Root surface biomodification with an Er:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts. Photomed Laser Surg 28(4):511–517CrossRefPubMedPubMedCentral
19.
go back to reference Ozcelik O, Seydaoglu G, Haytac CM (2016) Diode laser for harvesting de-epithelialized palatal graft in the treatment of gingival recession defects: a randomized clinical trial. J Clin Periodontol 43(1):63–71CrossRefPubMed Ozcelik O, Seydaoglu G, Haytac CM (2016) Diode laser for harvesting de-epithelialized palatal graft in the treatment of gingival recession defects: a randomized clinical trial. J Clin Periodontol 43(1):63–71CrossRefPubMed
20.
go back to reference Ozturan S et al (2011) Coronally advanced flap adjunct with low intensity laser therapy: a randomized controlled clinical pilot study. J Clin Periodontol 38(11):1055–1062CrossRefPubMed Ozturan S et al (2011) Coronally advanced flap adjunct with low intensity laser therapy: a randomized controlled clinical pilot study. J Clin Periodontol 38(11):1055–1062CrossRefPubMed
21.
go back to reference Santamaria MP et al (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. J Periodontol 88(4):320–328CrossRefPubMed Santamaria MP et al (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. J Periodontol 88(4):320–328CrossRefPubMed
22.
go back to reference Donovan TE, Cho GC (2001) Predictable aesthetics with metal-ceramic and all-ceramic crowns: the critical importance of soft-tissue management. Periodontol 27:121–130CrossRef Donovan TE, Cho GC (2001) Predictable aesthetics with metal-ceramic and all-ceramic crowns: the critical importance of soft-tissue management. Periodontol 27:121–130CrossRef
23.
go back to reference Sarfati A et al (2010) Risk assessment for buccal gingival recession defects in an adult population. J Periodontol 81(10):1419–1425CrossRefPubMed Sarfati A et al (2010) Risk assessment for buccal gingival recession defects in an adult population. J Periodontol 81(10):1419–1425CrossRefPubMed
24.
go back to reference Chambrone L et al (2010) Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review. J Periodontol 81(4):452–478CrossRefPubMed Chambrone L et al (2010) Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review. J Periodontol 81(4):452–478CrossRefPubMed
25.
go back to reference Santana RB, Mattos CM, Dibart S (2010) A clinical comparison of two flap designs for coronal advancement of the gingival margin: semilunar versus coronally advanced flap. J Clin Periodontol 37(7):651–658CrossRefPubMed Santana RB, Mattos CM, Dibart S (2010) A clinical comparison of two flap designs for coronal advancement of the gingival margin: semilunar versus coronally advanced flap. J Clin Periodontol 37(7):651–658CrossRefPubMed
26.
go back to reference Huang LH et al (2005) The effect of platelet-rich plasma on the coronally advanced flap root coverage procedure: a pilot human trial. J Periodontol 76(10):1768–1777CrossRefPubMed Huang LH et al (2005) The effect of platelet-rich plasma on the coronally advanced flap root coverage procedure: a pilot human trial. J Periodontol 76(10):1768–1777CrossRefPubMed
27.
go back to reference Moka LR et al (2014) Comparison of coronally advanced and semilunar coronally repositioned flap for the treatment of gingival recession. J Clin Diagn Res 8(6):ZC04–ZC08PubMedPubMedCentral Moka LR et al (2014) Comparison of coronally advanced and semilunar coronally repositioned flap for the treatment of gingival recession. J Clin Diagn Res 8(6):ZC04–ZC08PubMedPubMedCentral
28.
go back to reference Nedelec B et al (2000) Control of wound contraction. Basic and clinical features. Hand Clin 16(2):289–302PubMed Nedelec B et al (2000) Control of wound contraction. Basic and clinical features. Hand Clin 16(2):289–302PubMed
29.
go back to reference Wang CY et al (2015) Light-emitting diode irradiation promotes donor site wound healing of the free gingival graft. J Periodontol 86(5):674–681CrossRefPubMed Wang CY et al (2015) Light-emitting diode irradiation promotes donor site wound healing of the free gingival graft. J Periodontol 86(5):674–681CrossRefPubMed
30.
go back to reference Damante CA et al (2004) Histomorphometric study of the healing of human oral mucosa after gingivoplasty and low-level laser therapy. Lasers Surg Med 35(5):377–384CrossRefPubMed Damante CA et al (2004) Histomorphometric study of the healing of human oral mucosa after gingivoplasty and low-level laser therapy. Lasers Surg Med 35(5):377–384CrossRefPubMed
31.
go back to reference Walsh LJ, L'Estrange PR, Seymour GJ (1996) High magnification in situ viewing of wound healing in oral mucosa. Aust Dent J 41(2):75–79CrossRefPubMed Walsh LJ, L'Estrange PR, Seymour GJ (1996) High magnification in situ viewing of wound healing in oral mucosa. Aust Dent J 41(2):75–79CrossRefPubMed
32.
go back to reference Pini-Prato GP et al (2010) Coronally advanced flap versus connective tissue graft in the treatment of multiple gingival recessions: a split-mouth study with a 5-year follow-up. J Clin Periodontol 37(7):644–650CrossRefPubMed Pini-Prato GP et al (2010) Coronally advanced flap versus connective tissue graft in the treatment of multiple gingival recessions: a split-mouth study with a 5-year follow-up. J Clin Periodontol 37(7):644–650CrossRefPubMed
33.
go back to reference Pini-Prato G et al (2012) Long-term 8-year outcomes of coronally advanced flap for root coverage. J Periodontol 83(5):590–594CrossRefPubMed Pini-Prato G et al (2012) Long-term 8-year outcomes of coronally advanced flap for root coverage. J Periodontol 83(5):590–594CrossRefPubMed
34.
go back to reference Trylovich DJ et al (1992) The effects of the Nd:YAG laser on in vitro fibroblast attachment to endotoxin-treated root surfaces. J Periodontol 63(7):626–632CrossRefPubMed Trylovich DJ et al (1992) The effects of the Nd:YAG laser on in vitro fibroblast attachment to endotoxin-treated root surfaces. J Periodontol 63(7):626–632CrossRefPubMed
35.
go back to reference Kerner S et al (2008) A retrospective study of root coverage procedures using an image analysis system. J Clin Periodontol 35(4):346–355CrossRefPubMed Kerner S et al (2008) A retrospective study of root coverage procedures using an image analysis system. J Clin Periodontol 35(4):346–355CrossRefPubMed
Metadata
Title
Effectiveness of laser adjunctive therapy for surgical treatment of gingival recession with flap graft techniques: a systematic review and meta-analysis
Authors
Jing Yan
Jie Zhang
Qian Zhang
Xinlu Zhang
Kui Ji
Publication date
01-05-2018
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 4/2018
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-018-2440-x

Other articles of this Issue 4/2018

Lasers in Medical Science 4/2018 Go to the issue