Skip to main content

Advertisement

SpringerLink
Log in

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

  • Review Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Kassab MM, Cohen RE (2003) The etiology and prevalence of gingival recession. J Am Dent Assoc 134(2):220–225

    Article  PubMed  Google Scholar 

  2. Smith RG (1997) Gingival recession. Reappraisal of an enigmatic condition and a new index for monitoring. J Clin Periodontol 24(3):201–205

    Article  CAS  PubMed  Google Scholar 

  3. Mathur A et al (2009) Gingival recession in school kids aged 10-15 years in Udaipur, India. J Indian Soc Periodontol 13(1):16–20

    Article  PubMed  PubMed Central  Google Scholar 

  4. 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):71–77

    Article  PubMed  Google Scholar 

  5. 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):849–856

    Article  PubMed  Google Scholar 

  6. 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 9:7–11

    Article  PubMed  PubMed Central  Google Scholar 

  7. Yilmaz E et al (2014) Laser-assisted laterally positioned flap operation: a randomized controlled clinical trial. Photomed Laser Surg 32(2):67–74

    Article  PubMed  Google Scholar 

  8. 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–S739

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. 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):151–163

    Article  CAS  PubMed  Google Scholar 

  10. 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–S74

    CAS  PubMed  Google Scholar 

  11. 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):355–366

    Article  PubMed  Google Scholar 

  12. 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):239–244

    Article  PubMed  Google Scholar 

  13. 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):237–249

    Article  PubMed  Google Scholar 

  14. 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):682–688

    Article  PubMed  Google Scholar 

  15. 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):250–254

    Article  PubMed  Google Scholar 

  16. 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):152–158

    Article  PubMed  Google Scholar 

  17. 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):337–343

    Article  PubMed  PubMed Central  Google Scholar 

  18. 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):511–517

    Article  PubMed  PubMed Central  Google Scholar 

  19. 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):63–71

    Article  PubMed  Google Scholar 

  20. 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):1055–1062

    Article  PubMed  Google Scholar 

  21. 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):320–328

    Article  PubMed  Google Scholar 

  22. Donovan TE, Cho GC (2001) Predictable aesthetics with metal-ceramic and all-ceramic crowns: the critical importance of soft-tissue management. Periodontol 27:121–130

    Article  CAS  Google Scholar 

  23. Sarfati A et al (2010) Risk assessment for buccal gingival recession defects in an adult population. J Periodontol 81(10):1419–1425

    Article  PubMed  Google Scholar 

  24. Chambrone L et al (2010) Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review. J Periodontol 81(4):452–478

    Article  CAS  PubMed  Google Scholar 

  25. 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):651–658

    Article  PubMed  Google Scholar 

  26. 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):1768–1777

    Article  PubMed  Google Scholar 

  27. 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–ZC08

    PubMed  PubMed Central  Google Scholar 

  28. Nedelec B et al (2000) Control of wound contraction. Basic and clinical features. Hand Clin 16(2):289–302

    CAS  PubMed  Google Scholar 

  29. Wang CY et al (2015) Light-emitting diode irradiation promotes donor site wound healing of the free gingival graft. J Periodontol 86(5):674–681

    Article  CAS  PubMed  Google Scholar 

  30. 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):377–384

    Article  PubMed  Google Scholar 

  31. Walsh LJ, L'Estrange PR, Seymour GJ (1996) High magnification in situ viewing of wound healing in oral mucosa. Aust Dent J 41(2):75–79

    Article  CAS  PubMed  Google Scholar 

  32. 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):644–650

    Article  PubMed  Google Scholar 

  33. Pini-Prato G et al (2012) Long-term 8-year outcomes of coronally advanced flap for root coverage. J Periodontol 83(5):590–594

    Article  PubMed  Google Scholar 

  34. 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):626–632

    Article  CAS  PubMed  Google Scholar 

  35. Kerner S et al (2008) A retrospective study of root coverage procedures using an image analysis system. J Clin Periodontol 35(4):346–355

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Stomatology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300050, China

    Jing Yan, Jie Zhang, Qian Zhang, Xinlu Zhang & Kui Ji

Authors
  1. Jing Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jie Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qian Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xinlu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kui Ji
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jie Zhang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yan, J., Zhang, J., Zhang, Q. et al. Effectiveness of laser adjunctive therapy for surgical treatment of gingival recession with flap graft techniques: a systematic review and meta-analysis. Lasers Med Sci 33, 899–908 (2018). https://doi.org/10.1007/s10103-018-2440-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-018-2440-x

Keywords

Search

Navigation