الفهرس 
Review of literatureOnly 14 pages are availabe for public view
Abstract
Treatment of buccal gingival recession is a common requirement due to esthetic concern and root sensitivity. The ultimate goal of root coverage procedure is the complete coverage of gingival recession defect with good appearance related to adjacent soft tissues. Recent systematic reviews showed that CAF is a safe and predictable approach for root coverage and the adjunct use of SCTG enhances the probability to obtain CRC in RT1 and RT2 single gingival recession. The use of lasers in periodontal surgery offers precision of incision, hemostasis that allows clear visions with reducing post- operative patient’s morbidity. LLLT is one of the diode soft tissue laser families that offers superior efficiency being highly absorbed in water together with minimal thermal damage to soft tissues.
The aim of this randomized controlled clinical trial was to evaluate the effect of adjunctive LLLT with SCTG & CAF regarding recipient and donor sites as Primary outcome: Patient centered outcome, postoperative pain and bleeding following SCTG harvesting in both laser and control groups and Secondary outcome: total root coverage and esthetic outcomes in treating RT1 & RT2 recession defects following SCTG and CAF in both laser and control groups.
The current study included a total of twenty patients (14 females and 6 males) with RT1 and RT2 gingival recession defects, those patients were divided into two groups. Laser group included SCTG and CAF with LLLT bio-stimulation on recipient site and palatal donor sites while Control group included SCTG with CAF only.
Pre-surgically, all patients received initial phase I therapy then were re-evaluated after 4 weeks to be scheduled for periodontal surgery only if PI < 10 % & GI < 15%. At baseline clinical parameters were recorded including; PI, GI, PPD, CAL, RD, RW, KTW, WHI and Post-operative bleeding score. In addition GT that measured using CBCT. A bilaminar (SCTG+ CAF) was used in all groups. LLLT bio-stimulation was used immediately after surgery and four successive days following surgery on recipient and donor sites. Recall appointments were carried out at 1, 3, 6 months post-surgically to assess the same clinical parameters at baseline. Moreover post- operative morbidity was assessed using VAS, number of analgesics and patient’s satisfactions.
The laser group results regarding VAS & number of analgesic showed that there was no statistically significant difference from 1 week to 2 weeks as pain disappeared after the 1st week. The highest mean value was found in (After 1 day), while the lowest mean value was found after 1&2 weeks. However, both groups were statistically significant difference from 1st day (day of surgery) followed by 3rd day then to 1 week. In addition, there was statistically significant reduction in mean RH from baseline to 3&6 months post-surgically. At 6 months, % of RC was 75.97%. Moreover, there was statistically significant increase in mean GT from baseline (1.77 ± 0.41) to 6 months post-surgically (3.20 ± 0.25). Regarding KTW, there was statistically significant difference from baseline to 3&6 months and also from 3 months to 6 months.
The control group results regarding VAS & number of analgesic, showed that there was statistically significant difference from 1st week to 2nd week as pain only decreased at this period but not disappeared, however, the highest mean value was found after 1st day followed by 1st week, while the lowest mean value was found after 2nd week. In addition, there was statistically significant reduction in mean RH from baseline to 3&6 months post-surgically. At 6 months, % of RC was 73.67%. Moreover, there was statistically significant increase in mean GT from baseline (1.98 ± 0.23) to 6 months (3.06 ± 0.23). Regarding KTW, no statistically significant difference for the 3 time periods, where the highest value was found after 6 months followed by baseline, while the lowest mean value was found after 3 months post-surgically.
It was concluded that LLLT had an effect on VAS, wound healing and post-operative bleeding than the control group. Recession height, recession width and esthetic outcomes were considerably comparable between laser &control groups. However gingival thickness increased in laser than control group. In addition, the effect of LLLT needed to be investigated by further randomized controlled clinical trials with longer follow-up periods.