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Erschienen in: Lasers in Medical Science 7/2016

25.06.2016 | Original Article

Comparison of two power densities on the healing of palatal wounds after connective tissue graft removal: randomized clinical trial

verfasst von: Felipe Lucas da Silva Neves, Camila Augusto Silveira, Stephanie Botti Fernandes Dias, Milton Santamaria Júnior, Andrea Carvalho de Marco, Warley David Kerbauy, Antonio Braulino de Melo Filho, Maria Aparecida Neves Jardini, Mauro Pedrine Santamaria

Erschienen in: Lasers in Medical Science | Ausgabe 7/2016

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Abstract

Connective tissue graft (CTG), which is considered to be among the best techniques for treating gingival recession, has presented stable long-term results. However, this technique causes morbidity and discomfort in the palatine region due to graft removal at that site. A previous study reports that photobiomodulation (PBM) using a dosage of 15 J/cm2 may improve wound healing and the patient’s postoperative comfort. However, no other studies in the literature provide the best application dosage or comparisons between protocols for this purpose. The aim of this study is to compare two power densities of PBM on the wound-healing process of the donor palatine area after CTG removal. In this study, 51 patients presenting buccal gingival recession were randomized into one of the following groups: group 1: CTG procedure for root coverage and PBM application at the donor site using a 60 J/cm2 dose; group 2: CTG and PBM application using a 30 J/cm2 dose; or group 3: CTG and sham application. The evaluated parameters were the wound remaining area (WRA), scar and tissue colorimetry (TC), tissue thickness (TT), and postoperative discomfort (D), evaluated at baseline and 7, 14, 45, 60, and 90 days after surgery. Group 1 presented statistically significant smaller wounds at day 7 (p > 0.05). None of the patients presented scars at the operated area, and all of the patients reported mild discomfort, with low consumption of analgesic pills. We concluded that the protocol of 60 J/cm2 provided faster wound healing 7 days after removing the connective tissue graft for root coverage. Trial registration: ClinicalTrial.org (NCT02580357) https://​clinicaltrials.​gov/​ct2/​show/​NCT02580357.
Literatur
1.
Zurück zum Zitat Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–6CrossRefPubMed Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–6CrossRefPubMed
2.
Zurück zum Zitat Serino G, Wennstrom JL, Lindhe J, Enertoh L (1994) The prevalence and distribution of gingival recession in subjects with high standard of oral hygiene. J Clin Periodontol 21:57–63CrossRefPubMed Serino G, Wennstrom JL, Lindhe J, Enertoh L (1994) The prevalence and distribution of gingival recession in subjects with high standard of oral hygiene. J Clin Periodontol 21:57–63CrossRefPubMed
3.
Zurück zum Zitat Löe H, Anerud A, Boysen H (1992) The natural history of periodontal disease in man: prevalence, severity, extent of gingival recession. J Clin Periodontol 63:489–495CrossRef Löe H, Anerud A, Boysen H (1992) The natural history of periodontal disease in man: prevalence, severity, extent of gingival recession. J Clin Periodontol 63:489–495CrossRef
4.
Zurück zum Zitat Susin C, Haas AN, Oppermann RV, Haugejorden O, Albandar JM (2004) Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population. J Periodontol 75(10):1377–1386CrossRefPubMed Susin C, Haas AN, Oppermann RV, Haugejorden O, Albandar JM (2004) Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population. J Periodontol 75(10):1377–1386CrossRefPubMed
5.
Zurück zum Zitat Cairo F, Pagliaro U, Nieri M (2014) Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. A systematic review. J Clin Periodontol 41(15):44–62CrossRef Cairo F, Pagliaro U, Nieri M (2014) Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. A systematic review. J Clin Periodontol 41(15):44–62CrossRef
6.
Zurück zum Zitat Chambrone L, Sukekava F, Araújo MG, Pustiglioni FE, Chambrone LA, Lima LA (2010) Root coverage procedures for the treatment of localized recession-type defects—a Cochrane systematic review. J Periodontol 81(4):452–478CrossRefPubMed Chambrone L, Sukekava F, Araújo MG, Pustiglioni FE, Chambrone LA, Lima LA (2010) Root coverage procedures for the treatment of localized recession-type defects—a Cochrane systematic review. J Periodontol 81(4):452–478CrossRefPubMed
7.
Zurück zum Zitat Chambrone L, Tatakis DN (2015) Periodontal soft tissue root coverage procedures: a systematic review from the AAP regeneration workshop. J Periodontol 86(2):8–51CrossRef Chambrone L, Tatakis DN (2015) Periodontal soft tissue root coverage procedures: a systematic review from the AAP regeneration workshop. J Periodontol 86(2):8–51CrossRef
8.
Zurück zum Zitat Langer B, Langer L (1985) Subepithelial connective tissue graft technique for root coverage. J Periodontol 56(12):715–720CrossRefPubMed Langer B, Langer L (1985) Subepithelial connective tissue graft technique for root coverage. J Periodontol 56(12):715–720CrossRefPubMed
9.
Zurück zum Zitat Harris RJ, Harris AW (1994) The coronally positioned pedicle graft with inlaid margins: a predictable method of obtaining root coverage of shallow defects. Int J Periodontics Restorative Dent 14:228–241PubMed Harris RJ, Harris AW (1994) The coronally positioned pedicle graft with inlaid margins: a predictable method of obtaining root coverage of shallow defects. Int J Periodontics Restorative Dent 14:228–241PubMed
10.
Zurück zum Zitat Pini-Prato GP, Cairo F, Nieri M, Franceschi D, Rotundo R, Cortellini P (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, Cairo F, Nieri M, Franceschi D, Rotundo R, Cortellini P (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
11.
Zurück zum Zitat Cardaropoli D, Tamagnone L, Roffredo A, Gaveglio L (2012) Treatment of gingival recession defects using coronally advanced flap with a porcine collagen matrix compared to coronally advanced flap with connective tissue graft: a randomized controlled clinical trial. J Periodontol 83(3):321–328CrossRefPubMed Cardaropoli D, Tamagnone L, Roffredo A, Gaveglio L (2012) Treatment of gingival recession defects using coronally advanced flap with a porcine collagen matrix compared to coronally advanced flap with connective tissue graft: a randomized controlled clinical trial. J Periodontol 83(3):321–328CrossRefPubMed
12.
Zurück zum Zitat Karu T (1998) The science of low power laser therapy. Gordon and Breach Science Publishers, Australia Karu T (1998) The science of low power laser therapy. Gordon and Breach Science Publishers, Australia
13.
Zurück zum Zitat Sun G, Tunér J (2004) Low-level laser therapy in dentistry. Dent Clin N Am 48(4):1061–1076CrossRefPubMed Sun G, Tunér J (2004) Low-level laser therapy in dentistry. Dent Clin N Am 48(4):1061–1076CrossRefPubMed
14.
Zurück zum Zitat Fahimipour F, Mahdian M, Houshmand B, Asnaashari M, Sadrabadi AN, Farashah SE, Mousavifard SM, Khojasteh A (2013) The effect of He-Ne and Ga-Al-As laser light on the healing of hard palate mucosa of mice. Lasers Med Sci 28:93–100CrossRefPubMed Fahimipour F, Mahdian M, Houshmand B, Asnaashari M, Sadrabadi AN, Farashah SE, Mousavifard SM, Khojasteh A (2013) The effect of He-Ne and Ga-Al-As laser light on the healing of hard palate mucosa of mice. Lasers Med Sci 28:93–100CrossRefPubMed
15.
Zurück zum Zitat Fernandes-Dias SB, de Marco AC, Santamaria M Jr, Kerbauy WD, Jardini MAN, Santamaria MP (2015) Connective tissue graft associated or not with low laser therapy to treat gingival recession: randomized clinical trial. J Clin Periodontol 42(1):54–61CrossRefPubMed Fernandes-Dias SB, de Marco AC, Santamaria M Jr, Kerbauy WD, Jardini MAN, Santamaria MP (2015) Connective tissue graft associated or not with low laser therapy to treat gingival recession: randomized clinical trial. J Clin Periodontol 42(1):54–61CrossRefPubMed
16.
Zurück zum Zitat 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
17.
Zurück zum Zitat Dias SB, Fonseca MV, Dos Santos NC, Mathias IF, Martinho FC, Junior MS, Jardini MA, Santamaria MP (2014) 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):1695–1702CrossRefPubMed Dias SB, Fonseca MV, Dos Santos NC, Mathias IF, Martinho FC, Junior MS, Jardini MA, Santamaria MP (2014) 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):1695–1702CrossRefPubMed
18.
Zurück zum Zitat Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG, CONSORT (2012) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomized trials. Int J Surg 10:28–55CrossRefPubMed Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG, CONSORT (2012) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomized trials. Int J Surg 10:28–55CrossRefPubMed
19.
Zurück zum Zitat Zucchelli G, Amore C, Sforza NM, Montebugnoli L, De Sanctis M (2003) Bilaminar techniques for the treatment of recession-type defects. A comparative clinical study. J Clin Periodontol 30:862–870CrossRefPubMed Zucchelli G, Amore C, Sforza NM, Montebugnoli L, De Sanctis M (2003) Bilaminar techniques for the treatment of recession-type defects. A comparative clinical study. J Clin Periodontol 30:862–870CrossRefPubMed
20.
Zurück zum Zitat Bruno JF (1994) Technique de greffe conjonctive assurant le recouvrement de denudations radidulaires ét endues. Rev Int Parodont Dent Rest 14:127–137 Bruno JF (1994) Technique de greffe conjonctive assurant le recouvrement de denudations radidulaires ét endues. Rev Int Parodont Dent Rest 14:127–137
21.
Zurück zum Zitat Knösel M, Attin R, Jung K, Brunner E, Kubein-Meesenburg D, Attin T (2009) Digital image color analysis compared to direct dental CIE colorimeter assessment under different ambient conditions. Am J Dent 22(2):67–72PubMed Knösel M, Attin R, Jung K, Brunner E, Kubein-Meesenburg D, Attin T (2009) Digital image color analysis compared to direct dental CIE colorimeter assessment under different ambient conditions. Am J Dent 22(2):67–72PubMed
22.
Zurück zum Zitat Nagashima T, Kidokoro H, Isigaki H (1982) Intra-arterial infusion of PGE1 in peripheral arterial disease. J Gendai Iryou 14:1000–1013 Nagashima T, Kidokoro H, Isigaki H (1982) Intra-arterial infusion of PGE1 in peripheral arterial disease. J Gendai Iryou 14:1000–1013
23.
Zurück zum Zitat Mendez TM, Pinheiro AL, Pacheco MT, Nascimento PM, Ramanho LM (2004) Dose and wavelength of laser light have influence on the repair of cutaneous wounds. J Clin Med Surg 22(1):19–25CrossRef Mendez TM, Pinheiro AL, Pacheco MT, Nascimento PM, Ramanho LM (2004) Dose and wavelength of laser light have influence on the repair of cutaneous wounds. J Clin Med Surg 22(1):19–25CrossRef
24.
Zurück zum Zitat de Melo Rambo CS, Silva JA Jr, Serra AJ, Ligeiro AP, de Paula VR, Albertini R, Leal-Junior EC, de Tarso CCP (2014) Comparative analysis of low-level laser therapy (660 nm) on inflammatory biomarker expression during the skin wound-repair process in young and aged rats. Lasers Med Sci 29(5):1723–1733CrossRefPubMed de Melo Rambo CS, Silva JA Jr, Serra AJ, Ligeiro AP, de Paula VR, Albertini R, Leal-Junior EC, de Tarso CCP (2014) Comparative analysis of low-level laser therapy (660 nm) on inflammatory biomarker expression during the skin wound-repair process in young and aged rats. Lasers Med Sci 29(5):1723–1733CrossRefPubMed
25.
Zurück zum Zitat Thoma DS, Sancho-Puchades M, Ettlin DA, Hämmerle CH, Jung RE (2012) Impact of a collagen matrix on early healing, aesthetics and patient morbidity in oral mucosal wounds—a randomized study in humans. J Clin Periodontol 39:157–165CrossRefPubMed Thoma DS, Sancho-Puchades M, Ettlin DA, Hämmerle CH, Jung RE (2012) Impact of a collagen matrix on early healing, aesthetics and patient morbidity in oral mucosal wounds—a randomized study in humans. J Clin Periodontol 39:157–165CrossRefPubMed
Metadaten
Titel
Comparison of two power densities on the healing of palatal wounds after connective tissue graft removal: randomized clinical trial
verfasst von
Felipe Lucas da Silva Neves
Camila Augusto Silveira
Stephanie Botti Fernandes Dias
Milton Santamaria Júnior
Andrea Carvalho de Marco
Warley David Kerbauy
Antonio Braulino de Melo Filho
Maria Aparecida Neves Jardini
Mauro Pedrine Santamaria
Publikationsdatum
25.06.2016
Verlag
Springer London
Erschienen in
Lasers in Medical Science / Ausgabe 7/2016
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-016-1988-6

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