Er,Cr:YSGG Laser for Deepithelialization in Gingival Recession.

Not Applicable

Completed

• Conditions: Gingival Recession, Localized; Keratinized Tissue; Gingival Thickness; Pocket Depth

• Registration Number: NCT07064304
• Lead Sponsor: Wroclaw Medical University

Brief Summary

Abstract: Introduction: The deepithelialized free gingival graft (DGG) technique provides high-quality connective tissue grafts (CTGs) with predictable outcomes for recession cov-erage. This study evaluates a novel method of free gingival graft (FGG) deepithelialization using an Er,Cr:YSGG laser (LDEE) for treating multiple gingival recessions. Methods: A split-mouth study was conducted on 46 (n=46) recessions in 9 patients (23 per test and control group). Sites were randomized. Full-thickness palatal grafts were harvested with a scalpel. In the test group (LDEE), deepithelialization was performed extraorally using an Er,Cr:YSGG laser (2780 nm; 2.5 W, 83.3 mJ, 30 Hz, 600 µm tip). In the control group (DEE), a 15c scalpel was used. All CTGs were applied using the modified coronally advanced tunnel (TUN) technique. Clinical parameters-recession depth (RD), keratinized tissue width (KT), gingival thickness (GT), pocket depth (PD), clinical attachment loss (CAL), pink esthetic score (PES), approximal plaque index (API), mean root coverage (MRC), and complete root coverage (CRC)-were assessed at baseline (T0), 3 months (T1), and 6 months (T2). Results: Both LDEE and DEE groups showed significant improvements in RD, KT, GT, PD, and CAL over time (p \< 0.001). At T1 and T2, KT was significantly higher in the LDEE group (T1: 3.73±0.72 mm; T2: 3.98±0.76 mm) compared to the DEE group (T1: 3.21±0.61 mm; T2: 3.44±0.74 mm; p \< 0.05). Other parameters (RD, GT, PD, CAL) showed no statistically significant intergroup differences at any time point (p \> 0.05). After 6 months, MRC was 95% and CRC 82.6% for LDEE, compared to 94.8% and 82.6% for DEE (p \> 0.05). PES scores were similar between groups at all time points (p \> 0.05). Conclusion: Both laser- and scalpel-deepithelialized grafts effectively treated gingival recessions. LDEE combined with TUN resulted in significantly greater KT width compared to DEE + TUN.

Detailed Description

Not available

Study Timeline

• Study Start: 2021-02-01
• Primary Completion: 2022-08-31
• Study Completion: 2022-08-31
• Status Verified: 2025-06
• Study First Submitted: 2025-06-30
• Study First Submitted QC: 2025-07-10
• Last Update Submitted: 2025-07-10
• Study First Posted: 2025-07-14
• Last Update Posted: 2025-07-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 9

Inclusion Criteria

• Age between 18 and 70 years
• Presence of multiple Miller Class I or II gingival recessions
• Good general and oral health
• Patient consent to participate in the clinical trial
• Availability for follow-up at 3 and 6 months

Exclusion Criteria

• Smoking or history of smoking in the last 6 months
• Systemic diseases affecting wound healing (e.g., diabetes, immunodeficiencies)
• Pregnancy or lactation
• Use of medications that influence periodontal tissues (e.g., immunosuppressants, corticosteroids)
• History of periodontal surgery in the area of interest within the past 12 months Inadequate oral hygiene (plaque index >20%)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Primary Outcome Measures

Name	Time	Method
Change in Recession Depth	Baseline, 3 months, and 6 months postoperatively	Measurement of gingival recession depth in millimeters to evaluate soft tissue response to treatment.; Unit of Measure: mm
Change in Pocket Depth	Baseline, 3 months, and 6 months postoperatively	Probing depth measured from the gingival margin to the base of the periodontal pocket.; Unit of Measure: mm
Change in Pink Esthetic Score	Baseline, 3 months, and 6 months postoperatively	Percentage of interdental spaces with visible plaque, calculated to assess oral hygiene status. A lower percentage indicates better plaque control.; Unit of Measure: percentage (%)
Mean Root Coverage	6 months postoperatively	Average percentage of root surface covered by soft tissue following treatment, calculated across all treated sites.; Unit of Measure: percentage (%)
Change in Keratinized Tissue Width	Baseline, 3 months, and 6 months postoperatively	Measurement of the width of keratinized gingiva in millimeters from the mucogingival junction to the free gingival margin.; Unit of Measure: mm
Change in Gingival Thickness	Baseline, 3 months, and 6 months postoperatively	Assessment of gingival tissue thickness using a standardized probe. Unit of Measure: mm
Change in Clinical Attachment Level	Baseline, 3 months, and 6 months postoperatively	Measurement of the distance from the cementoenamel junction to the base of the periodontal pocket.; Unit of Measure: mm
Complete Root Coverage	6 months postoperatively	Proportion of treated sites that achieved 100% root coverage postoperatively. Unit of Measure: percentage (%)

Secondary Outcome Measures

Name	Time	Method
Histopathological Evaluation of Laser-Treated Connective Tissue Grafts	Immediately postoperatively	Microscopic assessment of grafts treated with Er,Cr:YSGG laser to evaluate the quality of deepithelialization and potential thermal damage. Parameters included the presence of a clear boundary between epithelium and connective tissue, absence of carbonization or necrosis, and preservation of tissue architecture.

Trial Locations

Locations (1)

Dentoplex; 🇵🇱 Bielsko-Biala, Poland