COMPARATIVE EVALUATION OF RECESSION COVERAGE FOLLOWING THE USE OF ADJUNCTIVE PHOTOBIOMODULATION OR BIOFUNCTIONALIZATION WITH EMDOGAIN FOR THE MANAGEMENT OF ISOLATED GINGIVAL RECESSION- A RANDOMIZED CONTROLLED TRIAL

Gingival recession (GR) is a common mucogingival deformity with a global prevalence of 78.16%, most frequently affecting mandibular anteriors. It is defined as the apical shift of the gingival margin beyond the cementoenamel junction, leading to root surface exposure, dentin hypersensitivity, esthetic concerns, and root caries. Risk factors include a thin biotype, lack of attached gingiva, bone deficiencies, tooth malposition, and high frenum attachment. With rising esthetic demands, managing GR is essential for both periodontal health and optimal functional outcomes. Coronally Advanced Flap (CAF) with Connective Tissue Graft (CTG) is considered the gold standard, achieving predictable root coverage (61.24–99%), while adjunctive therapies aim to further enhance clinical outcomes by improving wound healing and tissue regeneration. Photobiomodulation (PBM) therapy, utilizing low-level diode lasers (660–980 nm, 0.05–0.5 W), stimulates mitochondrial ATP production, accelerating wound healing, promoting neovascularization, reducing dentinal hypersensitivity, and modulating inflammation. Studies suggest PBM enhances root coverage and patient comfort. Enamel Matrix Derivatives (EMD), such as Emdogain, mimic the natural tooth development process, promoting angiogenesis, fibroblast proliferation, osteoblast differentiation, and anti-inflammatory effects. Systematic reviews indicate that EMD significantly improves complete root coverage when used as an adjunct to CAF. Additionally, studies suggest that combining EMD with CTG enhances clinical outcomes, including recession depth reduction and attachment gain. Despite the well-documented individual benefits of PBM and EMD, comparative evaluations of these adjuncts with CAF+CTG are limited. This randomized controlled clinical trial aims to systematically compare the efficacy of CAF+CTG with adjunctive PBM and CAF+CTG with adjunctive EMD in improving clinical parameters and patient-reported outcomes, bridging this knowledge gap and optimizing treatment approaches for gingival recession management.