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Cardoso MV, Sant'Ana ACP, Zangrando MSR, Damante CA. Effects of photobiostimulation and antimicrobial photodynamic therapy associated with gingival grafts for root coverage: three-arm randomized clinical trial. Lasers Med Sci 2025; 40:190. [PMID: 40227516 DOI: 10.1007/s10103-025-04449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Accepted: 04/04/2025] [Indexed: 04/15/2025]
Abstract
To compare the effects of different laser therapies as adjuncts to root coverage of multiple gingival recessions (MGR) through a three-arm parallel study. Fifty-four patients with MGR underwent standardized treatment with subepithelial connective tissue graft of 1 mm. The patients were divided into three groups: control group (C)-scaling only + sham (n = 18), antimicrobial photodynamic therapy (APDT) group (n = 18): toluidine blue O 10 mg/ml acidic pH + InAlGaP laser 660 nm; 100 mW, 2.32 W/cm2; 3 J, 30 s/tooth, (23 J/cm2/point), and photobiostimulation therapy (PBM) group (n = 18): InAlGaP laser 660 nm; 100 mW, 2.32 W/cm2; 7 J, 70 s/flap, 161 J/cm2 (23 J/cm2/point), a total of eight applications, each 48 h, within a 14-day period. Patient-Reported Outcome Measures (PROMs), and quality of life questionnaires (OHIP- 14) were collected up to 12 months. A total of 180 gingival recessions were treated, with the PBM group exhibiting superior outcomes in terms of complete root coverage (CRC) at 6 and 12 months. Complementary clinical outcomes showed no significant differences among groups. The PBM group achieved the highest frequency of completely covered teeth (100%) at six months, compared to the other groups (p: 0.021 PBM vs. APDT and p: < 0.001 PBM vs. C). Despite the study's limitations, the PBM group exhibited more favorable outcomes in CRC and demonstrated superior results in PROMs. The findings suggest that PBM may have contributed to accelerating root coverage outcomes, with positive effects observed as early as 3 months postoperatively and the results were sustained at 6 and 12 months. NCT03462368.
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Theodoro LH, Marcantonio RAC, Wainwright M, Garcia VG. LASER in periodontal treatment: is it an effective treatment or science fiction? Braz Oral Res 2021; 35:e099. [PMID: 34586213 DOI: 10.1590/1807-3107bor-2021.vol35.0099] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
There are several studies that evaluate the use of lasers in periodontal treatment in non-surgical or surgical therapy. However, while several studies showed clinically beneficial effects of some lasers in periodontal treatment, there are few clinical reports of additional advantages of lasers as adjunctive treatments in periodontology. The aim of this paper is to demonstrate and critically analyze the level of scientific evidence of effects of low-level lasers and high-power lasers in periodontology. A narrative review of the studies was carried out in each topic and type of laser or periodontal treatment. In nonsurgical periodontal therapy the results showed that there is an additional clinical benefit when using a diode laser (DL) associated with scaling and root planing (SRP) in patients with moderate to severe periodontitis. The Er:YAG laser seems to be the most suitable for nonsurgical periodontal therapy and promotes the same clinical effects as conventional therapy. In periodontal surgery vaporization of the gingival or mucosal tissue can be carried out with DL, CO2, Nd:YAG, Er:YAG and Er,Cr:YSGG lasers. Photobiomodulation (PBM), mediated by low-level lasers associated with non-surgical periodontal therapy, promotes additional benefits in the short term and accelerates the bone and gingival tissue repair process and also reduces postoperative symptoms of periodontal surgery. The effect of antimicrobial Photodynamic Therapy is relevant in the initial reevaluation periods. Studies have shown controversial results of the use of lasers in periodontics, and this fact may be due to the lack of standard parameters of irradiation in each clinical application.
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Affiliation(s)
- Letícia Helena Theodoro
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Diagnostic and Surgery, Araçatuba, SP, Brazil
| | | | - Mark Wainwright
- Liverpool John Moores University, School of Pharmacy & Biomolecular Sciences, Liverpool, UK
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education - Ilapeo, Curitiba, PR, Brazil
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Laterally closed tunnel technique with and without adjunctive photobiomodulation therapy for the management of isolated gingival recession-a randomized controlled assessor-blinded clinical trial. Lasers Med Sci 2021; 37:1625-1634. [PMID: 34545437 PMCID: PMC8452278 DOI: 10.1007/s10103-021-03411-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/02/2021] [Indexed: 11/01/2022]
Abstract
The objective of this prospective randomized controlled single-center clinical trial was to prove the efficacy of adjunctive photobiomodulation in improving selected outcomes following the use of laterally closed tunnel technique for the management of isolated gingival recession. Nineteen participants (with isolated gingival recession) each treated by laterally closed tunnel technique were randomized to either add on treatment with control (sham laser application) or test group (photobiomodulation with 660 nm diode, 3.5 J/cm2 per point of application). The primary outcome variable was change in recession depth and secondary variables included recession width, width of keratinized gingiva, periodontal biotype, and VAS score for pain assessment and EHS index for early wound healing assessment. Analysis was performed using a linear mixed effects model. There were no significant differences in the gingival recession depth (p = 0.8324) and recession width (p-0.969) at 3-month follow-up. The VAS scores were significantly lower for the test (laterally closed tunnel technique + photobiomodulation) group as compared to control (laterally closed tunnel technique + sham laser) over time (p = < 0.0001) as well as per site (p = 0.0006) The Early Wound Healing Index scores were significantly higher in the test (laterally closed tunnel technique + photobiomodulation) group as compared to control (laterally closed tunnel technique + sham laser) group (p < 0.0001). The adjunctive use of photobiomodulation did not show a better outcome concerning recession depth but appears to provide faster healing of the surgical wounds and better patient comfort. The result needs further evaluation in particular with respect to long-term effect and due to limitation in sample size. Clinical Trial Registry of India: CTRI/2019/11/022012.
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Ebrahimi P, Hadilou M, Naserneysari F, Dolatabadi A, Tarzemany R, Vahed N, Nikniaz L, Fekrazad R, Gholami L. Effect of photobiomodulation in secondary intention gingival wound healing-a systematic review and meta-analysis. BMC Oral Health 2021; 21:258. [PMID: 33985492 PMCID: PMC8120828 DOI: 10.1186/s12903-021-01611-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background Photobiomodulation is widely being used to improve the wound healing process in dentistry and a vast majority of studies have proven its benefits. But there are plenty of knowledge gaps according to the optimal laser characteristics which should be used to maximize the healing effects of lasers. The goal of this systematic review and meta-analysis was to determine the effect of photobiomodulation (PBM) as an adjunctive treatment to periodontal therapies to evaluate secondary intention gingival wound healing and post-operative pain. Methods Five databases (PubMed, Embase, Scopus, ProQuest, and Web of Sciences) were searched up to November 30, 2020, for clinical trials that reported the result of the application of PBM on secondary gingival healing wounds and post-operative pain and discomfort after periodontal surgeries. Two independent reviewers selected the eligible studies and the outcomes of interest were extracted. The quality of eligible studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Results Ultimately, twelve studies were included in this review. The application of PBM as an adjunct to periodontal surgeries resulted in a significant improvement in wound healing indices. The Landry wound healing index at the 7th post-operative day was significantly improved (SMD = 1.044 [95% CI 0.62–1.46]; p < 0.01) in PBM + surgery groups compared to the control groups. There was also a statistically significant increase in the complete wound epithelialization (RR = 3.23 [95% CI 1.66–6.31]; p < 0.01) at the 14th post-operative day compared to the control groups. The methods used to assess the post-operative pain were heterogeneous, and therefore the results were limited which made the meta-analysis for post-operative pain assessment not possible. Conclusion Based on the results of this review, PBM can be effectively used as a method to improve secondary intention wound healing. High-quality randomized clinical trials, however, are needed in the future to identify the optimal PBM irradiation parameters and the effect of PBM on post-operative pain. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01611-2.
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Affiliation(s)
- Pooya Ebrahimi
- Student Research Committee, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Hadilou
- Student Research Committee, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ferdos Naserneysari
- Student Research Committee, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amirmohammad Dolatabadi
- Student Research Committee, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rana Tarzemany
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Nafiseh Vahed
- Research Center for Evidence-Based Medicine, A Joanna Briggs Institute Affiliated Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Fekrazad
- Department of Periodontology, Dental Faculty, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Leila Gholami
- Department of Periodontics, Dental Research Center, School of Dentistry, Hamadan University of Medical Sciences, Shahid Fahmideh Blvd, 654178-38741, Hamadan, Iran.
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Diode versus CO 2 Laser Therapy in the Treatment of High Labial Frenulum Attachment: A Pilot Randomized, Double-Blinded Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217708. [PMID: 33105594 PMCID: PMC7659929 DOI: 10.3390/ijerph17217708] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022]
Abstract
Background: The labial frenula are triangular plicas departing from the alveolar mucosa and attaching themselves at different heights of the gingiva. Sometimes a high attachment can determine a gingival recession. The most suitable surgical resolution is the use of laser devices. The aim of this study was to compare the labial frenulectomy through the use of Diode and CO2 laser techniques in pediatric patients with a high labial frenulum attachment, clarifying at the same time the preventive role of the surgical treatment to avoid further recession. Methods: A pilot randomized, double-blinded clinical trial was conducted to compare both the surgical advantages and the preventive treatment of laser technology using two different wavelengths within a population of pediatric patients with a high labial frenulum attachment. Different parameters intra and post-surgery were taken into account (Bleeding, Wound Healing, Gingival Recession, Periodontal pocket and Numerical Scale Value for pain) to compare Diode versus CO2 laser therapy. Results: Although both the laser devices provide a good performance in the post-operative period, the Diode laser shows better results (p < 0.001) in three of the five parameters evaluated. Conclusions: From the results it was found that the Diode Laser device is more suitable compared to the CO2 device.
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Gholami L, Asefi S, Hooshyarfard A, Sculean A, Romanos GE, Aoki A, Fekrazad R. Photobiomodulation in Periodontology and Implant Dentistry: Part 1. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:739-765. [PMID: 31750783 DOI: 10.1089/photob.2019.4710] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
(Part 2 of this article can be located at www.liebertpub.com/doi/10.1089/photob.2019.4731.) Objective: Finding evidence-based treatment strategies for low-level light therapy (LLLT) and the correct incorporation of these treatment methods in the clinical practice of periodontics. Background: Photobiomodulation has been shown to have biostimulatory, anti-inflammatory and analgesic effects that can be beneficial in periodontal and dental implant treatment procedures. Methods: In this review we have addressed some clinical questions regarding the potential clinical application of low-level light irradiation and its photobiomodulatory effects in periodontology and implantology. The literature was searched for in vivo (animal or clinical) articles written in English in four electronic databases of PubMed, Scopus, Google Scholar, and Cochrane Library until April 2019. Only studies with low irradiation doses without any thermal effects used only for their photobiomodulatory purposes were included. Results: We were able to find relevant studies for all of our questions, and positive effects for the application of light therapy were reported in most of the studies. However, there is still great deal of heterogeneity in terms of study designs and most importantly in light irradiation devices and the parameters used. Owing to this issue it was not possible to reach specific evidence-based irradiation protocols for the questions addressed in this review. Conclusions: Based on our search results, an obvious positive effect of LLLT on stimulation of healing of periodontal soft and hard tissues and reduction of inflammation can be seen. Future well-designed randomized control studies with the same irradiation settings and systematic reviews evaluating the studies found on the questions mentioned are necessary to reach evidence-based recommendations.
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Affiliation(s)
- Leila Gholami
- Dental Implants Research Center, Department of Periodontology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sohrab Asefi
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirarsalan Hooshyarfard
- Dental Implants Research Center, Department of Periodontology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Anton Sculean
- Department of Periodontology, School of Dentistry, University of Bern, Bern, Switzerland
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Zhao L, Wang XY, Xu Y, Meng S. [Relationship of orthodontic treatment and periodontal soft tissue health]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:595-601. [PMID: 30593102 DOI: 10.7518/hxkq.2018.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
With the increasing number of the orthodontic patients, the relationship between periodontal and orthodontic becomes increasingly close. Orthodontic treatment can improve periodontal status, but the adverse clinical problems of periodontal tissue during orthodontic treatment are relatively common. In this paper, we discuss the problems of soft tissue, including causes, prevention, and treatment of gingivitis, gingival enlargement, gingival recession, and gingival invagination in orthodontic treatment.
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Affiliation(s)
- Lei Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiao-Yu Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shu Meng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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