Singh Neelesh, Uppoor Ashita, Naik Dilip
Department of Periodontology, Manipal College of Dental Sciences, Manipal University, Light House Hill Road, Mangalore, Karnataka, 575001, India.
Department of Periodontology, DEAN, Manipal College of Dental Sciences, Manipal University, Light House Hill Road, Mangalore, Karnataka, 575001, India.
J Esthet Restor Dent. 2015 Nov-Dec;27(6):355-66. doi: 10.1111/jerd.12160. Epub 2015 May 18.
Semilunar coronally advanced flap (SCAF) and its modifications or adjuncts have been proposed in the literature for root coverage. Low level laser therapy (LLLT) has been shown to enhance wound healing. The aim of this split-mouth randomized controlled clinical trial was to assess the effects of LLLT application with respect to root coverage after SCAF procedure for the treatment of human maxillary multiple adjacent facial gingival recessions.
Ten subjects with bilateral multiple adjacent maxillary facial gingival recession defects (Miller I and II) were included in this study (20 in test, 20 in control group). A diode laser (810 nm) at 0.3 watts was applied to test sites during and 1 week after surgery for 10 seconds. Comparisons of the surgical sites were made with clinical measurements.
Statistically significant differences were observed between test and control sites in the change in gingival recession depth, gingival recession width, clinical attachment level, and width of the keratinized tissue measurements after 6 months (p = 0.003, p = 0.001, p = 0.006, and p =< 0.001, respectively). The test group presented significantly greater complete root coverage (N = 18/20, 90%) compared with the control group (N = 6/20, 30%) at 6 months post-operatively.
Within the confines of this study, the results depicted that a Low Level Laser Technique application may enhance the predictability of SCAF procedure. Further long-term studies with more sample sizes are needed for a stronger evidence base.
Gingival recessions are commonly encountered in dentistry and pose an esthetic concern. Minimal gingival recessions can be treated by a Semilunar Coronally Advanced Flap (SCAF), but the predictability and stability of the outcomes are quiet questionable. In the present report, a Low Level Laser Technique (LLLT) application adjunct to SCAF depicted a significant improvement in the predictability and stability of root coverage outcomes (for a period of 6 months) compared with as achieved by SCAF alone. From this report, it can be stated that LLLT may be effectively used in a day to day practice for enhancing the root coverage outcomes of SCAF.
文献中已提出半月形冠状推进瓣（SCAF）及其改良术式或辅助方法用于牙根覆盖。低强度激光疗法（LLLT）已被证明可促进伤口愈合。本双盲随机对照临床试验的目的是评估在治疗人类上颌多个相邻面部牙龈退缩时，SCAF术后应用LLLT对牙根覆盖的影响。
本研究纳入了10名双侧上颌多个相邻面部牙龈退缩缺损（Miller I级和II级）的受试者（试验组20个部位，对照组20个部位）。在手术期间及术后1周，使用波长810nm、功率0.3瓦的二极管激光对试验部位照射10秒。通过临床测量对手术部位进行比较。
6个月后，试验组和对照组在牙龈退缩深度、牙龈退缩宽度、临床附着水平和角化组织宽度测量值的变化方面存在统计学显著差异（p分别为0.003、0.001、0.006和<0.001）。术后6个月时，试验组的完全牙根覆盖情况（N = 18/20，90%）显著优于对照组（N = 6/20，30%）。
在本研究范围内，结果表明应用低强度激光技术可能会提高SCAF手术的可预测性。需要进行更多样本量的长期研究以获得更有力的证据基础。
牙龈退缩在牙科中很常见，会引起美观问题。轻度牙龈退缩可用半月形冠状推进瓣（SCAF）治疗，但治疗效果的可预测性和稳定性存在很大疑问。在本报告中，与单独使用SCAF相比，SCAF联合应用低强度激光技术（LLLT）在牙根覆盖效果的可预测性和稳定性方面（6个月期间）有显著改善。从本报告可以看出，LLLT可有效应用于日常临床实践中，以提高SCAF的牙根覆盖效果。
