Rihawi Hummam, Al Habashneh Rola, Abdel-Hafez Reem, Alzoubi Majdi
Quintessence Int. 2025 Mar 18;56(3):226-235. doi: 10.3290/j.qi.b5809024.
This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment in the management of gingival enlargement during orthodontic treatment.
Forty-five healthy, orthodontic patients with labial gingival enlargement on the six anterior teeth were selected and randomly assigned to one of the groups (conventional, laser, and nonsurgical periodontal treatment). Clinical parameters including clinical crown length, periodontal pocket depth, and Vertical Gingival Overgrowth Index were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1, 3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months.
Statistically significant results were obtained for mean reduction in periodontal pocket depth for conventional, laser, and nonsurgical periodontal treatment groups (-1.43, -1.75, and -0.9 mm, respectively; P .001), clinical crown length gain (1.45, 1.70, and 0.35 mm, respectively; P .001) and mean Vertical Gingival Overgrowth Index score (-1.14, -1.29, and -0.76, respectively; P .001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to nonsurgical periodontal treatment (P .001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with the conventional group showing a statistically significant difference in mean pain score on days 1 and 3 compared to other groups.
Both conventional and laser gingivectomies were more effective in controlling enlargement over nonsurgical periodontal treatment alone at 1, 3, and 6 months.
Laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to nonsurgical periodontal treatment alone in the treatment of gingival enlargement and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.
本临床试验旨在评估和比较二极管激光牙龈切除术、传统牙龈切除术和非手术牙周治疗在正畸治疗期间牙龈增生管理中的有效性。
选取45例健康的正畸患者，其上前牙唇侧牙龈增生，随机分为三组（传统组、激光组和非手术牙周治疗组）。在基线、1个月、3个月和6个月时记录临床参数，包括临床冠长度、牙周袋深度和垂直牙龈增生指数。在术后1天、3天和7天评估术后疼痛。在第10天记录对手术的美学满意度和接受度，并在6个月后重复记录。
传统组、激光组和非手术牙周治疗组在6个月时牙周袋深度平均减少量（分别为-1.43、-1.75和-0.9mm；P<0.001）、临床冠长度增加量（分别为1.45、1.70和0.35mm；P<0.001）以及平均垂直牙龈增生指数评分（分别为-1.14、-1.29和-0.76；P<0.001）均获得了具有统计学意义的结果。与非手术牙周治疗相比，两个试验组在6个月时临床参数的变化在统计学上更显著（P<0.001）。三组术后疼痛在7天内逐渐减轻，传统组在第1天和第3天的平均疼痛评分与其他组相比有统计学意义的差异。
在1个月、3个月和6个月时，传统牙龈切除术和激光牙龈切除术在控制牙龈增生方面比单纯非手术牙周治疗更有效。
与单纯非手术牙周治疗相比，激光和传统牙龈切除术作为辅助治疗在正畸治疗期间牙龈增生和牙龈炎症的治疗中取得了更好的效果，两种治疗方法之间无显著临床差异。
