Effects of photobiostimulation and antimicrobial photodynamic therapy associated with gingival grafts for root coverage: three-arm randomized clinical trial.

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/cm; 3 J, 30 s/tooth, (23 J/cm/point), and photobiostimulation therapy (PBM) group (n = 18): InAlGaP laser 660 nm; 100 mW, 2.32 W/cm; 7 J, 70 s/flap, 161 J/cm (23 J/cm/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.