Banyś Artur, Fiegler-Rudol Jakub, Grzech-Leśniak Zuzanna, Wiench Rafał, Matys Jacek, Shibli Jamil A, Grzech-Leśniak Kinga
EMDOLA-European Master Degree in Oral Laser Application, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
J Clin Med. 2025 Jul 29;14(15):5335. doi: 10.3390/jcm14155335.
: The deepithelialized free gingival graft (DGG) technique provides high-quality connective tissue grafts (CTGs) with predictable outcomes for recession coverage. This study evaluates a novel method of free gingival graft (FGG) deepithelialization using an Er,Cr:YSGG laser (LDEE) for treating multiple gingival recessions. : A split-mouth study was conducted on 46 ( = 46) recessions in nine patients (23 per test and control group). Sites were randomized. Full-thickness palatal grafts were harvested with a scalpel. In the test group (LDEE), deepithelialization was performed extraorally using an Er,Cr:YSGG laser (2780 nm; 2.5 W, 83.3 mJ, 30 Hz, 600 µm tip). In the control group (DEE), a 15c scalpel was used. All CTGs were applied using the modified coronally advanced tunnel (TUN) technique. Clinical parameters-recession depth (RD), keratinized tissue width (KT), gingival thickness (GT), pocket depth (PD), clinical attachment loss (CAL), pink esthetic score (PES), approximal plaque index (API), mean root coverage (MRC), and complete root coverage (CRC)-were assessed at baseline (T0), 3 months (T1), and 6 months (T2). : Both LDEE and DEE groups showed significant improvements in RD, KT, GT, PD, and CAL over time ( < 0.001). At T1 and T2, KT was significantly higher in the LDEE group (T1: 3.73 ± 0.72 mm; T2: 3.98 ± 0.76 mm) compared to the DEE group (T1: 3.21 ± 0.61 mm; T2: 3.44 ± 0.74 mm; < 0.05). Other parameters (RD, GT, PD, CAL) showed no statistically significant intergroup differences at any time point ( > 0.05). After 6 months, MRC was 95% and CRC 82.6% for LDEE, compared to 94.8% and 82.6% for DEE ( > 0.05). PES scores were similar between groups at all time points ( > 0.05). : Both laser- and scalpel-deepithelialized grafts effectively treated gingival recessions. LDEE combined with TUN resulted in significantly greater KT width compared to DEE + TUN.
去上皮游离龈瓣移植术（DGG）可提供高质量的结缔组织移植片（CTG），用于覆盖牙龈退缩，效果可预测。本研究评估了一种使用铒铬：钇-钪-镓石榴石激光（LDEE）对游离龈瓣（FGG）进行去上皮的新方法，用于治疗多处牙龈退缩。
对9名患者的46处（n = 46）牙龈退缩进行了一项双侧对照研究（试验组和对照组各23处）。将部位随机分组。用手术刀切取全厚腭部移植片。在试验组（LDEE）中，使用铒铬：钇-钪-镓石榴石激光（2780 nm；2.5 W，83.3 mJ，30 Hz，600 µm尖端）在口外进行去上皮。在对照组（DEE）中，使用15c手术刀。所有CTG均采用改良冠向推进隧道（TUN）技术应用。在基线（T0）、3个月（T1）和6个月（T2）时评估临床参数——退缩深度（RD）、角化组织宽度（KT）、牙龈厚度（GT）、牙周袋深度（PD）、临床附着丧失（CAL）、粉色美学评分（PES）、邻面菌斑指数（API）、平均牙根覆盖（MRC）和完全牙根覆盖（CRC）。
LDEE组和DEE组的RD、KT、GT、PD和CAL随时间均有显著改善（P < 0.001）。在T1和T2时，LDEE组的KT显著高于DEE组（T1：3.73±0.72 mm；T2：3.98±0.76 mm）（DEE组：T1：3.21±0.61 mm；T2：3.44±0.74 mm；P < 0.05）。其他参数（RD、GT、PD、CAL）在任何时间点组间均无统计学显著差异（P > 0.05）。6个月后，LDEE组的MRC为95%，CRC为82.6%，DEE组分别为94.8%和82.6%（P > 0.05）。各组在所有时间点的PES评分相似（P > 0.05）。
激光去上皮移植片和手术刀去上皮移植片均能有效治疗牙龈退缩。与DEE + TUN相比，LDEE联合TUN导致KT宽度显著增加。
