Comparative assessment between bio-adhesive material and silk suture in regard to healing, clinical attachment level and width of keratinized gingiva in gingival recession defects cases

The objective of this study was to compare the silk suture with a cyanoacrylate adhesive to stabilize the free gingival graft in conjunction with Er: YAG laser-assisted recipient site preparation to augment the keratinized tissue in gingival recession cases. This randomized trial comprised of 300 recession defects patients. All the included patients were diagnosed using Miller class I and II gingival recession defects classification. Group I sites were treated with a free gingival graft (FGG) harvested using an Er: YAG laser and further sutured with silk. Group II sites were stabilized with isoamyl 2 cyanoacrylate bio-adhesive material. Clinical parameters, such as gingival recession depth, clinical attachment level, gain in gingival tissue thickness, and width of keratinized gingiva were recorded at baseline, and at third month, sixth month, and 12th month postoperatively. The mean changes in gingival recession from months 3 to 6 and months and 6 to 12 were significant (p < 0.05) in both groups. However, the improvement in recession depth was better in group II than in group I. The mean change in clinical attachment level did not differ significantly between the groups at the different time intervals. However, values tended to be higher in group II than in group I. The width of the keratinized gingiva tended to be higher from baseline to 3 months, baseline to 6 months, baseline to 12 months, 3 to 6 months, and from 6 to 12 months in group II as compared with group I (p > 0.05). Cyanoacrylate could be used as a substitute to silk sutures to stabilize FGGs. Cyanoacrylate was easy to apply, consumed less operating time, and was considered equally efficacious for stabilizing FGGs.

All done procedure by laser in free gingival graft treatment: A case series study

AIM

This case series study evaluated the application of Er;Cr:YSGG laser for a free gingival graft procedure and the effect of low level laser therapy on post surgical pain and wound healing.

CASES

6 cases with mucogingival problems needing free gingival grafts were selected. First, the recipient site was anesthetized and de-epithelialization was done with a Er;Cr:YSGG laser. After tracing the palatal donor site with the laser, the graft was harvested. For root modification of the recipient tooth, conditioning of the dentin was done by the same laser. The inner side of graft was trimmed by the laser before suturing at the recipient site. After final adaptation of the grafts and suturing process, the recipient and donor sites were irradiated by therapeutic laser for reduction of post surgical complications.

RESULTS

All patients reported the reduction in pain level after day 2 on donor and recipient site. Also, the wound healing was achieved after 14 days in all cases in donor site.

CONCLUSION

According to high surface absorbance, better incision, coagulation and application on both soft and hard tissues, Er;Cr:YSGG laser can be safe, minimally invasive manner and useful for all steps of the free gingival graft procedure.