Bilaminar technique in the treatment of miller I II gingival recession defects using er:yag laser for the root surface biomodification

In the treatment of the gingival recessions, Er:YAG laser is considered to be used for removing the smear layer and biomodifying the root surface due to its tissue friendly mechanism of action and safety. Exposing the collagen fibers of the root surface, this procedure may lead to enhanced wound healing. The aim of this randomized controlled clinical study was to evaluate the clinical outcomes of coronally advanced flap (CAF) + connective tissue graft (CTG) combined with an Er:YAG laser or an ultrasonic device instrumentation for root surface biomodification.Twenty patients with single Miller I gingival recessions were treated with CAF+ CTG combined with the root surface application of Er:YAG laser (test) (30Hz, 50Mj, under water irrigation) or ultrasonic device (control) with 2 different tips (designed for supragingival scaling and root planing). Plaque and gingival indices, probing depth, clinical attachment level, recession height, gingival thickness and keratinized tissue were evaluated at baseline and 6 months after the surgical procedure, as well as final complete and mean defect coverages.At 6-month follow-up, significant clinical improvements were detected in the evaluated parameters within both treatment groups (p<0.05). However, no significant differences were detected between the groups in any of the evaluated parameters (p>0.05).Within the limits of this study, no significant advantages were obtained for Er:YAG laser over ultrasonic treatment of the root surface in combination with CAF+ CTG. Further long-term studies on larger sample size, accompanied with histological evaluation, are required to provide support and evidence for the clinical and biologic aspects of laser biomodification.