Effect of GaAlAs 940 nm Photobiomodulation on palatal wound healing after free gingival graft surgery: a split mouth randomized controlled clinical trial

Abstract

Background The aim of this study was to evaluate the effects of photobiomodulation (PBM) on wound healing, pain, and discomfort at free gingival graft (FGG) donor sites. Methods Sixteen patients in need of bilateral FGG were selected for this randomized, controlled, triple-blinded, and split mouth clinical trial. The FGG donor sites in test group were treated with LLLT GaAlAs 940 nm, 5 J/cm2 immediately after surgery and every other day within the following ten days. The control group received sham irradiation. Remaining Wound Area (RWA), Epithelialization and color match were evaluated on the day of surgery and 7, 14, 21, 28, and 60 days after surgery. A questionnaire was administered to measure pain and bleeding in the first ten days after surgery. Results RWA was significantly smaller in the test than control group on the days 7 (p < 0.001) and 14 (p = 0.048) after the surgery. Bleeding was higher in the test group than in the control group on the day of surgery (p = 0.046). Pain and discomfort at the palatal donor site, however, had no significant difference between laser and control group during 11 days after the surgery (p > 0.05), nor did the Color match scores on the 28th and 60th days after the surgery (p > 0.05). Conclusions It can be concluded that PBM enhances FGG donor site wound healing one and two weeks after the surgery. Trial registration IRCT2017092036203N2, registered 01.11.2017.

Wound‐healing agents for palatal donor area: A network meta‐analysis

“…Nine RCTs were included in the pairwise meta-analysis (Bitencourt et al, 2022;Castro-Gaspar et al, 2021;Femminella et al, 2016;Hassan et al, 2020;Işler et al, 2019;Morshedzadeh et al, 2022;Patarapongsanti et al, 2019;Pekbagriyanik et al, 2021;Yilmaz, Comerdov, et al, 2022) and 7 RCTs were included in NMA (Bitencourt et al, 2022;Femminella et al, 2016;Hassan et al, 2020;Işler et al, 2019;Morshedzadeh et al, 2022;Patarapongsanti et al, 2019;Pekbagriyanik et al, 2021) for pain assessment (using Seven RCTs were included in pairwise meta-analysis (Alvarez-Medina et al, 2023;Femminella et al, 2016;Heidari et al, 2017;Isler et al, 2018;Morshedzadeh et al, 2022;Patarapongsanti et al, 2019;Pekbagriyanik et al, 2021) and 8 RCTs were include in NMA (open loop of evidence) (Alpan & Cin, 2023;Heidari et al, 2017;Isler et al, 2018;Miguel, Mathias-Santamaria, Rossato, Ferraz, Figueiredo-Neto, et al, 2021, Miguel, Mathias-Santamaria, Rossato, Ferraz, Rangel, et al, 2021Morshedzadeh et al, 2022;Pekbagriyanik et al, 2021;Yilmaz, Kayaalti-Yuksek, & Karaduman, 2022) for the palatal wound complete epithelialization evaluation (using hydrogen peroxide test) after 14-and 21-day. Pairwise meta-analysis for pain assessment and wound healing were reported in the Appendix S1.…”

“…Laser modulation using LED also promoted less pain in comparison to spontaneous healing (Vieira et al., 2010). However, no differences in pain levels between diode laser and spontaneous healing (da Silva Neves et al., 2016; Dias et al., 2015; Işler et al., 2019), palatal stent (Morshedzadeh et al., 2022), topical gaseous ozone (Isler et al., 2018; Işler et al., 2019), collagen membrane (Işler et al., 2019) and L‐PRF (Işler et al., 2019) were reported in five studies (da Silva Neves et al., 2016; Dias et al., 2015; Isler et al., 2018; Işler et al., 2019; Morshedzadeh et al., 2022). One study described a greater VAS pain score after 3 days of post‐operative in the diode laser group in comparison to spontaneous healing (Heidari et al., 2017).…”

“…Eight studies (Bitencourt et al., 2022; da Silva Neves et al., 2016; Dias et al., 2015; Heidari et al., 2017; Lafzi et al., 2019; Lavu et al., 2022; Morshedzadeh et al., 2022; Mukhtar et al., 2023) reported superior wound healing with the use of diode laser in comparison to spontaneous healing (Bitencourt et al., 2022; da Silva Neves et al., 2016; Dias et al., 2015; Heidari et al., 2017; Lafzi et al., 2019; Lavu et al., 2022), palatal stent (Morshedzadeh et al., 2022) and L‐ PRF (Mukhtar et al., 2023). Laser modulation using LED also promoted higher wound healing in comparison to spontaneous healing (Vieira et al., 2010).…”

“…Nine RCTs were included in the pairwise meta‐analysis (Bitencourt et al., 2022; Castro‐Gaspar et al., 2021; Femminella et al., 2016; Hassan et al., 2020; Işler et al., 2019; Morshedzadeh et al., 2022; Patarapongsanti et al., 2019; Pekbagriyanik et al., 2021; Yilmaz, Comerdov, et al., 2022) and 7 RCTs were included in NMA (Bitencourt et al., 2022; Femminella et al., 2016; Hassan et al., 2020; Işler et al., 2019; Morshedzadeh et al., 2022; Patarapongsanti et al., 2019; Pekbagriyanik et al., 2021) for pain assessment (using VAS) at 1, 3 and 7 days of post‐operative. A direct comparison between cyanoacrylate with the other interventions linked in the evidence network was not possible, consequently, to ensure a closed loop of evidence in NMA for pain assessment, the studies of Yilmaz, Kayaalti‐Yuksek, and Karaduman (2022) and Castro‐Gaspar et al.…”

“…Seven RCTs were included in pairwise meta‐analysis (Alvarez‐Medina et al., 2023; Femminella et al., 2016; Heidari et al., 2017; Isler et al., 2018; Morshedzadeh et al., 2022; Patarapongsanti et al., 2019; Pekbagriyanik et al., 2021) and 8 RCTs were include in NMA (open loop of evidence) (Alpan & Cin, 2023; Heidari et al., 2017; Isler et al., 2018; Miguel, Mathias‐Santamaria, Rossato, Ferraz, Figueiredo‐Neto, et al., 2021, Miguel, Mathias‐Santamaria, Rossato, Ferraz, Rangel, et al., 2021; Morshedzadeh et al., 2022; Pekbagriyanik et al., 2021; Yilmaz, Kayaalti‐Yuksek, & Karaduman, 2022) for the palatal wound complete epithelialization evaluation (using hydrogen peroxide test) after 14‐ and 21‐day. Pairwise meta‐analysis for pain assessment and wound healing were reported in the Appendix S1.…”