Eficácia do laser de baixa potência na cicatrização por primeira intenção e nos fatores centrados do paciente após cirurgia de aumento de coroa clínica em área estética: ensaio clínico randomizado

Abstract

Low-Level Laser (LLL) Therapy has gained interest in Dentistry due to its photobiomodulatory action, which is associated with accelerating tissue repair and reducing postoperative pain. Objective: To evaluate the efficacy of LLL photobiomodulation on primary intention tissue healing and patientcentered outcomes following clinical crown lengthening surgery with osteotomy for aesthetic purposes over a three-month follow-up period. Methods: A total of 27 systemically healthy patients with <10% bleeding on probing and characterized by altered passive eruption participated in this study. It was a split-mouth, triple-blind, randomized, controlled clinical trial. Participants were divided into two groups: control group (CG): hemiarcade underwent surgery only; test group (TG): hemiarcade underwent laser application after surgery (30J, 660nm, 100W, applied for 5 minutes in a sweeping motion across the surgical area). Evaluations were conducted at baseline, on days 4, 7, 11, 14, 45, and three months post-surgery. Laser applications were performed in five sessions: immediately postsurgery and on days 4, 7, 11, and 14. Periodontal parameters evaluated included Bleeding on Probing (BOP), Probing Depth (PD), Gingival Phenotype (GP), Keratinized Mucosa (KM), healing (assessed using the Landry Healing Index), postoperative pain (measured with the Numerical Visual Scale - NVS), quality of life (OHIP-14), patient satisfaction, and aesthetics (measured with the Pink Esthetic Score - PES). A statistical significance level of p < 0.05 and 95% confidence intervals were adopted for analyses. Results: All patients completed the study in a periodontal health state. No statistically significant intergroup differences were observed for healing variables (p > 0.05), postoperative analgesia (p > 0.05), or periodontal aesthetics (p > 0.05) at any time point. However, a positive effect of clinical crown lengthening surgery in aesthetic areas on patient quality of life and satisfaction was observed from baseline to the three-month follow-up (p < 0.001). Conclusion: Low-level laser therapy did not accelerate primary intention tissue healing or reduce pain following clinical crown lengthening surgery, but it had a positive impact on patient satisfaction and quality of life over a three-month follow-up period.