Electrical stimulation effect on coronally advanced flap for the treatment of gingival recession: randomized controlled clinical trial

Author(s)

Felipe Lucas da Silva Neves

• Document type: Doctoral Thesis
• Press: São José dos Campos. 2019-02-25.
• Institution: Universidade Estadual Paulista (Unesp). Instituto de Ciência e Tecnologia. São José dos Campos
• Defense date: 2019-02-06
• Advisor: Mauro Pedrine Santamaria

Abstract

Gingival recession is a very common problem in dentistry and can affect up to 100% of the population. Even the best surgical techniques for root coverage have some variation in their results, and many strategies are used to accelerate the healing process. The objective of this study was to evaluate clinically and through the quantification of several biomarkers, the 6-month results of the coronally advanced flap (CAF), associated or not to an electrostimulation protocol (E) for the treatment of gingival recessions. For this, 40 patients with Miller Class I and II gingival recessions were divided into 2 groups: CAF+E (n=20): advanced flap coronally followed by electrical stimulation and CAF group (n=20): advanced flap coronally and SHAM stimulation. Clinical and patient-centered outcomes were assessed at baseline and 6 months post-procedure. The crevicular fluid of the treated sites was analyzed for cytokines, collagenases and their inhibitors. At six months, both groups had a significant percentage of root coverage and recession reduction, being 79.4±27.2% for CAF and 85.9 ± 17.4% for CAF+E (p=0.6). Complete root coverage was obtained in 53% and 56% of the defects treated with CAF and CAF+E, respectively (p=0.9). At 7 days, patients in the CAF+E group reported less postoperative discomfort (p=0.04). The expression of IL-1β, IL-6, TNF-α and VEGF was significantly reduced in the CAF+E group at 7 and 14 days (p˂0.05), whereas the concentration of MMPs and TIMPs showed no difference between groups in any of the evaluated periods. Electrical stimulation did not present additional benefits when associated with CAF in terms of root coverage for the treatment of gingival recessions. However, the electrotherapy protocol used promoted less postoperative discomfort and favorable modulation of inflammatory markers during the first week of healing. (AU)

• FAPESP's process: 16/07528-9 - Electrical stimulation effect on coronally advanced flap for the treatment of gingival recession: randomized controlled clinical trial
• Grantee: Felipe Lucas da Silva Neves
• Support Opportunities: Scholarships in Brazil - Doctorate