Comparison of two treatment modalities in the management of gingival enlargement during orthodontic treatment: a randomized clinical trial

Objective: This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment in the management of gingival enlargement during orthodontic treatment.
Method and materials: Forty-five healthy, orthodontic patients with labial gingival enlargement on the six anterior teeth were selected and randomly assigned to one of the groups (conventional, laser, and nonsurgical periodontal treatment). Clinical parameters including clinical crown length, periodontal pocket depth, and Vertical Gingival Overgrowth Index were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1, 3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months.
Results: Statistically significant results were obtained for mean reduction in periodontal pocket depth for conventional, laser, and nonsurgical periodontal treatment groups (−1.43, −1.75, and −0.9 mm, respectively; P .001), clinical crown length gain (1.45, 1.70, and 0.35 mm, respectively; P .001) and mean Vertical Gingival Overgrowth Index score (−1.14, −1.29, and −0.76, respectively; P .001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to nonsurgical periodontal treatment (P .001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with the conventional group showing a statistically significant difference in mean pain score on days 1 and 3 compared to other groups.
Conclusion: Both conventional and laser gingivectomies were more effective in controlling enlargement over nonsurgical periodontal treatment alone at 1, 3, and 6 months.
Clinical significance: Laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to nonsurgical periodontal treatment alone in the treatment of gingival enlargement and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.