An interventional study of Topical Hyaluronic Acid Gel and Low-Level Laser Therapy in Gingival Recession, Mucogingival Surgery, sponsored by Altinbas University. Recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-07.
Sponsored by Altinbas University · Not applicable, Interventional, and Treatment
The goal of this randomized clinical trial was to learn whether low-level laser therapy or hyaluronic acid application improves healing after free gingival graft surgery in adults with insufficient keratinized gingival tissue in the mandibular lower teeth region.
The main questions it aimed to answer were:
Researchers compared three groups: free gingival graft surgery alone, free gingival graft surgery with low-level laser therapy and free gingival graft surgery with hyaluronic acid application.
Participants underwent free gingival graft surgery and were followed for six months. During follow-up, researchers measured graft size and shrinkage, periodontal clinical measurements, pain at the donor and recipient sites, pain medication use, wound healing, esthetic outcomes, and oral health-related quality of life.
This randomized controlled clinical trial evaluated the effects of low-level laser therapy and hyaluronic acid application on graft shrinkage, postoperative morbidity, wound healing, clinical outcomes, esthetic results, and oral health-related quality of life following free gingival graft surgery. Adult participants with insufficient keratinized gingival tissue in the mandibular anterior region were randomly assigned to one of three parallel groups: free gingival graft surgery alone as the control group, free gingival graft surgery combined with low-level laser therapy, or free gingival graft surgery combined with hyaluronic acid application. All participants underwent a standardized free gingival graft procedure. In the low-level laser therapy group, an 810-nm diode laser was applied at 0.1 W in continuous-wave mode for 60 seconds on the day of surgery and on postoperative days 1, 3, 7, and 14. In the hyaluronic acid group, 0.8% hyaluronic acid gel was applied in addition to the surgical procedure, while the control group received no additional treatment. Postoperative pain at the donor and recipient sites was assessed using a visual analog scale during the first seven postoperative days, and analgesic consumption was recorded. Donor-site epithelialization and early wound healing were evaluated on postoperative days 7, 14, and 21. Clinical periodontal measurements, including recession depth, recession width, vestibular depth, keratinized tissue width, probing depth, plaque index, gingival index, and bleeding on probing, were recorded at baseline and at the 1-, 3-, and 6-month follow-up visits. Graft dimensions and shrinkage were assessed using standardized clinical photographs and digital image analysis, while esthetic outcomes were evaluated during the 3- and 6-month follow-up periods. Oral health-related quality of life was assessed at baseline and at 6 months.
426 studies on the registry are indexed under Gingival Recession; 106 are open to participants now.
This study's planned enrollment of 30 is close to the median of 30 across 390 interventional studies indexed under Gingival Recession.
Browse Gingival Recession studies →Altinbas University is the lead sponsor of 14 studies on the registry; 1 is open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants underwent standardized free gingival graft surgery without additional low-level laser therapy or hyaluronic acid application.
Procedure: Free Gingival Graft Surgery
Participants underwent standardized free gingival graft surgery and received low-level laser therapy using an 810-nm diode laser at 0.1 W in continuous-wave mode for 60 seconds on the day of surgery and on postoperative days 1, 3, 7, and 14.
Device: Low-Level Laser Therapy
Participants underwent standardized free gingival graft surgery. A 0.8% hyaluronic acid gel was applied topically to the palatal donor site immediately after surgery. Participants were also instructed to apply the hyaluronic acid gel to the palatal donor site three times daily for two weeks.
Device: Topical Hyaluronic Acid Gel
A 0.8% hyaluronic acid gel was applied directly to the recipient bed immediately before placement and stabilization of the free gingival graft. The gel was also applied topically to the palatal donor site immediately after surgery. Participants were prescribed the same gel and instructed to apply it to the palatal donor site three times daily for 14 days.
Low-level laser therapy was administered to the palatal donor site and the recipient site using an 810-nm diode laser at 0.1 W in continuous-wave mode for 60 seconds. Laser applications were performed immediately after free gingival graft surgery and repeated on postoperative days 1, 3, 7, and 14.
A standardized free gingival graft was harvested from the palatal donor site and placed and stabilized at the recipient site in the mandibular anterior region to increase the width of keratinized gingiva.
Graft Shrinkage
Free gingival graft area was measured from standardized clinical photographs using ImageJ software. Graft shrinkage was calculated as the percentage reduction in graft area compared with the baseline postoperative graft area. Higher percentage values indicate greater graft shrinkage.
Time frame: Baseline and Months 1, 3, and 6
Postoperative Pain
Postoperative pain at the palatal donor site and mandibular recipient site was recorded separately using a visual analog scale ranging from 0 to 10, where 0 indicated no pain and 10 indicated the worst imaginable pain. Lower scores indicate less postoperative pain.
Time frame: Postoperative Days 1 through 7
Modified Pink Esthetic Score
In this study, the Pink Esthetic Score (PES) was adapted from the original index described by Belser et al. (2009). The index was considered modified (m-PES) because the original PES was developed to evaluate peri-implant soft tissue esthetics, whereas no implants were placed in the present study. Instead, the scoring criteria were applied to free gingival graft (FGG)-treated sites, using the adjacent healthy teeth as the reference for esthetic evaluation. The m-PES included seven variables: mesial papilla, distal papilla, facial mucosal curvature, facial mucosal level, alveolar process deficiency, and the color and texture of the facial soft tissue. Each parameter was scored as 0, 1, or 2, with higher scores indicating a more favorable esthetic outcome. The m-PES was assessed at baseline and at the 6-month follow-up. This modified index was selected because it provides a standardized, objective, and reproducible method for evaluating soft tissue esthetic changes over time.
Time frame: Baseline and Months 3 and 6
Oral Health-Related Quality of Life Assessed by OHIP-14
Oral health-related quality of life was assessed using the validated Turkish version of the 14-item Oral Health Impact Profile (OHIP-14). The questionnaire includes seven domains: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. Each item was scored from 0 (never) to 4 (very often), resulting in a total score ranging from 0 to 56. Lower scores indicate better oral health-related quality of life.
Time frame: Baseline and Month 6
Postoperative Analgesic Consumption
Postoperative analgesic consumption was assessed by recording the number of tablets taken by each participant during the first seven days following free gingival graft surgery. Participants recorded their daily analgesic intake, and the total number of tablets consumed during the postoperative evaluation period was calculated.
Time frame: Postoperative Days 1 through 7
Change in Probing Pocket Depth
Probing pocket depth was measured in millimeters using a UNC-15 periodontal probe. The distance from the gingival margin to the base of the periodontal pocket was recorded at six sites per tooth: mesiobuccal, mid-buccal, distobuccal, mesiolingual/palatal, mid-lingual/palatal, and distolingual/palatal. Lower values indicate shallower periodontal pockets.
Time frame: Baseline and 1, 3, and 6 months after surgery
Change in Plaque Score
Plaque accumulation was assessed dichotomously as present or absent using a periodontal probe. Measurements were performed at four surfaces of each tooth: mesiobuccal, mid-buccal, distobuccal, and mid-lingual/palatal. The plaque score was calculated by dividing the number of plaque-positive surfaces by the total number of examined surfaces and multiplying by 100. Scores range from 0% to 100%, with lower scores indicating better plaque control.
Time frame: Baseline and 1, 3, and 6 months after surgery
Change in Bleeding on Probing Score
Bleeding on probing was assessed using a UNC-15 periodontal probe at six sites per tooth. A site was recorded as positive when bleeding occurred within 10 to 15 seconds after probing and negative when no bleeding occurred. The bleeding on probing score was calculated by dividing the number of bleeding-positive sites by the total number of examined sites and multiplying by 100. Scores range from 0% to 100%, with lower scores indicating less gingival inflammation.
Time frame: Baseline and 1, 3, and 6 months after surgery
Keratinized Tissue Thickness
Keratinized tissue thickness was measured in millimeters at the mid-buccal aspect of the treated tooth, at the midpoint between the gingival margin and the mucogingival junction. Under local anesthesia, a number 25 endodontic spreader with a silicone stop was inserted perpendicular to the tissue until hard tissue was contacted. The penetration depth was subsequently determined by placing the spreader beside a periodontal probe and measuring the distance from the tip of the spreader to the silicone stop. Higher values indicate greater keratinized tissue thickness.
Time frame: Baseline
Change in Gingival Recession Depth
Gingival recession depth was measured in millimeters using a UNC-15 periodontal probe and an individualized 2-mm-thick transparent acrylic splint. A vertical reference groove was prepared on the splint parallel to the long axis of the treated tooth to ensure reproducible probe positioning. The distance from the cementoenamel junction to the gingival margin was recorded. Lower values indicate a reduction in gingival recession depth.
Time frame: Baseline and 1, 3, and 6 months after surgery
Change in Gingival Recession Width
Gingival recession width was measured in millimeters at the widest horizontal dimension of the recession defect. A periodontal probe was positioned horizontally between the mesial and distal margins of the gingival recession at the midline of the defect. Lower values indicate a reduction in gingival recession width.
Time frame: Baseline and 1, 3, and 6 months after surgery
Change in Vestibular Depth
Vestibular depth was measured in millimeters using a periodontal probe and an individualized transparent splint. The probe was positioned within a vertical reference groove on the splint, parallel to the long axis of the treated tooth, and advanced until the mucogingival junction was reached. The distance between the lower border of the splint and the mucogingival junction was recorded as the vestibular depth. Higher values indicate greater vestibular depth.
Time frame: Baseline and 1, 3, and 6 months after surgery
Plan to share: No — Individual participant data will not be shared because a prospective IPD-sharing plan was not included in the study protocol or informed consent process. Only aggregated and anonymized study results will be reported in scientific publications.
Started Sep 2026 (actual). Primary completion is estimated for Mar 2027, 6 months after the start.
Of 233 non-industry interventional studies with no phase under Gingival Recession, half reached primary completion within 19 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 30. This study's planned 6 months is below that.
Counting every sponsor, half of 235 studies reached it within 19 months; a quarter within 11 and three quarters within 30.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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