The Journal of prosthetic dentistry, cilt.134, sa.3, ss.686-693, 2025 (SCI-Expanded)
Statement of problem: Gingival displacement can be effectively performed using mechanical, mechanical–chemical, or laser-based techniques without complications. However, comparative studies evaluating the impact of these methods on inflammatory cytokine levels in gingival crevicular fluid (GCF) and the extent of gingival recession after displacement are lacking. Purpose: The purpose of this randomized split-mouth clinical study was to compare 4 gingival displacement techniques in terms of their effects on gingival recession, levels of tumor necrosis factor-alpha (TNF-α) in GCF, and patient-reported pain perception. Material and methods: Twelve participants with a thick gingival phenotype who required fixed dental prostheses for at least 1 tooth in each quadrant were enrolled. Each participant received 1 of the 4 gingival displacement techniques (mechanical, mechanical-chemical, diode laser, and Nd:YAG laser) assigned to different quadrants before impression making, with only 1 technique applied in each quadrant. Gingival recession was evaluated on days 0, 7, and 28. Periodontal examinations were conducted on days 0, 1, 7, 14, and 28. Pain was measured using a visual analog scale on days 1 and 7. GCF was collected on days 0, 1, and 7 for TNF-α analysis. Nonparametric tests were used for the statistical comparisons (α=.05). Results: No significant intergroup differences were found (P>.05). Intragroup analyses demonstrated statistically significant changes from baseline in periodontal parameters, patient-reported pain scores, gingival recession, and TNF-α levels. By day 28, gingival recession had significantly decreased in all groups (P<.05), except for the mechanical group (P>.05). A significant decrease in visual analog scores was observed by day 7 in all groups (P<.05), except for the diode laser group (P>.05). GCF TNF-α levels showed a significant increase on day 1 (P<.05) except for the mechanical group (P>.05), followed by a return to baseline levels by day 7 in all teeth. Conclusions: Comparable clinical, inflammatory, and pain-related outcomes were observed across all 4 gingival displacement techniques.