Alveolar Ridge Augmentation Assessment Using a Minimalistic Approach, with and without Low-Level Laser Therapy (LLLT)-A Comparative Clinical Trial

Abstract

Background and Objective: A narrow alveolar ridge is an obstacle to optimal rehabilitation of the dentition. There are several complex and invasive techniques to counter the ridge augmentation dilemma, with most of them exhibiting low feasibility. Hence, this randomized clinical trial aims to evaluate the effectiveness of a Minimalistic Ridge Augmentation (MRA) technique, in conjunction with low-level laser therapy (LLLT). Materials and Methods: A total of 20 patients (n = 20) were selected, with 10 assigned to the test group (MRA+LLLT) and the other 10 to the control group (MRA). A vertical incision of approximately 10 mm was placed mesial to the defect and tunneled to create a subperiosteal pouch across the entire width of the defect. At the test sites, a diode laser (AnARC Fox^TM Surgical Laser 810 nm) was used to deliver LLLT (parameters: 100 mW, with a maximum energy distribution of 6 J/cm² in the continuous wave mode for 60 s per point) to the exposed bone surface inside the pouch, followed by graft (G-Graft, Surgiwear^TM, Shahjahanpur, India) deposition with a bone graft carrier. The control sites were not irradiated with a laser. Results: A horizontal ridge width gain of >2 mm was observed in both groups. The changes in bone density for the test and control groups were -136 ± 236.08 HU and -44.30 ± 180.89 HU, respectively. Furthermore, there was no statistically significant difference between the test and control groups in these parameters. Conclusion: The study findings reveal that the MRA technique is relatively simple and feasible for alveolar ridge augmentation. The role of LLLT in the process requires further elucidation.

Keywords: alveolar ridge; bone graft; low-level laser therapy; minimalistic; ridge augmentation; tunneling.

Figure 1

Consort flow diagram showing the randomization, follow-up, and analysis involved in the study.

Figure 2

Surgical technique: (A) preoperative ridge width; (B) vertical incision on the attached gingiva mesial to the defect; (C) flap elevation with periosteal elevator; (D) diode laser tip inserted into the pouch for LLLT; (E) graft carrier inserted for bone graft deposition; (F) graft filled; (G) Vicryl sutures placed; (H) three months follow-up; (I) six months follow-up.

Figure 3

CBCT analysis of the ridge width and bone density. (A) Preoperative ridge width and bone density in the axial plane; (B) preoperative ridge width shown in the coronal plane 10.5 mm above the inferior alveolar nerve; (C) postoperative ridge width and bone density in the axial plane; (D) postoperative ridge width shown in the coronal plane 10.5 mm above the inferior alveolar nerve.