Laser-Assisted Minimally Invasive Esthetic Crown Lengthening Using Flapless vs. Tunneled Flap Approach

Laser-Assisted Minimally Invasive Esthetic Crown Lengthening Using Flapless vs. Tunneled Flap Approach (Randomized Controlled Clinical Trial)

Crown lengthening surgery is one of the most commonly performed periodontal procedures. Multiple techniques have been used throughout the years to overcome the postoperative pain and adverse outcomes that may be associated with surgical crown lengthening. One of the most popular choices among clinicians is using different types of lasers in different techniques to overcome those adverse effects. Treatment effectiveness can be monitored non-invasively through salivary levels of Leukocyte Esterase enzyme and the stability clinical outcomes.

Study Overview

• Status: Enrolling by invitation
• Conditions: Altered Passive Eruption of Teeth
• Intervention / Treatment: Procedure: surgical esthetic crown lengthening; Procedure: laser assissted crown lengthening; Procedure: Laser-assisted tunneled flap approach

• Study Type: Interventional
• Enrollment (Estimated): 45
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Alexandria Governorate
    • Alexandria, Alexandria Governorate, Egypt
      • Alexandria University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Patients with an excessive gingival display of at least 3 mm
2. Age >21 years
3. At least six anterior maxillary teeth requiring ECL
4. Healthy periodontal status, indicated by a full-mouth plaque index and bleeding on probing index scores of <15%.
5. Patients with thick gingival phenotype

Exclusion Criteria:

1. Treatment sites with probing depths more than 3 mm
2. Patients with a history of smoking
3. Patients with a history of mucogingival surgery in the intended treatment area
4. Systemic conditions that could hinder tissue healing (e.g., uncontrolled diabetes and autoimmune diseases)
5. Patients undergoing active orthodontic treatment
6. Presence of any cause of excessive gingival display other than altered passive eruption

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: conventional surgical crown lenhthening; gold standard of treatment	Procedure: surgical esthetic crown lengthening; surgical crown lengthening using scalpels and rotary instruments.
Active Comparator: Laser assissted flapless approach	Procedure: laser assissted crown lengthening; laser-assissted flapless crown lengthening and laser-assissted tunneled flap approach
Active Comparator: Tunneled flap approach	Procedure: Laser-assisted tunneled flap approach; In this approach, the gingival margin will be tunneled to provide visibility for the operator during bone removal using laser.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
leukocyte esterase enzyme assessment using Periomonitor	Periomonitor strips will be used to detect the amount of leukocyte esterase enzyme in saliva	1 month
Clinical outcome stability	Clinical outcome stability will be assessed by measuring the length of the crown and interdental papillae immediately postoperatively, 1 week postoperatively, 1 month postoperatively, 3 months postoperatively and 6 months postoperatively.	6 months
PROM	Binary questionnaire (Yes/No) questions will be asked.	1 week

Secondary Outcome Measures

Outcome Measure	Time Frame
Marginal bone loss evaluated using CBCT	6 months

Collaborators and Investigators

• Sponsor: Alexandria University

Study record dates

Study Major Dates

• Study Start (Actual): March 30, 2026
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: June 4, 2026
• First Submitted That Met QC Criteria: June 12, 2026
• First Posted (Actual): June 16, 2026

Study Record Updates

• Last Update Posted (Actual): June 16, 2026
• Last Update Submitted That Met QC Criteria: June 12, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: periodontology; esthetic crown lengthening; altered passive eruption; leukocyte esterase
• Other Study ID Numbers: 9296348

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No