Advances in adjunctive root coverage techniques: a narrative review of laser therapy, hyaluronic acid, and nanomaterials

Abstract

Gingival recession (GR) is a prevalent condition characterized by the apical migration of the gingival margin, leading to root exposure and aesthetic and functional challenges. While conventional surgical techniques like coronally advanced flaps and connective tissue grafts are considered the gold standard for root coverage, these methods are limited by patient morbidity and inconsistent long-term outcomes. Adjunctive strategies such as laser therapy, hyaluronic acid (HA), and nanomaterials have been introduced to improve clinical results. This narrative review explores the rationale and clinical relevance of these adjunctive therapies in root coverage procedures. This narrative review (2017–2025) critically examines laser therapy, hyaluronic acid, and nanomaterials as adjuncts in surgical root coverage. Human studies were prioritized, with preclinical data included for nanomaterials. Biological mechanisms, clinical efficacy, and limitations were analyzed to provide a comparative perspective and highlight future research directions in periodontal regeneration. The literature indicates that while these therapies offer distinct benefits, their clinical effectiveness remains inconclusive. Laser therapy aids tissue healing, HA offers regenerative effects, and nanomaterials facilitate bioactive delivery. However, clinical evidence on long-term efficacy, especially in achieving consistent root coverage, remains limited. Adjunctive therapies such as laser therapy, HA, and nanomaterials show promise in improving outcomes for gingival recession treatment. However, further high-quality clinical trials are needed to validate their efficacy, safety, and long-term results.