Introduction
The purpose of this case series is to evaluate the clinical efficacy of advanced platelet‐rich fibrin (A‐PRF) in combination with coronally advanced flap (CAF) in the management of gingival recession defects and its first of its kind.
Case series
Fourteen systemically healthy patients presenting with 35 RT1 recession defects were treated with A‐PRF + CAF. Recession height (RH), recession width (RW), probing pocket depth (PPD), clinical attachment level (CAL), keratinized tissue height (KTH), and width of attached gingiva (WAG) were measured at baseline, 3, and 6 months. Gingival thickness (GTH) and phenotype were evaluated at baseline and 6 months postsurgery. Mean root coverage percentage (MRC%) was estimated at 3 and 6 months. At the end of 6 months, esthetics was measured on the scale of visual analogue scale (VAS) and recession esthetic scale (RES). Statistically significant reduction in mean RH was observed from baseline (2.49 ± 0.65 mm) to 6 months (0.66 ± 0.80 mm). At 6 months, the MRC% attained was 75.94 ± 26.72. Complete root coverage was achieved in 18 sites. At 6 months, there was a significant gain in GTH, CAL, WAG, and KTH (p ≤ 0.001). The mean RES and VAS esthetic scores were 8.54 ± 1.57 and 8.83 ± 1.17, respectively.
Conclusion
Based on the findings of this study, A‐PRF may be suggested as a viable treatment option for the management of recession in maxillary anteriors and premolars.
ARTICLE INFO ABSTRACTMinimally Invasive Periodontal Surgery (MIPS) is a surgical technique using small incisions indicated for performing regenerative therapy in periodontal defects. It can be performed using magnification from surgical microscopes, surgical telescopes, or endoscopic visualization. MIPS seals the healing wound from the contaminated oral environment by ensuring primary closure. Preserving soft tissues and maintaining minimal gingival recession, minimal hypersensitivity claim to be essential requisites to meet the demands of the patient and the clinician in the esthetic zone. Minimally invasive methods for periodontal treatment yield long-term reductions of probing depths and enhanced clinical attachment levels. The exclusive property of MIPS is that it reduces the chair time required to perform the procedure and results in limited morbidity to the patient during the surgical procedure, as well as in the postoperative period. However, it cannot be applied in all cases. A stepwise decisional algorithm should support clinicians in choosing the proper approach.
The health of the periodontium including the soft tissues – gingiva and periodontal ligament; and the hard tissues – cementum and alveolar bone is of key importance in the overall homeostasis of the dentition. Injury to the periodontal tissues in any form such as microbial, physical, thermal, chemical, mechanical, occlusal and habitual injury affects the harmony of the periodontal attachment apparatus thereby altering the entire functioning of the dentition. The type of tissue damage when trauma is unintentional and iatrogenic tends to be acute and self-limiting. On the other hand, mechanical and occlusal forces could result in chronic damage. This book chapter provides a review on the various forms of non-microbial trauma to the periodontal tissues, their clinical manifestations and its management.
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