Comparative clinical evaluation of coronally advanced flap with or without platelet rich fibrin membrane in the treatment of isolated gingival recession

Abstract

Aim:The aim of this study was to determine whether the addition of an autologous platelet rich fibrin (PRF) membrane to a coronally advanced flap (CAF) would improve the clinical outcome in terms of root coverage, in the treatment of isolated gingival recession.Materials and Methods:Systemically healthy 20 subjects each with single Miller's class I or II buccal recession defect were randomly assigned to control (CAF) or test (CAF + PRF) group. Clinical outcome was determined by measuring the following clinical parameters such as recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), width of keratinized tissue (WKT), gingival thickness (GTH), plaque index (PI), and gingival index (GI) at baseline, 3rd, and 6th month postsurgery.Results:The root coverage was 65.00 ± 44.47% in the control group and 74.16 ± 28.98% in the test group at 6th month, with no statistically significant difference between them. Similarly, CAL, PD, and WKT between the groups were not statistically significant. Conversely, there was statistically significant increase in GTH in the test group.Conclusion:CAF is a predictable treatment for isolated Miller's class I and II recession defects. The addition of PRF to CAF provided no added advantage in terms of root coverage except for an increase in GTH.

Platelet-Rich Fibrin as a New Approach in Treating Gingival Recession: Systematic Review and Meta-Analysis

“…The age of the participants ranged from 18 to 52 years with a follow-up period ranging from 6 to 12 months. Four included studies compared PRF in conjunction with CAF (PRF + CAF) to CAF alone (CAF) [31,33,36,40] while other four studies compared PRF + CAF to CAF in conjunction with CTG (CAF + CTG) [34,35,37,39]. One study assessed the effect of the addition of PRF to CAF in conjunction to CTG (PRF + CTG + CAF) and compared the results with CAF + CTG [32].…”

“…While, one study included all teeth [40]. The remaining three studies did not mention the type of teeth treated in a detailed manner [31,36,38]. All studies included Miller's class I and II GR; however the exact baseline depth of recession was mentioned in only one study [38].…”

“…Four studies clearly included both maxillary and mandibular (2) teeth [31,32,35,40], where as two included maxillary teeth only [33,39]. The remaining four studies did not mentioned which arch was treated [34,36,37,38].…”

“…A full thickness periosteal flap was elevated on the buccal aspect of the tooth being treated in four trials [31,36,37,39], where one of them obtained a trapezoidal full thickness flap by the addition of two vertical incisions starting from its mesial and distal extremities extending beyond the muco-gingival junction [31]. Howeve, the other three did not perform any vertical incisions [36,37,39].…”

“…Study design and patient features: Ten RCTs [31][32][33][34][35][36][37][38][39][40] were included as shown in Table 1. The age of the participants ranged from 18 to 52 years with a follow-up period ranging from 6 to 12 months.…”