Coronally advanced flap and connective tissue graft with or without plasma rich in growth factors (PRGF) in treatment of gingival recession

Abstract

BackgroundSeveral researchers have tried to improve the results of gingival recession treatment techniques. One of the methods is to use growth factors The present study was undertaken to evaluate the effect of CAF (coronally advanced flap) + CTG (connective tissue graft) + PRGF (plasma rich in growth factors) in the treatment of Miller Class I buccal gingival recession.Material and MethodsTwenty-two teeth with Miller Class I gingival recession in 6 patients 26 ‒ 47 years of age were included in a split-mouth designed randomized controlled trial (RCT). In each patient, one side was treated with CAF + CTG + PRGF (test) and the other side was treated with CAF + CTG (control). The following parameters were measured before surgery and up to 6 months after surgery on the mid-buccal surface of the tooth: keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), vertical recession depth (VRD), recession depth (RD), gingival thickness (GT), root coverage in percentage (RC%) and the distance between the CEJ and mucogingival junction (MGJL). Data were analyzed with paired t-test and repeated measures ANOVA.ResultsAfter 6 months noticeable improvements were observed in both groups in all the variables measured except for PD; however, the differences between the two groups were not significant. RC% was 80 ± 25% and 67 ± 28% in the test and control groups, respectively, after 6 months.ConclusionsBoth CAF + CTG + PRGF and CAF + CTG treatment modalities resulted in favorable root coverage; however, the addition of PRGF added no measurable significant effect. Key words:Connective tissue graft, dental root coverage, gingival recession, growth factors, mucogingival surgery, periodontal plastic surgery.

Clinical evaluation of injectable platelet‐rich fibrin with connective tissue graft for the treatment of deep gingival recession defects: A controlled randomized clinical trial

“…Similar results were confirmed by Jenabian et al (2018). Diversity of these findings may be explained with different PRF characteristics which are affected by preparation methods, application models and concentration of GFs (Jenabian et al, 2018).…”

“…Although CAF is a predictable RC method and CTG might increase the probability of CRC, inconsistent CRC outcomes (18.1% to 86.7%) and limited regeneration of the missing attachment apparatus have been reported after the use of CAF+CTG (Chambrone et al, ; Keceli, Kamak, Erdemir, Evginer, & Dolgun, ). Therefore, many materials capable of stimulating tissue regeneration, have been proposed to improve outcomes for obtaining the best healing results (Cairo et al, ; Eren & Atilla, , ; Jankovic, Zoran, Iva, & Bozidar, ; Jenabian, Motallebnejad, Zahedi, Sarmast, & Angelov, ; Keceli et al, ; Kuka, Ipci, Cakar, & Yılmaz, ).…”

Biologics‐based regenerative technologies for periodontal soft tissue engineering

“…Platelet‐rich plasma (PRP) and plasma rich in growth factor (PRGF) are considered the first generation of PCs . Their impact on root coverage outcomes has been shown to be minimal and in general, non‐significant . The biological limitation of autogenous platelet concentrates is that the growth factor (GF) composition is orders of magnitude lower than can be achieved with recombinant GFs such as PDGFs and FGFs.…”

“…46 Their impact on root coverage outcomes has been shown to be minimal and in general, non-significant. [47][48][49] The biological limitation of autogenous platelet concentrates is that the growth factor (GF) composition is orders of magnitude lower than can be achieved with recombinant GFs such as PDGFs and FGFs. As such, it remains questionable that biologically relevant concentrations to promote significant regeneration can be achieved with these procedures.…”

Miller Class III root coverage with coronary tissue repositioning associate with conjunctive graft

“…Gingival Recessions (GR) are understood as processes of apical migration of periodontal tissues in relation to the cement-enamel junction, that is, they result in an inadequate positioning of the periodontium of protection, causing the consequent root exposure of the dental elements involved; which corroborates with the existence of aesthetic problems, the propensity for the appearance of root caries, and an increase in the thermal and tactile dental sensibility. This condition has several etiological factors, such as anatomical variations, occlusal alterations, periodontal diseases, inappropriate dental brushing, or due to deleterious habits, as well as iatrogenic causes arising from restorative and / or periodontal procedures [1][2][3] . In order to obtain correct diagnoses and prognoses, in addition to an adequate treatment plan for each patient, classification of gingival recess is essential, being Miller's classification 4 the most widely used, although some limitations are found.…”