Patient-centered evaluation of microsurgical management of gingival recession using coronally advanced flap with platelet-rich fibrin or amnion membrane: A comparative analysis

Abstract

Objective:To evaluate the efficacy of coronally advanced flap (CAF) procedure under microsurgical approach for the management of Miller's Class I and II gingival recession defects with the use of either platelet-rich fibrin (PRF) or amnion membrane (AM) in comparison to CAF alone.Materials and Methods:A total of 45 sites with Miller's Class I or II gingival recession defect were randomly distributed for: Experimental Group I (CAF with PRF) sites (n = 15) which were treated with the microsurgical approach using CAF along with PRF; experimental Group II (CAF with AM) sites (n = 15) were treated with the microsurgical approach using CAF along with AM; control Group III (CAF alone) sites (n = 15) were treated with the microsurgical approach using CAF alone. Vertical gingival recession (VGR), horizontal gingival recession (HGR), gingival thickness (GT) (using transgingival probing [TGP] and ultrasonography [USG]) and patients’ response and acceptance were documented at baseline, 3 months and 6 months after surgical interventions.Results:CAF alone and in combination with PRF or AM, were effective techniques for root coverage with average VGR values of 1.47 ± 0.92 mm (56%), 0.67 ± 1.23 mm (36%) and 0.60 ± 1.06 mm (33%) in Group I (CAF with PRF), Group II (CAF with AM), and Group III (CAF alone), respectively. Complete coverage (100%) was obtained in 33.3% sites of Group I (CAF with PRF), 26.6% sites of Group II (CAF with AM) and 13.3% in Group III (CAF alone). Patients’ response and acceptance for surgical treatment modality in terms of patient esthetic score and decrease in hypersensitivity score was highest for Group I (CAF with PRF), whereas patient comfort score was highest for Group II (CAF with AM). At 6 months follow-up, significant increase in GT measurements (using TGP and USG) in Group I (CAF with PRF), whereas, nonsignificant increase for Group II (CAF with AM) and no change or decrease for Group III (CAF alone) as compared to baseline was observed.Conclusion:The present study observed enhancement in root coverage when PRF or AM are used in conjunction with CAF as compared to CAF alone. These results are based on 6-month follow-up. Therefore, the long-term evaluation may be necessary to appreciate the clinical effect of autologous PRF and AM.

Comparative evaluation of platelet-rich fibrin versus beta-tri-calcium phosphate in the treatment of Grade II mandibular furcation defects using cone-beam computed tomography

“…PRF acquired in the middle clot was cautiously collected by removing RBC clot using sterilized scissor [Figure 2]. [15] The centrifuge machine was kept closed to the operator, and all efforts were made to minimize the time between the preparation of PRF and its placement into the defect so as to retain maximum regenerative potential. [15]…”

Effect of A-PRF Application on Palatal Wound Healing after Free Gingival Graft Harvesting: A Prospective Randomized Study

“…5,6 L-PRF is a very dense fibrinogenic biomaterial with winning biomechanical and biological properties 7 and broad application in several areas of medicine. [8][9][10][11][12][13][14][15] In this way, it serves as a biological healing matrix and acts as an immune regulation node with inflammation control abilities, supporting the cell migration and cytokines. 5 Recently, advanced platelet-rich fibrin (A-PRF) emerged with the decrease of rotations per Eur J Dent 2020;14:63-69…”

Optimized Platelet‐Rich Fibrin With the Low‐Speed Concept: Growth Factor Release, Biocompatibility, and Cellular Response

“…Since its introduction in 2001, 1 PRF has been extensively used in dentistry for a variety of procedures, and its effectiveness has been demonstrated for extraction socket management, 8 gingival recessions, 9–11 intrabony defect regeneration, 12 , 13 and sinus elevation procedures 7 . Major advantages include having completely immune‐compatible growth factors collected at relatively no costs without anticoagulants 14–17 .…”