Coronally Advanced Flap With Connective Tissue Graft and PRF for Recession Coverage
Condition: Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional
Phase: Phase 3

Summary: 
      Over the years, numerous surgical techniques such as free autografts and pedicle grafts have
      been introduced to correct gingival recession defects. Combination grafts with either
      autografts or allografts, and newer concepts of guided tissue regeneration (GTR), platelet
      concentrates, etc., were developed more recently to correct mucogingival defects. The use of
      PRF in various surgical procedures such as degree II furcations, intrabony defects, sinus
      floor segmentation during implant placement and on facial plastic surgeries have shown
      promising results. However to our knowledge, till this study was completed, no studies have
      been reported with the clinical outcomes of autologous platelet rich fibrin membrane for the
      treatment of localized gingival recession defects.

      Hence, this study was designed to compare coronally advanced flap with platelet rich fibrin
      membrane versus subepithelial connective tissue graft in treatment of Miller's Class I and
      Class II gingival recession defects.
    

Detailed description: 
      The study design consist of twenty sites from ten patients were randomly selected by tossing
      the coin for the study, which are divided into test group( Root coverage was performed by
      coronally advanced flap with platelet rich fibrin membrane) and Control group (Root coverage
      was performed with coronal advanced flap with subepithelial connective tissue graft.)

      The Surgical Procedure consist of i) Preparation of the recipient bed: After adequate
      anesthesia, trapezoidal flap was designed using three incisions which is followed by
      reflection of partial thickness flap was raised apical to the crest of the osseous
      dehiscence. A periosteal releasing incision was given to enable the coronal advancement of
      the flap. Following this, root planing was done and the mesial and distal interdental
      papillae were deepithelialized.

      The exposed root surface was conditioned with tetracycline hydrochloride for four mins. (The
      tetracycline hydrochloride powder was mixed with saline in dappen dish and then applied on
      the root surface).

      In test group, preparation of PRF was carried out, after which the flap was coronally
      positioned over the membrane to completely cover it and secured with non resorbable sutures.
      The surgical area was covered with a non - eugenol periodontal dressing with post-operative
      antibiotics and analgesics and post-operative instructions that were given to all the
      patients.

      In control group, connective tissue graft harvesting was carried out which was followed by
      placement of connective tissue graft on the recipient site. The connective tissue graft was
      placed on the recipient site and secured in position with vicryl sutures. The flap was
      coronally positioned over the connective tissue graft and secured with non resorbable
      sutures. The recipient bed was covered with a non-eugenol periodontal dressing with
      post-operative antibiotics and analgesics and post- operative instructions that were given to
      all the patients.
    

Intervention name(s): CAF with Platelet rich fibrin; CAF with connective tissue graft
Intervention type(s): Procedure; Procedure
Intervention description(s): In test group, preparation of PRF was carried out, after which the flap was coronally positioned over the membrane to completely cover it and secured with 4-0 non resorbable sutures.; In control group, connective tissue graft was harvested, after which the flap was coronally positioned over the graft to completely cover it and secured with 4-0 non resorbable.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment