Platelet-Rich Fibrin in the Treatment of Multiple Gingival Recessions
Condition: Gingival Recessions
MeSH terms: Gingival Recession
Study type: Interventional
Phase: Early Phase 1

Summary: 
      The main objective of this study was to evaluate the clinical effectiveness of platelet-rich
      fibrin membrane used in combination with a coronally advanced flap and to compare it with the
      use of a subepitelial connective tissue graft in combination with a coronally advanced flap
      in Miller class I-II bilateral gingival recession treatment
    

Detailed description: 
      Purpose

      The main objective of this study was to evaluate the clinical effectiveness of platelet-rich
      fibrin (PRF) in combination with modified coronally advanced flap (MCAF) in the treatment of
      multiple gingival recessions. Furthermore the second aim of the present study was to compare
      plastic periodontal surgical procedure, with PRF membrane and connective tissue graft, by a
      randomized splitmouth controlled study.

      Clinical effectiveness of platelet-rich fibrin (PRF) in combination with modified coronally
      advanced flap (MCAF) as measured by Clinical measurements.

      Material and Methods

      Twenty patients with multiple gingival recession defects (Miller I, II) participated in this
      split-mouth trial. Sixty defects received either MCAF+PRF (test) or MCAF with subepithelial
      connective tissue graft (SCTG) (control). Gingival recession depth (RD), gingival recession
      width (RW), keratinized tissue width (KTW), recession area (RA), probing depth (PD), clinical
      attachment level (CAL) and gingival thickness (GT) were evaluated at baseline and 6 months.
      Additionally post-surgery patient satisfaction and pain status were measured by comparing
      visual analogue scale (VAS) scores.

      Clinical measurements were taken at starting point and 6 months postoperatively. The
      measurements comprised an assessment of probing depth (PD),clinical attachment level (CAL)
      and gingival recession parameters including recession depth (RD), recession width (RW),
      keratinized tissue width (KTW) and gingival thickness (GT) were assessed by a calibrated
      examiner (E. Ö.). PD, CAL, RD, RW and KTW values were recorded by a Williams probe graduated
      in 1-mm increments and rounded up to the nearest millimeter (Hu Friedy, Chicago, IL, USA). To
      standardize the clinical measurements acrylic stents were prepared on patients' casts. The
      following measurements were recorded at the mid-buccal point of the teeth at baseline and6
      months after surgery. GT was evaluated using endodontic reamer attached to a rubber stopper
      inserted perpendicularly into the gingival tissue 3 mm below the gingival margin under local
      anesthesia, and then the thickness was measured to the nearest 0.1 mm using a caliper.RD was
      measured from the CEJ to the gingival margin, RW was measured tangentially at the mid-facial
      CEJ and RA was calculated as the area within the contour of denuded root. KTW recorded as the
      distance from the mucogingival junction to the gingival margin. Duplicate measurements were
      made for RD, RW, RA and KTW with an interval of 24 hours and the average value of two
      measurements was used for the assessment. The postoperative pain was evaluated with a visual
      analog score (VAS).
    

Intervention name(s): test groups; Control groups
Intervention type(s): Procedure; Procedure
Intervention description(s): At the test sites, the previously prepared PRF was positioned over the recession defects, the coronal margin of the PRF was placed at the CEJ; Split-full-split thickness flap incisions were performed in a coronal-apical direction. The papillae adjacent to the involved tooth were de-epithelialized to create a connective tissue bed. The gingival flap was repositioned without tension, with its margin located on the enamel, on the test and control sides. It was held in that position with 5-0 resoble sutures
Other intervention name(s): PRF groups; Connective tissue graft groups
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Platelet rich fibrin; Gingival Recession