Mechanisms of LPRF Action in the Promotion of Wound Healing and Tissue Regeneration
Condition: Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      This study evaluates the clinical and biological effects of leucocyte and platelet-rich
      fibrin (L-PRF) on intraoral wound healing.
    

Detailed description: 
      Gingival recession is characterized by the exposure of root surfaces of the tooth, is
      attributed to the apical migration of the gingival marginal tissue, and it is a frequently
      noted clinical feature in all populations. Other than cosmetic problems, a gingival recession
      can have a causative role in tooth sensitivity, and contribute to difficulties in oral
      hygiene maintenance or root caries. Moreover, it may worsen with time.

      The ultimate goal of surgical root-coverage procedures (Periodontal plastic surgery) is the
      elimination of the recession defect with minimal probing depths after treatment, along with
      the ability to restore the natural color and texture of the gingiva (gum). By achieving root
      coverage, overall improved aesthetics, prevention of non-carious cervical lesions or root
      caries, and treatment of the resulting root sensitivity should be expected.

      Surgical interventions in general, and in particular those aiming to reconstruct tissues lost
      due to trauma or disease in particular, are biologically dependent on a cascade of unimpaired
      wound healing mechanisms, including a non-disrupted inflammatory process,
      vascularization(blood supply) of the wound area, and consequent tissue regeneration. Wound
      healing has been defined as "the natural response to injury compiling a cascade of complex
      events orchestrated in a way that many cell types guided by the release of soluble mediators
      and signals. In a bid to enhance this phase, autologous platelet 'concentrates' were
      developed, derived from centrifuged blood of patients and applied as surgical adjuncts.
      Previous studies indicate that leucocyte plasma rich fibrin (LPRF/newest generation of
      platelet concentrates) preparations significantly modulate wound healing and promote tissue
      regeneration in a variety of oral surgical procedures. Clinical studies where LPRF is
      analyzed at the molecular level to quantify the temporal release of growth factors,
      cytokines, or other biomolecular components are still lacking. Despite the broad application
      of LPRF in modern dentistry information which integrates clinical and molecular data from in
      vivo models are essential to elucidate its relevant biological mechanisms. The mechanisms of
      action are unclear, and the relative role of their different components have not been fully
      explained. This study will aim to investigate if LPRF can offer superior clinical outcomes
      and will compare the concentrations and kinetics of wound healing regulators in root coverage
      procedures with and without local application of LPRF.
    

Intervention name(s): leucocyte and platelet-rich fibrin (L-PRF) in combination with CAF; CAF
Intervention type(s): Procedure; Procedure
Intervention description(s): Completing root coverage by coronally advanced flap technique in combination with L-PRF.; Completing root coverage by coronally advanced flap technique alone
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Split-mouth design allowing to assess two types of treatment in the same patient.
Masking: Double (Care Provider, Outcomes Assessor)
Primary purpose: Treatment