Platelet-Rich Fibrin Prepared With Titanium in the Treatment of Multiple Gingival Recessions
Condition: Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      The aim of this study was to treat the areas with Miller Class I bilateral multiple gingival
      recession in the maxillary teeth using the Titanium Platelet-Rich Fibrin (T-PRF), an
      autogenous biomaterial applied in combination with a Modified Coronally Positioned Flap
      (MCPF) prepared using microsurgical techniques, and the gold standard Subepithelial
      Connective Tissue Graft (SCTG), to evaluate the efficacy of the treatments and to compare the
      clinical results 6 months after the treatment.
    

Detailed description: 
      AİM:

      The aim of this study was to treat the areas with Miller Class I bilateral multiple gingival
      recession in the maxillary teeth using the Titanium Platelet-Rich Fibrin (T-PRF), an
      autogenous biomaterial applied in combination with a Modified Coronally Positioned Flap
      (MCPF) prepared using microsurgical techniques, and the gold standard Subepithelial
      Connective Tissue Graft (SCTG), to evaluate the efficacy of the treatments and to compare the
      clinical results 6 months after the treatment.

      MATERIALS AND METHODS A total of 20 patients (118 defects), consisting of 13 females and 7
      males, with maxillary bilateral Miller Class I gingival recession who were aged between 18
      and 65, applied to Necmettin Erbakan University, Faculty of Dentistry, Department of
      Periodontology and had aesthetic anxiety and sensitivity problems due to multiple gingival
      recessions were included in our study. As a randomized controlled clinical trial, in the
      patients' bilateral recession sites, while gingival recessions of one group were treated with
      T-PRF, the gingival recessions of the other group were treated with SCTG using a simple
      randomization method. The study protocol was in accordance with the Declaration of Helsinki
      of 1975, as revised in 2002 and was submitted to and approved by the ethical committee of
      Necmettin Erbakan University and the Ministry of Health General Directorate of Health
      Services (protocol number:2019/238). All patients included in the study were given detailed
      information about the clinical trial, and their written informed consent was obtained. The
      study was performed between January 2019 and November 2020 in Necmettin Erbakan University
      Department of Periodontology.

      The individuals were divided into 2 groups in accordance with the study protocol:

      Group1: SCTG group (n=60) Group2: T-PRF group (n=58) The criteria for inclusion in the study
      were determined as systemically and periodontally healthy volunteers between the ages of
      18-65, the absence of parafunctional habits, non-smoking, the presence of Miller Class I
      gingival recession defect in teeth located in the bilateral maxillary region, the absence of
      any hard tissue defects in the relevant region and the absence of a restorative, endodontic
      procedure or periodontal surgical intervention, a full-mouth plaque score (FMPS) of ≤ 25%,
      having a marginal gingival thickness of at least 1 mm in the area with gingival recession,
      the absence of a shallow hard palate dome, having a soft tissue thickness of at least 3 mm,
      the absence of torus in the area where the graft was taken, the absence of any systemic
      disease, not using antibiotics for any reason in the last 6 months, the presence of at least
      20 teeth in the mouth, not being pregnant and breastfeeding, and patients who applied to the
      periodontology clinic with various periodontal problems and were indicated for connective
      tissue graft operation due to gingival recession. The individuals who were outside the
      exclusion criteria and did not agree to participate in the study were excluded from the
      study.

      In the study with a sample size of 118, the effect size value (G * Power 3.1 for Windows)
      calculated based on the power (1-β err probe) = 95% and α = 5% t-test was determined as 0.334
      for the analysis of repeated measurements.
    

Intervention name(s): COMPARISON OF PLATELET-RICH FIBRIN PREPARED WITH TITANIUM AND SUBEPITHELIAL CONNECTIVE TISSUE GRAFT
Intervention type(s): Procedure
Intervention description(s): In the study, 118 maxillary bilateral multiple Miller Class I gingival recessions in 20 patients were treated. The gingival recessions were randomly treated with either T-PRF (58 teeth) or SCTG (60 teeth) using the modified coronally positioned flap technique. Gingival index, plaque index, probing pocket depth, gingival thickness, recession height, recession width, keratinized gingival width, and open root surface area were measured and recorded at baseline and at the 6th month. Postoperative pain levels were evaluated using the VAS (Visual Analogue Scale), and healing status was evaluated using the wound healing index. The pre- and post-treatment results of both treatment groups and the differences between the groups were evaluated and compared.
Other intervention name(s): MODİFİYE CORONALLY ADVANCED FLAP
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: As a randomized controlled clinical trial, in the patients' bilateral recession sites, while gingival recessions of one group were treated with T-PRF, the gingival recessions of the other group were treated with SCTG using a simple randomization method.
Masking: Double (Participant, Investigator)
Primary purpose: Health Services Research
Keywords: recession; gingival; subepithelial connective tissue graft