Platelet Rich Fibrin in the Treatment of Multiple Gingival Recessions

Study Overview
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Brief Summary
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The aim of this randomized controlled clinical study is to evaluate and compare the effectiveness of platelet rich fibrin (PRF) and connective tissue grafts in the treatment of multiple gingival recessions.

Detailed Description
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The aim of this randomized controlled clinical study is to evaluate and compare the effectiveness of platelet rich fibrin (PRF) and connective tissue grafts in the treatment of multiple gingival recessions. Primary outcome variables were percentage of complete root coverage and mean root coverage percentages at 6 months follow up. The secondary outcome variables include keratinized tissue and gingival thickness gain. Sample size has been estimated as 13 in each treatment arm. All recessions are treated with modified coronally advanced flap. On test sites PRF membrane and on control sites connective tissue grafts will be placed under modified coronally advanced flaps. Random allocation of the treatment sites to test and control groups were performed using a computer software designed for randomization. Clinical parameters such as gingival index, plaque index, keratinized tissue width, gingival recession depth and width were measured at 1, 3 and 6 months. Probing pocket depth, clinical attachment level, gingival thickness and gingival recession area were measure at baseline and 6 months. All gingival recession-related parameters such as recession height, recession width and recession area and keratinized tissue width along with mean root coverage and complete root coverage were assessed on standardized clinical photographs using an image analysis software. Clinical photographs were obtained at baseline and 1, 3 and 6 months after surgical intervention. 4 mm length wire was placed on gingiva to check reproducibility and to obtain standardized pictures. Gingival tissue thickness were measured with an #15 endodontic reamer attached to rubber stopper inserted perpendicularly into the gingival tissue 2 mm below the gingival margin; thickness of the reamer will be measured with a digital caliper. Mean root coverage percentage was calculated as percentage of covered root surface area at 6 months. Follow up of subjects was 6 months.

Official Title
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Comparison of Platelet Rich Fibrin and Connective Tissue Graft in Treatment of Multiple Gingival Recessions

Conditions
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Gingival Recession

Intervention / Treatment
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* Procedure: connective tissue graft
* Procedure: platelet rich fibrin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Two or more adjacent teeth with at least 2 mm Miller Class I gingival recessions at non-molar teeth Identifiable CEJ on all teeth Age ≥ 18 Presence of tooth vitality and absence of restorations and superficial caries in the treatment area No past surgical treatment history of affected area. Gingival thickness ≥ 0,8 mm for recession areas. Sufficient palatal donor tissue for connective tissue harvesting. Exclusion Criteria: Smoking Pregnancy or lactation Systematic diseases that may affect outcomes of periodontal therapy Self-reported antibiotic medication within three months Occlusal trauma in treatment site

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: connective tissue graft<br>connective tissue graft harvested from palatum of subjects and placed under modified coronally advanced flap | Procedure: connective tissue graft<br> <br> |
| Experimental: Platelet rich fibrin<br>Autogenous platelet rich fibrin was obtained from subjects own blood samples after centrifugation. Platelet rich fibrin membranes were placed under modified coronally advanced flaps. | Procedure: platelet rich fibrin<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean root coverage percentage | mean area of root coverage achieved by surgical root coverage therapy. | 6 months | 
| complete root coverage percentage | percentage of gingival recession defects completely covered by flaps after 6 months | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| keratinized tissue width | changes in keratinized tissue width at 6 months | 6 months | 
| gingival tissue thickness | changes from baseline in gingival tissue thickness at 6 months | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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multiple gingival recession, platelet rich fibrin, connective tissue graft, microsurgery, periodontal diseases, gingival recession