Evaluation of Root Coverage After the Use of Coronally Advanced Flap Either With Advanced Paltelet Rich Fibrin or Subepithilial Connective Tissue Graft in Treatment of Miller Class I and II Gingival Recession.

Study Overview
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Brief Summary
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patients with Miller class I , II gingival recession will be divided into 2 groups (control, intervention).the control one will receive coronally advanced flap with subepithililal connective tissue graft harvested from the palate while the intervention one will have coronally advanced flap with advanced platelet rich fibrin(A-PRF).as it represent a new generation of platelet concentrate allow for better healing and root coverage results. Null hypothesis: In patients with Miller class I and II gingival recession, there is no difference in amount of root coverage (mm) following the application of SCTG+A-PRF compared to CAF+SCTG.

Detailed Description
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Population (P): Patients with single Miller class I, II gingival recessions. Intervention (I): Coronally advanced flap (CAF) plus platelet rich fibrin (A-PRF). Comparator (C): Coronally advanced flap (CAF) plus subepithelial connective tissue graft (SCTG). Primary Outcome (O): Root coverage (mm). Time frame: 9 months. Study design: Randomized controlled clinical trial. Patients are to be selected from the outpatient clinic of the department of Oral Medicine and Periodontology-Cairo University

Official Title
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Root Coverage After the Use of Coronally Advanced Flap With Advanced Platelet Rich Fibrin (A- PRF) Compared With Subepithelial Connective Tissue Graft in Management of Miller Class I and II Gingival Recession. A Randomized Clinical Trial

Conditions
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Gingival Recession

Intervention / Treatment
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* Procedure: CAF + (A-PRF)
* Procedure: CAF+SCTG


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Systemically healthy patients 18 years old and older both males and females. Good oral hygiene after phase I therapy. Miller's class I or II gingival recession. Not using antibiotics, steroids, chemotherapy or other medications that may modify results of the surgery and healing. Cooperative patients able and accept to come for follow up appointments Exclusion Criteria: Pregnant or lactating females. Current Smokers. Patients with any systemic disease that may affect the periodontal healing. Teeth with endodontic treatment, buccal restoration or caries. Patients with poor oral hygiene

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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Accepts Healthy Volunteers

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: intervention<br>CAF+ APRF | Procedure: CAF + (A-PRF)<br>* advanced platelet rich fibrin prepared by low speed centrfugation concept(LSCC) together with coronally advanced flap .<br>|
| Active Comparator: control<br>CAF+SCTG | Procedure: CAF+SCTG<br>* cornally advanced flap plus subepithilial connective tissue graft harvested from the palate<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| root coverage | measured in millimeter | 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gingival esthetics | Root coverage esthetic score | 9 months | 
| Recession width | measured in millimeter | 9 months | 
| Clinical attachment level | measured in millimeter | 9 months | 
| Width of keratinized gingiva | measured in millimeter | 9 months | 
| Probing depth | measured in millimeter | 9 months | 
| Gingival thickness | measured in millimeter | 9 months | 
| Post-operative pain | Visual analog scale (VAS) Questionnaire | measured daily for the first 2 weeks post- operatively. | 
| Patient Satisfaction | Post-Surgical Patient Satisfaction Questionnaire | 9 months | 
| Early wound healing | Early wound healing index | 1,2,4 weeks post- surgical | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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advanced platelet rich fibrin,A-PRF