Cytokine and MMP Levels in Gingival Crevicular Fluid in the Treatment of Localized Gingival Recessions

Study Overview
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Brief Summary
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The main objective of this study was to evaluate the matrix metalloproteinase (MMP)-8, and -9, tissue inhibitor of matrix metalloproteinase and interleukin-1beta levels in gingival crevicular fluid during the early and late stages of healing for gingival recession sites treated by coronally advanced flap plus platelet rich fibrin (PRF) compared to CAF plus connective tissue graft. As PRF consists of several growth factors, it may enhance the healing potential of soft tissues, the investigators hypothesized that using PRF in the treatment of gingival recessions might regulate inflammation and promote wound healing.

Detailed Description
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The aim of this study was to evaluate the effect of PRF by assessing gingival crevicular fluid (GCF) levels of MMP-8, MMP-9, tissue inhibitor of matrix metalloproteinase (TIMP-1) and interleukin-1beta (IL-1β) during the early and late stages of healing following coronally advanced flap (CAF) plus PRF or CAF plus connective tissue graft (CTG) treatment. Primary outcome variables were biochemical parameters, such as: GCF MMP-8, -9, TIMP-1 and IL-1β levels. The secondary outcome variables were change in gingival recession expressed as recession reduction in millimeters at follow-up visits. Sample size has been estimated in 24 subjects per treatment groups. Random allocation of the treatment sites to test (CAF+ PRF) and control (CAF + SCTG) groups will be performed using a computerized selection of random numbers for allocation of the study groups. Biochemical parameters: GCF samples were obtained from each recession defect in each subject immediately prior to treatment of recessions and at 10 days, 1 month, 3 months and 6 months after surgery. Periodontal parameters including probing depth (PD), clinical attachment level (CAL), and gingival recession parameters including recession depth (RD), recession width (RW), and keratinized tissue width (KTW),were assessed by a calibrated examiner. At baseline and at 6 months, PD, RD, RW and KTW were evaluated by clinical assessment. Follow-up of subjects: 6 months.

Official Title
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Cytokine (IL-1ß) and Matrix Metalloproteinase (MMP) Levels in Gingival Crevicular Fluid After Use of Platelet Rich Fibrin or Connective Tissue Graft in the Treatment of Localized 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: Similar bilateral Miller Class I or II localized gingival recessions at least ≥ 2 mm located on incisors, canines or premolars on both jaws Identifiable cementoenamel junction Age ≥ 18 years Presence of tooth vitality and absence of restorations and superficial caries in the area to be treated No periodontal surgical treatment in the previous 24 months on the involved sites Sufficient palatal donor tissue for the indicated SCTG. Exclusion Criteria: Smoking Patients with a pregnancy or lactation period or self-reported history of antibiotic medication within three months Molar, mobile or teeth with crown or filling were also excluded.

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: Diagnostic
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Connective tissue graft<br>Connective tissue graft Soft tissue harvested from palatum of the subjects. | Procedure: Connective tissue graft<br>* gingival recession treated with connective tissue graft<br>|
| Experimental: Platelet Rich Fibrin<br>Autogenous platelet and leukocyte fibrin material was obtained from blood. | Procedure: Platelet Rich Fibrin<br>* gingival recession treated with platelet rich fibrin<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline in MMP-8 gingival crevicular fluid level at 10 days, 1, 3 and 6 months |  | Baseline, 10 days, 1, 3 and 6 months | 
| Change from Baseline in MMP-9 gingival crevicular fluid level at 10 days, 1, 3 and 6 months |  | Baseline, 10 days, 1, 3 and 6 months | 
| Change from Baseline in TIMP-1 gingival crevicular fluid level at 10 days, 1, 3 and 6 months |  | Baseline, 10 days, 1, 3 and 6 months | 
| Change from Baseline in IL-1beta gingival crevicular fluid level at 10 days, 1, 3 and 6 months |  | Baseline, 10 days, 1, 3 and 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gingival recession depth |  | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gingival recession, fibrin, connective tissue, gingival crevicular fluid, matrix metalloproteinase, cytokine