Evaluation of Treatment for Isolated Bilateral Miller’s Class I or II Gingival Recession with Platelet Rich Fibrin Membrane- A Comparative Study (original) (raw)
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Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: Gingival recession has been associated with dentinal hypersensitivity, root caries, and esthetic compromise. Root coverage procedures aim at providing both tangible and intangible benefits to the patients. Various procedures have been tried to obtain root coverage of single-rooted teeth. Miller Classes I and II gingival recessions hold out the best promise for root coverage as there is no interdental bone and soft-tissue loss associated with these recessions. AIM: The objective of the study was to evaluate and compare the effectiveness of coronally advanced flap (CAF) with platelet-rich fibrin (PRF) membrane with CAF + connective tissue graft (CTG) on recession coverage. MATERIALS AND METHODS: A total of 16 patients required recession coverage for a single tooth were divided into two groups. The test group received CAF + PRF while the control group got CAF + CTG. Different parameters were taken preoperatively (amount of recession, width, and thickness of attached gingiva) and repeated for the two groups 2 months after surgery. RESULTS: Comparing the two groups after 2 months from surgery showed that the PRF not only has an effect in the management of recession but also has a greater effect on tissue thickness. CONCLUSION: PRF is a minimum invasive approach and a promising material for root coverage and manipulating the gingival biotype.
Journal of Applied Oral Science, 2018
Evaluation of the effect of dosedependent platelet-rich fibrin membrane on treatment of gingival recession: a randomized, controlled clinical trial Miller's class I gingival recessions (GR) have been treated using coronally advanced flap (CAF) with platelet-rich fibrin membrane (PRF membrane) or connective tissue graft (CTG). Objective: The aim of this study was to evaluate the effect of different multiple layers of PRF membranes for the treatment of GR compared with the CTG procedure. Material and Methods: Sixty-three Miller class I GR were treated in this study. Twenty-one GR selected randomly were treated with two layers of PRF membranes+CAF in 2PRF+CAF (test group-1), four layers of PRF membranes+CAF in 4PRF+CAF (test group-2), and CTG+CAF in the control group. The plaque index (PI), gingival index (GI), probing depth (PD), keratinized tissue thickness (KTT), clinical attachment level (CAL), recession depth (RD), recession width (RW), and keratinized tissue height (KTH) measurements were performed at baseline and 1, 3, and 6 months after surgery. The post-operative discomfort of patients, assessed with the visual analog scale (VAS) and healing index (HI), was recorded after surgery. Results: PI, GI, and PD scores were similar for all patients at all times. RD and RW scores were similar for each patient at 1 month, but these values were significantly increased in the subsequent periods in test group-1. The increase in KTT was significantly higher in the control group compared with the test groups. Similar root coverage scores were obtained in the test group-2 and control groups, and these scores were significantly higher compared with test group-1. Conclusions: The PRF membrane+CAF technique may be an alternative to the CTG+CAF technique for postoperative patient comfort. However, PRF membranes should use as many layers as possible.
Al-Azhar Journal of Dental Science, 2018
Background: The present study was conducted to compare the clinical outcome of using SCTG combined with coronally advanced flap against using PRF membrane combined with coronally advanced flap in treatment of gingival recession. Methods: fifteen patients with 20 recession defects were included in the study, Patients were divided according to treatment modalities into two groups. Group I: Patients were treated using SCTG combined with coronally advanced flap. Group II: Patients were treated using PRF membrane combined with coronally advanced flap. Measurements of gingival index (GI), Plaque index (PI), Recession height (RH), Probing depth (PD), Clinical attachment level (CAL) and width of keratinized gingiva (WKG) were recorded for both groups at baseline, 3 and 6 months post-operatively. Results: there was no statistically significant difference between both groups regarding gingival index (GI), Plaque index (PI), Recession height (RH), Probing depth (PD), Clinical attachment level (CAL) and width of keratinized gingiva (WKG) after 3 and 6 months post-operatively. Conclusion: PRF membrane can be considered a safe and effective alternative treatment modality in treatment of gingival recession.
Al-Azhar Assiut Dental Journal (Print), 2022
Aim: The purpose of this study was to evaluate the efficacy of the (PRF) combined with collagen membrane in the management of gingival recession compared to the use of (PRF) alone. Subjects and methods: 10 sites including at least one tooth with Miller's class II or class III buccal/labial gingival recession defect after phase I therapy were divided randomly into 2 groups, Group (I) was treated with open flap surgery while using (PRF) and Group (II) was treated with open flap surgery while using (PRF) combined with collagen membrane. Clinical parameters were recorded at baseline, 3and 6 months postoperatively. Results: both treatment groups showed no significant root coverage, Probing sulcus depth (PSD) reduction, Clinical attachment level (CAL) gain 6-months after surgery when compared with baseline between two groups. However, there was a significant increase of Height of keratinized gingiva (HKG) between (Group I) and (Group II) at 3-months and 6-months. Conclusion: Both the treatment modalities proved to be effective techniques in treatment of root coverage and Using of PRF + Collagen membrane showed superior effect compared to PRF alone, suggest that PRF + Collagen membrane can provide additional benefits not in the treatment of gingival recession but in increasing of the width of attached gingiva
The Journal of Contemporary Dental Practice, 2021
Aim and objective: Coronally advanced flap (CAF) with connective tissue graft (CTG) has been considered the gold standard for obtaining complete root coverage. However, some limitations have been reported with the use of CTG, especially because it increases morbidity and leads to postoperative pain and bleeding. Recently, platelet-rich fibrin (PRF) has been used in periodontal plastic surgery for the treatment of gingival recessions (GRs). The aim of this study was to evaluate the outcome of PRF combined with a CAF (test) compared to de-epithelialized connective tissue graft (DeCTG) + CAF (control) for GR coverage. Materials and methods: Ten healthy patients exhibiting mandibular or maxillary Miller class I and II were treated with PRF + CAF or DeCTG + CAF. GR, probing depth (PD), and gingival thickness (GT) were evaluated at baseline, 6 weeks, and 28 weeks postoperatively. Results: GR, PD, and GT differences between the test and control groups at 28 weeks were not statistically significant. GR was 3.30 ± 1.25 mm and 3.00 ± 1.63 mm (control vs test) group (baseline) and −0.10 ± 0.32 vs −0.20 ± 0.42 mm (7 months), respectively. Conclusion: Within the limitations of the present study, it can be concluded that localized gingival recessions could be successfully treated with CAF + PRF or CAF + DeCTG. Clinical significance: This study suggests that PRF membrane may be an alternative and valid graft material for treating localized gingival recessions Miller class I and II.
A propitious approach for the treatment of multiple site gingival recession: a case report
2016
Gingival recession is increasingly becoming a prominent condition in oral health and is one of the most common aesthetic concerns associated with the periodontal tissues. Numerous root coverage procedures such as coronally advanced flap (CAF), lateral pedical graft (LPG), subepithelial connective tissue procedure can be done either alone or in combination with other regenerative material to treat these recession defects. PRF is a fibrin matrix in which platelet cytokines, growth factors, and cells are trapped and may be released after a certain time and that can serve as a resorbable membrane. This paper reports the use of a platelet rich fibrin membrane in combination with coronally advanced flap for root coverage.
IP International Journal of Periodontology and Implantology, 2021
Gingival anatomic factors, chronic trauma, periodontitis, and tooth alignment are the main conditions leading to gingival recession. The present study was conducted to compare the root coverage of localized GR using modified coronally advanced flap (CAF) and root conditioning with 24% EDTA when performed under magnification and without magnification. This study was conducted on 30 patients with Miller’s Class I and II GR. Patients were divided into 2 groups i.e 15 in each group. Group I (Coronally advanced flap with microsurgery ) was test group and group II (Coronally advanced flap with macrosurgical approach) was control. Plaque index (PI), gingival index (GI), pocket probing depth (PD), and clinical attachment level (CAL) width of keratinized gingival, recession width and recession depth was recorded in both groups at baseline 1and 3 months for the test and control group. Visual analog scale (VAS) was used to record pain postoperatively on 3rd and 7th day of the surgery. CAF and ...
Journal of Periodontology, 2013
Background: Gingival recession (GR) is one of the most common esthetic concerns associated with periodontal tissues. Recently, tissue engineering technology has been developed and applied in periodontology for the treatment of GR. The aim of this study is to compare the clinical efficacy of collagen membrane with or without autologous gingival fibroblasts under a coronally advanced flap for root coverage.Methods: In this split‐mouth, controlled clinical study, 22 sites are selected from 11 patients with Miller Class I recessions affecting canines or premolars in the maxillary arch. One tooth in each patient was randomized to receive either a collagen membrane (CM) (control group) or a collagen membrane seeded with autologous gingival fibroblasts (CM+GF) (test group) under a coronally advanced flap. Thickness of the gingiva, GR, and percentage of root coverage (PRC) were recorded by a calibrated examiner at baseline and 3, 6, and 12 months postoperatively. Furthermore, GR and PRC wer...
Perio J (Online), 2022
Background: One of the most common esthetic concerns in dentistry is gingival recession (GR), and despite the various treatment strategies for root coverage, multiple recessions still present a great challenge, especially Miller Class III/RT2. Thus, this study aimed to compare the effect of platelet-rich fibrin (PRF) versus connective tissue graft (CTG) using vestibular incision subperiosteal tunnel access (VISTA) in patients with Miller class III/RT2 multiple recessions for root coverage. Methods: Twenty-eight patients with multiple Class III/RT2 gingival recessions were randomly allocated to two equal groups-group 1 (VISTA+PRF) and group 2 (VISTA+CTG). Recession depth (RD) and width (RW), probing depth (PD), clinical attachment level (CAL), gingival thickness, keratinized tissue width, and root coverage esthetic score (RES) were measured at 0, 3, and 6 months. Statistical analysis was performed using repeated measures analysis of variance (ANOVA). Bonferroni's post-hoc test was used for pair-wise comparisons when ANOVA was significant. For non-parametric data, the Mann-Whitney U test was used to compare between the two groups. Results: Within each group, a significant difference from baseline to six months was found. However, between groups, the results for the VISTA+CTG group significantly surpassed the VISTA+PRF group in most clinical outcomes; gingival recession depth (0.5 [0.25-1.75] and 1.33 [0.75-2], respectively), and width (1 [0.38-3.75] and 2.33 [1.33-3], respectively), gingival thickness at three and six months (2.62±0.36 and 2.63±0.36, respectively) and (1.85±0.2 and 1.87±0.18, respectively), and keratinized tissue width (3.98±0.72 and 3.33±0.56, respectively). However, CAL and PD showed a statistically insignificant difference when comparing both groups. Conclusion: The use of CTG is superior to PRF in root coverage of Miller Class III/RT2 when the VISTA technique is used. Connective tissue grafts can be considered the gold standard for root coverage.