Comparing PRF membrane and subepithelial connective tissue graft in the treatment of gingival recession (original) (raw)
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International journal of health sciences
Objective: To evaluate the amount of recession width following the use CAF and advanced platelet rich fibrin (A-PRF) compared to CAF with SCTG in the treatment of single gingival recession. Materials and Methods: Twenty gingival recession defects were randomly assigned to receive either CAF+SCTG (n=10) or CAF+A-PRF (n=10). Recession width in mm was assessed at 3, 6 and 9 months post-operatively. Results: Patients in test group (CAF+A-PRF) reported 2.13 ± 0.35 recession width at 3 months, 2.00 ± 0 after 6 months. While, finally decreased to 1.25±1.04 after 9 months. In the control group (CAF+SCTG), the amount of recession width recorded 1.00 ± 1.07 at 3 months, while, after 6 and 9 months decreased to 0.5 ± 0.93. Conclusion and recommendation: There was no statistically significant difference between the two studied groups after 9 months. While, A significant difference reported at 3 and 6 months. Further studies with larger sample size and longer follow-up is needed.
Journal of Periodontology, 2000
Background: Gingival recession represents a significant concern for patients and a therapeutic problem for clinicians. Several techniques have been proposed to achieve root coverage. The purpose of this randomized clinical trial was to evaluate the effect of a guided tissue regeneration (GTR) procedure in comparison to connective tissue graft (CTG) in the treatment of gingival recession defects. Methods: Twelve patients, each contributing a pair of Miller Class I or II buccal gingival recessions, were treated. In each patient one randomly chosen defect received a poly(lactic acid)based bioabsorbable membrane, while the paired defect received a CTG. Clinical recordings included oral hygiene standards and gingival health, recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KT). Results: Mean RD statistically significantly decreased from 2.5 mm presurgery to 0.5 mm with GTR (81% root coverage), and from 2.5 mm to 0.1 mm with CTG (96% root coverage), at 6 months postsurgery. Prevalence of complete root coverage was 58% for the GTR group and 83% for the CTG group. Mean CAL gain was 2.0 mm for the GTR group and 2.2 mm for the CTG group. No statistically significant differences between treatment groups were observed for changes in RD, RW, PD, CAL, and KT. Conclusions: Treatment of human gingival recession defects by means of either GTR or CTG results in clinically and statistically significant improvement of the soft tissue conditions of the defect when pre-and post-treatment measurements were compared. Although differences between CTG and GTR in mean root coverage and prevalence of complete coverage consistently favored the CTG procedure, the differences in measurements were not statistically significant.
Journal of Periodontology, 2001
Background: The clinical outcome of connective tissue grafts in the treatment of gingival recessions has been documented in numerous studies. However, no attempt has been made to correlate the postoperative mucogingival changes with the surgical parameters. The present retrospective clinical study was undertaken to 1) evaluate root coverage and mucogingival changes 1 to 1.5 years following treatment of Miller's Class I and II recession defects using 2 variants of the subepithelial connective tissue graft (SCTG) procedure, and 2) assess the effect of the surgical parameters on the postoperative gingival width. Methods: Thirty-one recessions in 10 patients treated with the envelope technique (E) and 31 recessions in 11 patients treated with coronally positioned flap combined with connective tissue graft (CP) were retrospectively analyzed to evaluate: 1) percentage of root coverage obtained with the 2 procedures and variations in width of keratinized tissue (KT) 1 to 1.5 years postsurgery, and 2) the effect of the surgical parameters on the postoperative gingival width. Results: Results showed a mean root coverage percentage of 89.6 ± 15% for the E group and 94.7 ± 11.4% for the CP group; the difference between groups was statistically insignificant (P = 0.1388). Mean KT increased significantly from 1.4 ± 1.1 mm presurgery to 4.5 ± 1.1 mm postsurgery for the E group while a minor increase in KT was observed in the CP group (2 ± 1.5 mm presurgery versus 2.7 ± 1.6 mm postsurgery). For both treatment groups, the mean postsurgical width of keratinized tissue (POSTKT) was found to be mathematically correlated with the mean presurgical width of keratinized tissue (PREKT) and the corono-apical height of the graft that remained exposed (GE) coronal to the flap margin in the recipient site. Conclusions: Treatment of human gingival recession defects by the 2 variants of SCTG resulted in significant recession reduction. When SCTG is grafted beneath alveolar mucosa using the combined technique (CP), transformation of the mucosa into keratinized tissue does not seem to occur, at least within 1 to 1.5 years postsurgery. The treatment outcome in terms of keratinized tissue width seems to be correlated with the presurgical gingival dimensions and the height of the graft that remains exposed at the end of the surgical procedure.
Journal of Clinical Periodontology, 2005
Background: Short-term data have indicated that treatment of gingival recession type defects by coronally positioned flap procedures with or without biodegradable membranes may result in similar treatment outcome. The aim of this study was to compare 12-month and 6-year follow-up results for these two treatment approaches. Methods: Twenty patients with buccal bilateral Miller Class I or Class II gingival recession defects in cuspids or bicuspids were treated randomly by coronally positioned flap alone (20 sites) or in combination with a biodegradable membrane (20 sites). Clinical measurements at baseline, 6, 12 months and 6 years included apical extent of gingival recession, width of the defect at the cemento-enamel junction (CEJ), width of keratinized tissue, as well as attachment level and probing depth. Eleven patients were available for the 6-year evaluation. Results: At 12 months (20 sites), both treatments resulted in significant gain of root coverage (po0.001), stable probing depth, and increased attachment level (po0.001). The 6-year evaluation (11 sites) showed a significant gain of root coverage for the non-membrane group only (po0.05). No significant between-group differences were detected for any other treatment variable regardless of smoking status (p40.05). Compared with baseline, the 6-year results showed that seven membrane sites gained root coverage, three were unchanged and one lost root coverage. For the 11 non-membrane sites, eight gained root coverage, and three were unchanged. The five membrane and the 10 non-membrane sites exhibiting complete root coverage at 6 months were reduced to two and one, respectively, at the 6-year evaluation. Conclusions: The coronally positioned flap procedure offers a simple and reliable treatment alternative as a root coverage procedure in Class I and Class II recession type defects. Placement of a biodegradable membrane underneath the flap does not seem to improve neither the short-nor the long-term results. Long-term outcome stability seems to be critically dependent on a continuous follow-up program with re-instruction in non-traumatic brushing habits.
Journal of Medicine and Life
Numerous surgical procedures are used to correct gingival recession, like free gingival graft, pedicle graft, and connective tissue graft. Our study aimed to compare and clinically evaluate root coverage using a coronally advanced flap (CAF) with and without Biomesh® membrane to treat recession type 1 (RT1) and type 2 (RT2) defects. A total of 20 systemically stable patients, both males and females between the ages of 20 and 40, with bilateral recession defects in maxillary canines and premolars, were included in the study. Patients were divided into two groups: the control group: coronally advanced flap only and the test group: coronally advanced flap with Biomesh® membrane. All clinical parameters showed significant reductions from baseline, 1 month, 3 months, and 6 months post-surgery. Gingival recession significantly reduced both in test and control groups with no intergroup difference. The exposed root was covered by 70% in the test group and 78% in the control group. Clinical ...
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.
F1000Research
Background: The importance of esthetics has escalated over the years. The purpose of any perioplastic surgery is to address gingival recession while ensuring predictable root coverage and a pleasing appearance. An array of surgical procedures have been recommended for the management of recession defects. The present study compares the clinical and patient related outcome measures of coronally advanced flap with chorion membrane and connective tissue graft in the management of multiple adjacent gingival recessions. Methods: The study was a prospective randomized controlled trial which included eight systemically healthy patients with an age range of 30-44 years with 36 labial/buccal, multiple adjacent, Cairo’s RT1 gingival recession defects, bilaterally. CAF+CM was performed on one side whereas CAF+CTG was performed on the other side. The two groups were compared clinically at three and six months postoperatively. Results: There was statistically significant decrease in recession de...
Journal of Periodontology, 1999
Background: Connective tissue grafts and guided tissue regeneration (GTR) are the most current procedures in the treatment of gingival recession, but very few clinical comparative studies have been conducted. Methods: The purpose of this study was to compare 2 types of treatment of gingival recession in the same patients. Fourteen pairs of Miller Class I defects were selected in 14 patients. In each pair, one recession was randomly assigned for treatment by GTR using a bioabsorbable membrane, and the other treated by subepithelial connective tissue graft (CTG). Height of recession (HR), clinical attachment level (CAL), probing sulcus depth (PSD), height of keratinized tissue (HKT), and distance from the cemento-enamel junction to the mucogingival junction (CEJ-MGJ) were recorded before surgery and 6 months postoperatively. Results: The initial width and height of recession were, respectively, 3.73 mm (SD 0.56) and 3.85 mm (SD 1.15) for the CTG group, and 4.04 mm (SD 0.92) and 4.28 mm (SD 1.20) for the GTR group. The differences were not significant. CAL changes were not different. Both in the CTG group and in the GTR group, mean HR reduction was 2.89 mm (SD 1.18), representing a mean root coverage of 76% and 70.2%, respectively. The difference was not significant. HKT mean gain was significantly greater (P = 0.0001) with CTG (2.03 mm, SD 0.92) than with GTR (0.42 mm, SD 0.91). The GTR technique displaced the mucogingival junction significantly (P = 0.007) more coronally (2.35 mm, SD 1.44) than the CTG technique (0.78 mm, SD 1.23). Conclusions: Within the limits of this study, no difference could be found between subepithelial connective tissue graft and GTR with a bioabsorbable membrane with regard to root coverage, but the GTR technique did not increase the height of keratinized tissue and displaced the mucogingival junction more coronally at 6 months.
Journal of dentistry (Shiraz, Iran), 2016
Gingival recession has been considered as the most challenging issue in the field of periodontal plastic surgery. The purpose of this study was to evaluate the clinical efficacy of root coverage procedures by using partial thickness double pedicle graft and compare it with full thickness double pedicle graft. Eight patients, aged 15 to 58 years including 6 females and 2 males with 20 paired (mirror image) defects with class I and II gingival recession were randomly assigned into two groups. Clinical parameters such as recession depth, recession width, clinical attachment level, probing depth, and width of keratinized tissue were measured at the baseline and 6 months post-surgery. A mucosal double papillary flap was elevated and the respective root was thoroughly planed. The connective tissue graft was harvested from the palate, and then adapted over the root. The pedicle flap was secured over the connective tissue graft and sutured. The surgical technique was similar in the control ...
World Journal of Dentistry
Aim: The aim of this trial was to compare the semilunar coronally position flap (SCPF) and the conventional coronally advanced flap (CAF) regarding the applied modifications in treating gingival recession. Materials and methods: Sample consisted of 16 patients with bilateral class I gingival recessions, they were treated with SCPF or CAF. Two modifications were applied: a root surface biomodification with tetracycline (TTC) and suture anchors on the contact points of the tooth. Clinical parameters and a questionnaire were used as measures to evaluate the trial. Wilcoxon test was used for statistical analysis. Results: The mean percentage of root coverage (RC) and complete RC (CRC) was 82.3 ± 15.6% (31.3%, n = 5/16) and 79.8 ± 27.7% (43.8%, n = 7/16), respectively, using SCPF and CAF. Statistically significant differences were observed in the intergroup width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), vestibular depth (VD), and position of the mucogingival junction (MGJ). A significant difference was observed in wound healing index (WHI) 1 week postoperative. Full root coverage esthetic score (RES) was achieved in four teeth using SCPF and in two teeth using CAF. No statistically significant differences were observed in the intergroup in the postoperative pain and root sensitivity during the follow-up. Conclusion: Both SCPF and CAF with the mentioned modifications were effective in managing shallow gingival recessions. However, SCPF's results showed a significant gain in WKT, TKT, and VD. Clinical significance: Our findings confirm that both procedures with the mentioned modifications can be used to treat gingival recession with effectively and satisfied results for periodontist and patient. Our results suggest it is preferable to use the SCPF in case of a shallow oral vestibulum and high demanded for esthetic.