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PTG may be more appropriate for peri-implantitis surgery than xenograft due to inert structure and comfortable use of PTG to provide mechanical support for enlarging the surface area of the implant.

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.

Background: The aim of this study is to compare the effect of mesial and distal adjacent gingival phenotypes of the tooth or teeth region of free gingival graft (FGG) on the shrinkage ratio of graft at 6 months postoperatively.Methods: Thirty-one patients with inadequate keratinized gingival width (KGW) around mandibular incisors were included in this study. The phenotype of the mesial and distal terminal teeth was evaluated by the probe transparency method and keratinized gingival thickness measurements; study groups were divided as thick and thin phenotype. The plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL) and recession height (GRH), recession width (GRW) and KGW measurements were recorded at baseline and sixth month. Vertical dimension of graft (VDG), horizontal dimension of graft (HDG), recipient area horizontal width (RAHW), recipient area vertical depth (RAVD) were recorded during surgery. The shrinkage ratio was calculated with a Java-based analysis program. Results:There was no significant difference in the clinical and surgical measurements between the groups. KGW mean values for both of adjacent teeth increased at 6th month compared to baseline but there was no difference between the groups at 6 months. GRH value has decreased significantly in thick phenotype group at the 6th month. The shrinkage ratio was found 23.14 ± 12.21% and 17.76 ± 11.05% in the thin and thick phenotype group, respectively. The difference between the groups was not statistically significant (p = 0.210). Conclusion:The phenotype of the adjacent teeth has a similar impact on FGG shrinkage ratio at the sixth month. Thick phenotype of adjacent teeth seems to be more supportive for root coverage.