Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage

Abstract

BACKGROUND Collagen membrane and platelet-rich fibrin (PRF) have emerged as vital biomaterials in the field of periodontal regeneration. Minimally invasive techniques are being preferred by most periodontists, as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques. Thus, in this study we have evaluated the effect of injectable PRF (i-PRF) with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access (VISTA) technique for gingival recession coverage. AIM To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage. METHODS A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study. The sites were randomly assigned to control group (VISTA using collagen membrane alone) and the test group (VISTA using collagen membrane with i-PRF). The clinical parameters assessed were pocket depth, recession depth (RD), recession width (RW), relative attachment level, keratinised tissue width (KTW), keratinised tissue thickness (KTT), and percentage root coverage. RESULTS RD showed a statistically significant difference between the test group at 3 mo (0.5 ± 0.513) and 6 mo (0.9 ± 0.641) and the control group at 3 mo (0.95 ± 0.51) and 6 mo (1.5 ± 0.571), with P values of 0.008 and 0.04, respectively. RW also showed a statistically significant difference between the test group at 3 mo (1 ± 1.026) and 6 mo (1.65 ± 1.04) and the control group at 3 mo (1.85 ± 0.875) and 6 mo (2.25 ± 0.759), with P values of 0.008 and 0.001, respectively. Results for KTW showed statistically significant results between the test group at 1 mo (2.85 ± 0.489), 3 mo (3.5 ± 0.513), and 6 mo (3.4 ± 0.598) and the control group at 1 mo (2.45 ± 0.605), 3 mo (2.9 ± 0.447), and 6 mo (2.75 ± 0.444), with P values of 0.04, 0.004, and 0.003, respectively. Results for KTT also showed statistically significant results between test group at 1 mo (2.69 ± 0.233), 3 mo (2.53 ± 0.212), and 6 mo (2.46 ± 0.252) and the control group at 1 mo (2.12 ± 0.193), 3 mo (2.02 ± 0.18), and 6 mo (1.91 ± 0.166), with P values of 0.001, 0.001, and 0.001, respectively. The test group showed 91.6%, 81.6%, and 67% root coverage at 1 mo, 3 mo, and 6 mo, while the control group showed 82.3%, 66.4%, and 53.95% of root coverage at 1 mo, 3 mo, and 6 mo, respectively. CONCLUSION The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.

Effectiveness of i-PRF in periodontal regeneration – A systematic review and meta-analysis

“…The three studies that assessed GI did not show any significant difference between the group treated with i-PRF and the conventional group, as seen in Fig. 5 ( Faour et al, 2022 , Nair et al, 2022 , Patra et al, 2022 ).

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“…Table 2 provides information on the demographic and technical characteristics of the six studies ( Elbarbary et al, 2022 , Faour et al, 2022 , Nair et al, 2022 , Patra et al, 2022 , Ucak Turer et al, 2020 , Vuckovic et al, 2020 ) included in the review, and Table 3 highlights the technical characteristics. Sample sizes ranged from 12 to 36, in the age range of 18 to 75 years.…”

“…No specific gender predilection was noted in the studies. Two studies were from India ( Nair et al, 2022 , Patra et al, 2022 ), one from Egypt ( Elbarbary et al, 2022 ) and two from Syria ( Faour et al, 2022 , Ucak Turer et al, 2020 ) and Serbia ( Vuckovic et al, 2020 ).…”

“…PD was assessed in all six studies ( Elbarbary et al, 2022 , Faour et al, 2022 . ; Nair et al, 2022 , Patra et al, 2022 , Ucak Turer et al, 2020 , Vuckovic et al, 2020 ), with 112 samples in experimental and control groups. A statistically significant difference was noted with a mean difference of 0.75 (95 % CI: 1.43:0.07), suggesting the control group had a higher PD at p = 0.03 as seen in Fig.…”

Minimally Invasive Gingival Recession Treatment by Using Vista Combined With PRF and Collagen Membrane: A Case Report

“…The apical migration of the gingival margin, which aff ects a substantial part of the population, is one of the most prevalent cosmetic issues related to periodontal tissue that results in hypersensitivity, aesthetic concerns and carious or non-carious lesions by the root exposure [1]. Aetiologic factors that can lead to this common problem are recognised to be either anatomical, such as thin gingival biotype, abnormal tooth positioning (too buccally or lingually), aberrant frenal attachment, or iatrogenic, such as tooth brush trauma, subgingivally extending restorative margins, the presence of an infl ammatory process such as peri-odontal disease due to poor oral hygiene, inadequate crown emergence angles [2,3].…”