Treatment of Miller I Mandibular Gingival Recessions Using PRF vs. Connective Graft

Abstract

Gingival recession (GR) can cause aesthetic and functional problems. Using connective tissue graft (CTG) and coronally advanced flap (CAF) is considered the technique of choice for treating GR. Considering the morbidity resulting from taking CTG, different alternative biomaterials have been described, including plasma-rich fibrin (PRF) membrane. Studies in lower teeth are few because of the complexity of the factors that can influence obtaining less predictable outcomes. Objective. To compare between CAF + PRF and CAF + CTG in the treatment of lower teeth Miller I gingival recession. Methodology. Split-mouth included 26 isolated GR (13 in each side of the mouth). The left side was treated with CAF + PRF and the right side with CAF + CTG. Clinical variables, probing depth (PD), GR, keratinized tissue (KT), vestibular soft tissue thickness (VSTT), and teeth sensitivity (TS), were assessed at the baseline. GR, KT, VSTT, extraoral inflammation (EI), and patient discomfort (PaD) were assessed at 45 days. Results. Statistically greater VSTT at 45 days was obtained using CAF + CTG ( p < 0.05). Less EI and PaD were obtained using CAF + PRF ( p < 0.05). No change was observed in GR, KT, and TS values in the intergroup or intragroup comparisons. Conclusion. Even with the limitations of this study, using PRF and CTG in lower teeth demonstrated an improvement in terms of root coverage, although it was without a total percentage of coverage. Regarding the VSTT, better results were obtained using the CTG + CAF, suggesting eventually long-term stable clinical results. We suggest a combined technique for future investigations.

Efficacy of Tunnel Technique (TUN) versus Coronally Advanced Flap (CAF) in the Management of Multiple Gingival Recession Defects: A Meta-Analysis

“…Currently, there are several interventions for the treatment of GR [26]. The treatment of GR has become an important problem in periodontal surgery, since it is highly prevalent, especially in patients with risk factors [27][28][29]. CAF is a technique that can be performed alone or in combination with CTG [27].…”

The Effectiveness of the Influence of the Second Generation Platelet-rich Fibrin in the Treatment of Localized Individual Miller I and II Gingival Recessions (Case Report)

“…Malocclusions and malpositioned teeth, as orthodontic anomalies, and the post-period of fixed appliances, are states of the anatomical challenge of the mucogingival complex as part of the periodontal complex, and those combined with the thin gingival biotype, are also one of the etiological causes of the recession [6]. The most common clinical manifestation of recession is a loss of interproximal attachment, but the conditions of vestibular or palatal "attachment loss" are not rare [7]. Assessment of periodontal status and etiopathogenesis that lead to changes in the periodontal complex as a whole is express through periodontal indices, which were published by Loe in 1967 [8].…”