Clinical impact of platelet rich plasma in treatment of gingival recessions

Abstract

Root coverage supported with complete regeneration of lost periodontal tissues represents the ultimate goal of gingival recession treatment. This study was designed to evaluate clinical effectiveness of platelet rich plasma gel (PRP) with connective tissue graft (CTG) in the treatment of gingival recession. 15 gingival recessions Miller class I or II were treated with CTG and PRP (group PRP). Connective tissue graft was harvested from the premolar region using trap door technique. After elevation of the flap, the regional bone and root surface were smeared with activated PRP gel. CTG was also irrigated with PRP gel before placement over the exposed root surface and local bone. Fixed CTG was covered with a coronally advanced flap. The same number of gingival recessions were treated with CTG in combination with the coronally advanced flap with no PRP gel (group TVT). Clinical recordings included recession depth (RD), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT) before and 1 year after mucogingival surgical treatment. Mean value of RD was significantly decreased from 4.93 +/- 0.86 mm to 0.60 +/- 0.37 (p < 0.01) with CTG and PRP and from 4.76 +/- 0.74 mm to 0.63 +/- 0.29 mm (p < 0.01) in CTG group. This difference was not statistically significant. Results of the keratinized tissue width showed significant increase from 0.88 +/- 0.30 mm presurgery to 3.78 +/- 0.49 mm (p < 0.01) six months after treatment in PRP group and from 0.90 +/- 0.34 mm to 3.15 +/- 0.41 in TVT group (p < 0.01). This difference was statistically significant (p > 0.05). No statistically significant differences were observed between treatment groups in CAL and PD. Clinical results validate both procedures as effective and highly predictable surgical techniques in solving gingival recession problem. Histological evaluation may confirm advantage of PRP use related to regeneration of periodontal tissues.