Abstract
BackgroundSeveral researchers have tried to improve the results of gingival recession treatment techniques. One of the methods is to use growth factors The present study was undertaken to evaluate the effect of CAF (coronally advanced flap) + CTG (connective tissue graft) + PRGF (plasma rich in growth factors) in the treatment of Miller Class I buccal gingival recession.Material and MethodsTwenty-two teeth with Miller Class I gingival recession in 6 patients 26 ‒ 47 years of age were included in a split-mouth designed randomized controlled trial (RCT). In each patient, one side was treated with CAF + CTG + PRGF (test) and the other side was treated with CAF + CTG (control). The following parameters were measured before surgery and up to 6 months after surgery on the mid-buccal surface of the tooth: keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), vertical recession depth (VRD), recession depth (RD), gingival thickness (GT), root coverage in percentage (RC%) and the distance between the CEJ and mucogingival junction (MGJL). Data were analyzed with paired t-test and repeated measures ANOVA.ResultsAfter 6 months noticeable improvements were observed in both groups in all the variables measured except for PD; however, the differences between the two groups were not significant. RC% was 80 ± 25% and 67 ± 28% in the test and control groups, respectively, after 6 months.ConclusionsBoth CAF + CTG + PRGF and CAF + CTG treatment modalities resulted in favorable root coverage; however, the addition of PRGF added no measurable significant effect. Key words:Connective tissue graft, dental root coverage, gingival recession, growth factors, mucogingival surgery, periodontal plastic surgery.
Highlights
Gingival recession has been defined as the migration of marginal soft tissue to a point apical to the tooth or the platform of a dental implant and is prevalent in between 20-100% in the general population [1,2] (Löe et al 1994, Albandar & Kingman 1999)
One side was designated as the control side and was treated with connective tissue graft in conjunction with coronally advanced flap (CAF+CTG), and the other side in the same patient was designated as the case side and treated plasma rich in growth factors (PRGF) in addition to the connective tissue graft and coronally advanced flap (CAF+CTG+PRGF)
Comparison of EVAS up to the 6-week post-operative interval with the pre-operative situation did not exhibit any significant differences; at 6-month post-operative interval there were significant differences between the two groups, indicating the superiority of the control group (CAF+CTG), contrary to the results reported by Cheung et al (2004) [36], demonstrating better esthetic results with the use of platelet concentrates, which might be attributed to the use of a more accurate technique for the evaluation of esthetic results in that study
Summary
Gingival recession has been defined as the migration of marginal soft tissue to a point apical to the tooth or the platform of a dental implant and is prevalent in between 20-100% in the general population [1,2] (Löe et al 1994, Albandar & Kingman 1999). Advanced flap (CAF) in conjunction with the connective tissue graft (CTG) is considered the gold standard of treatment of gingival recession due to its high predictability of the treatment results [8,15] (Wennström & Zucchelli 1996, Paolantonio 2002). Anitua introduced a new technique to prepare plasma rich in growth factors (PRGF) [16]. The aim of the present study was to evaluate the effect of PRGF on the results of root coverage procedures with the use of CAF+CTG. The present study was undertaken to evaluate the effect of CAF (coronally advanced flap) + CTG (connective tissue graft) + PRGF (plasma rich in growth factors) in the treatment of Miller Class I buccal gingival recession. Conclusions: Both CAF + CTG + PRGF and CAF + CTG treatment modalities resulted in favorable root coverage; the addition of PRGF added no measurable significant effect
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