Evaluation of Treatment for Isolated Bilateral Miller’s Class I or II Gingival Recession with Platelet Rich Fibrin Membrane- A Comparative Study

Abstract

Background: A recent innovation in dentistry is the use of second generation platelet concentrate which is an autologous platelet rich fibrin gel (PRF) with growth factors and cicatricial properties for root coverage procedures. The aim of this study was to determine the addition of an autologous platelet-rich fibrin membrane (PRF) to coronally advanced flap (CAF) (site A) would improve the clinical outcome compared to an CAF alone (Site B) for the treatment of isolated Miller’s Class I or II gingival recessions. Materials and Methods: Ten subjects, presenting isolated bilateral Miller Class I or II gingival recessions of similar extent were enrolled in the study. The mean recession depth value at baseline was 3.30 ± 0.95 mm for test sites and 3.30 ± 0.95 mm for control sites. Each patient was treated on both sides by CAF technique; the combination treatment (with PRF membrane) was applied on the test side. Probing depth (PD), recession width, clinical attachment level (CAL), keratinized gingival width, and gingival/ mucosal thickness (GTH) were measured at baseline, 1 month, 3 months and at 6 months post-surgery. Results: At 6 months, complete root coverage was obtained at 73.86% of the sites treated with the test (site A) procedure but 67.52% of root coverage at the site B. A statistically significant difference between the two sites (A & B) in relation to gingival thickness was observed at 3 and 6 months. At 6months, the increase in GTH was statistically significant when comparing the test sites (from1.13±0.08mm at baseline to1.58±0.12 mm at 6months) to the control sites (from1.13±0.08 mm at baseline to 1.31± 0.07 mm at 6 months). In the case of Recession width, PD, CAL and Width of keratinized gingiva (WKG) there was no significant difference. Conclusion: The addition of PRF membrane with CAF provides superior root coverage with additional benefits of gain in CAL and WKG at 6 months postoperatively. Key words: Gingival recession, Coronally advanced flap, Platelet rich fibrin membrane.