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

Hernan S Garzon,Gustavo Jaimes,Francisco J Vega,Katherine Isaza,Ana Muñoz,Camilo Alfonso,Katherine Rivera,Andrea García,Gaetano Isola

doi:10.1155/2021/6616688

Hernan S Garzon, Gustavo Jaimes + Show 7 more

Open Access

https://doi.org/10.1155/2021/6616688

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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.

Highlights

Gingival recession (GR) is defined as the displacement of the gingival margin to the apical side of the cementoenamel junction (CEJ) [1]
Even with the limitations of this study, using plasma-rich fibrin (PRF) and connective tissue graft (CTG) in lower teeth demonstrated an improvement in terms of root coverage, it was without a total percentage of coverage
A greater vestibular soft tissue thickness (VSTT) was found in the CTG group at 45 days after surgery. ere were less extraoral inflammation (EI) and patient discomfort (PaD) with the use of coronally advanced flap (CAF) + PRF (p < 0.05)

Summary

Introduction

Gingival recession (GR) is defined as the displacement of the gingival margin to the apical side of the cementoenamel junction (CEJ) [1]. Treatment of GR has become a research focus in periodontal plastic surgery as it is present in postorthodontic patients or those who anatomically challenging mucogingival conditions associated with a thin gingival phenotype or trauma of brushing [4]. Another condition associated with the presence of gingival recessions is periodontal disease or its sequelae. E role of inflammation in gingival recessions favors the growth and anastomosis of the rete pegs. This inflammation may favor the destruction of connective tissue and bone resorption mediated by proinflammatory cytokines through cellular activation. As a result of this chronic inflammatory process and even its therapy, it influences the appearance of gingival recessions [5, 6]

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