Coronally Advanced Flap Group Research Articles

Comparison of the efficacy and long-term stability of tunnel technique and coronally advanced flap in the treatment of gingival recession: a Meta-analysis.

This study aimed to evaluate the efficacy and long-term stability of tunnel technique (TUN) and coronally advanced flap (CAF) combined with connective tissue graft (CTG) in treating gingival recession. Databases including PubMed, Web of Science, Embase, and CNKI were electronically searched to collect randomized controlled trial (RCT) of CAF+CTG compared to TUN+CTG in the treatment of Miller class Ⅰ or Ⅱ gingival recession on September 1, 2022. There were 8 RCTs with 305 patients (454 recession sites) participating. The results of the Meta-analysis revealed that, in terms of mean root coverage (MRC) of main indicators, no significant difference was found between the CAF group and the TUN group in both short- and long-term results, which were [MD: 1.45%, 95%CI (-2.93%, 5.82%), P=0.52] and [MD: -0.70%, 95%CI (-6.41%, 5.00%), P=0.81]. However, the CAF group outperformed the TUN group in the long term [MD: 5.69%, 95%CI (0.87%, 10.50%), P=0.02], and the results of complete root coverage (CRC) analysis were similar to those of MRC. In the short term, the TUN group grew keratinized gingiva significantly faster than the CAF group [MD: -0.38 mm, 95%CI (-0.67 mm, -0.10 mm), P=0.008]. Long-term findings revealed no significant difference between the two groups [MD: -0.26 mm, 95%CI (-0.94 mm, 0.43 mm), P=0.46]. The TUN group's secondary index root coverage esthetic score (RES) was statistically significantly higher than the CAF group's [MD: 0.62, 95%CI (0.28, 0.96), P=0.000 3]. Given that there were few results included in the literature and the heterogeneity was too great, no significant difference was observed in the postoperative VAS pain index score [MD: 0.53, 95%CI (-1.96, 3.03), P=0.68]. This study discovered that both CAF+CTG and TUN+CTG can achieve good root coverage in treating gingival recession, with CAF outperforming TUN and both groups achie-ving good long-term stability. After the operation, the TUN group had a higher RES than the CAF group. Given the limitations of this study, more high-quality studies are needed in the future to demonstrate the efficacy of TUN in gingival retraction surgery.

Clinical effectiveness of periosteal pedicle graft for the management of gingival recession defects-a systematic review and meta-analysis.

The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of periosteal pedicle graft (PPG) in terms of root coverage and patient related outcomes. To the best of our knowledge this is the first systematic review with meta-analysis on PPG. A comprehensive search was performed using electronic and hand searches upto January 2023. Primary outcomes were Recession depth Reduction (Rec Red), mean root coverage (mRC) and complete root coverage (CRC). Secondary outcomes were gain in width of keratinized gingiva (WKG) and patient reported outcome measures (PROMs). Meta-analysis was performed when possible. The risk bias assessment was done using RevMan5.4.1 and Joanna Briggs institute scale for the included RCTs and case series respectively. A total of 8 RCTs and 2 case series (538 recession sites) were included based upon the predefined inclusion and exclusion criteria. The follow up period ranged from 6 months to 18 months. Results demonstrated that mRC of PPG + Coronally advanced flap (CAF) was 87.7% for localized gingival recession defects (GRDs) and 84.83% for multiple GRDs. An overall gain in WKG (Weighted Mean =1.49 ± 0.27 mm) was observed among all the included studies in the PPG + CAF group with mean difference (-0.10 (95% CI [-0.52, 0.33], p = 0.66)). Sub-group meta-analysis comparing PPG + CAF with sub-epithelial connective tissue graft (SCTG) + CAF resulted in similar outcomes in terms of Rec Red (0.10 (95% CI [-0.56 to 0.77], p = 0.76)) and gain in WKG (-0.03 (95% CI [-0.25 to 0.18], p = 0.76)). In terms of PROMs systematic review revealed better patient satisfaction with PPG + CAF than SCTG + CAF. PPG + CAF is a viable treatment modality for management of GRDs. The primary and secondary outcomes achieved utilizing PPG + CAF were found to be comparable to other conventional techniques including the gold standard i.e., SCTG.

Healing of buccal gingival recessions following treatment with coronally advanced flap alone or combined with a cross-linked hyaluronic acid gel. An experimental study in dogs.

AimTo clinically and histologically evaluate in dogs the healing of gingival recessions treated with coronally advanced flap (CAF) with or without cross‐linked hyaluronic acid (HA).Materials and methodsGingival recession defects were surgically created on the vestibular side of both maxillary canines in 8 dogs. After 8 weeks of plaque accumulation, the 16 chronic defects were randomly treated with either CAF alone or CAF and HA‐gel (CAF/HA). Clinical and histological outcomes were evaluated at 10 weeks post‐surgically.ResultsCompared to baseline, the clinical measurements at 10 weeks revealed a statistically significant decrease in gingival recession for both CAF (p < 0.01) and CAF/HA (p < 0.001) groups. Statistically significant differences were found in clinical attachment level (p < 0.05) and width of gingival recession (p < 0.01) favouring the CAF/HA group. Bone formation was statistically significantly greater in the CAF/HA group than in the CAF group (1.84 ± 1.16 mm vs., 0.72 ± 0.62 mm, respectively, p < 0.05). Formation of cementum and connective tissue attachment were statistically significantly higher in the CAF/HA group compared with the CAF group (i.e. 4.31 ± 1.78 mm versus 2.40 ± 1.35 mm and 1.69 ± 0.98 mm versus 0.74 ± 0.68 mm, respectively (p < 0.05)).ConclusionsThe present data have for the first time provided histologic evidence for periodontal regeneration of gingival recession defects following treatment with CAF and HA.Clinical relevanceThe use of HA in conjunction with CAF may represent a novel modality for treating gingival recession defects.

Coronally advanced flap achieved higher esthetic outcomes without a connective tissue graft for the treatment of single gingival recessions: a 4-year randomized clinical trial.

Limited long-term data are available when comparing the esthetic outcomes of coronally advanced flap (CAF) with or without a connective tissue graft (CTG). The aim of this study was to compare the 4-year esthetic outcomes of CAF vs CAF + CTG for the treatment of isolated maxillary gingival recessions. Forty-eight patients were randomly assigned for treatment either with CAF (control; N = 24) or to CAF + CTG (test group; N = 24). Patients were followed after the surgery until the final evaluation. A professional esthetic evaluation was performed using the Root coverage Esthetic Score (RES). Recession reduction, mean root coverage, and complete root coverage were also evaluated. Forty-two patients completed the study at the 4-year recall. A significant recession reduction was evident at 4 years, without significant intergroup differences. The CAF group showed a statistically significant higher final RES compared with the CAF + CTG group (9.14 ± 1.08 vs 7.25 ± 1.29, respectively, p < 0.001). Regarding the individual components of RES, gingival margin and marginal tissue contour were significantly higher in the CAF group compared with that in the CAF + CTG group. CAF presented with a significantly higher overall esthetic score than CAF + CTG, and in the individual RES components of marginal tissue contour and gingival margin after 4 years. CAF without the addition of CTG provided higher esthetic outcomes for the treatment of isolated gingival recessions.

Autologous Platelet Concentrates as Clinical Substitutes for Connective Tissue Graft in the Treatment of Miller Class I and II Gingival Recessions: An Updated Meta-Analysis.

This meta-analysis aimed to evaluate the clinical effectiveness of autologous platelet concentrates (APC) + coronally advanced flap (CAF) (Group A) compared with connective tissue graft (CTG) + CAF (Group B), and CAF alone (Group C), in patients with Miller Class I or II gingival recessions. Relevant articles published before December 2018 were retrieved electronically without date or language restriction and screened according to inclusion criteria. Quantitative meta-analysis was conducted comparing the groups. The inverse variance method was applied in fixed or random effects models according to heterogeneity. Sixteen randomized controlled trials were included. Root coverage (RC), clinical attachment level (CAL), gingival thickness (GT), and probing depth (PD) did not differ significantly between Groups A and B. The keratinized gingival width (KGW) of Group A was significantly less than that of Group B. The RC and GT of Group A were significantly greater than that in Group C. CAL and PD for Group A were lower than for Group C. KGW for Group A did not differ significantly from that of Group C. The results suggested that APC + CAF represents a promising alternative for root coverage for Miller Class I and II gingival recession defects. Nevertheless, CTG + CAF exhibits superior outcomes in terms of KGW. Hence, in scenarios lacking keratinized gingiva (Miller Class II), APC + CAF might not be the most suitable therapeutic choice.

The Additional Effect of Autologous Platelet Concentrates to Coronally Advanced Flap in the Treatment of Gingival Recessions: A Systematic Review and Meta-Analysis.

Background To improve the efficacy of regenerative treatment for gingival recessions, the autologous platelet concentrates (APCs) combined with coronally advanced flap (CAF) have been investigated. However, few studies systematically assess the complementary effect of APCs in periodontal regeneration. The present study aims to evaluate the additional effect of different types of APCs to CAF in the treatment of gingival recessions. Methods Electronic databases (EMBASE, MEDLINE, and Cochrane Central Register of Controlled Trails) and relevant journals were searched until May 15, 2019. Only randomized controlled trials (RCTs) in English were included. Outcome variables include root coverage (RC), recession depth (RD), clinical attachment level (CAL), keratinized tissue width (KTW), and gingival thickness (GT). Data were analyzed with Revman5.3. The estimate of effect sizes was expressed as the mean differences and the 95% confidence interval. Results 8 RCTs involving 170 patients (328 sites) were included. Our meta-analysis indicated RC, RD, CAL, KTW, and GT were better improved in the CAF plus APCs groups than the CAF alone. The subgroup analyses revealed that platelet-rich fibrin (PRF) brought significant improvement in RC, RD, CAL, and GT. Concentrated growth factors (CGF) lead clinic beneficial in CAL, KTW, and GT. No significant effect of platelet-rich plasma (PRP) could be found in any clinical parameters when combined with CAF. Conclusions PRF could exert additional effect to CAF; the preferred treatment for gingival recessions was considered. Based on the limited studies, it seemed that PRP failed to show any additional effect and it was not suggested for gingival recessions. Given the limited research and high risk of bias, it is still needed to confirm the additional effect of CGF by more high-quality studies.

The treatment of gingival recession with coronally advanced flap with platelet-rich fibrin

Background: Of the various techniques developed for the treatment of gum recession, the current innovation in the use of platelet rich plasma (PRF) has been applied to the treatment of root-end closure procedures. Purpose: This study analyzed the effect of the coronally advanced flap (CAF) in combination with platelet-rich fibrin (PRF) during treatment of gingival recession. Methods: This research constituted an experimental study incorporating a split-mouth design which was conducted on eight participants (with 16 recession defects) who were divided into two groups consisting of the CAF group with PRF and another CAF group without PRF. Clinical parameters consisting of gingival recession (GR), keratinized gingival width (KGW), recession width (RW) and clinical attachment level (CAL) were measured both before and 21 days after surgery). Results: The average differences between clinical parameters in the test group were as follows: GR (2.25 ± 0.27), KGW (1.81 ± 0.75), RW (3.44 ± 1.35), and CAL (2.56 ± 0.50); while in the control group they were as follows: GR (2.00 ± 0.71), KGW (1.94 ± 0.78), RW (3.50 ± 1.91) and CAL (2.00 ± 0.76). There were significant differences in the GR and CAL between the test and control groups (p ≤ 0.05). Conclusion: A combination of the CAF procedure and PRF was proven to be more effective in covering the GR and increasing the CAL.

Clinical evaluation of coronally advanced flap with or without platelet-rich fibrin for the treatment of multiple gingival recessions.

The aim of this randomized, controlled study was to assess the clinical effect of platelet-rich fibrin (PRF) in combination with coronally advanced flap (CAF) on root coverage, esthetics, and patient satisfaction when compared to CAF alone for the treatment of multiple Miller class I recessions. A total of 24 patients with 52 Miller class I multiple recessions ≥3mm were included and divided into CAF + PRF and CAF groups. At baseline and 12months after surgery, recession height (RH), keratinized tissue height, gingival thickness (GT), and mean and complete defect coverage were evaluated. Patient satisfaction and root coverage esthetic scores were also assessed. Baseline RH in CAF + PRF and CAF groups was 3.15±0.24 and 3.36±0.34mm, respectively. Intragroup comparisons revealed significant differences at 12months for all parameters (p<0.05). RH reduction was 2.75±0.33 and 2.51±0.33mm (mean root coverage of 88.36 and 74.63%) in the CAF + PRF and CAF groups, respectively. Intergroup differences were found to be significant for GT gain (p<0.05). The additional use of PRF membrane did not provide additional benefits in terms of root coverage outcomes compared with CAF alone. The use of PRF membranes increased tissue thickness significantly.

Patient morbidity and root coverage outcomes after the application of a subepithelial connective tissue graft in combination with a coronally advanced flap or via a tunneling technique: a randomized controlled clinical trial.

Subepithelial connective tissue grafts (SeCTG) in conjunction with a coronally advanced flap (CAF) or with tunneling technique (TT) are common periodontal procedures with similar indications for the treatment of a denuded root surface; however, it is unclear whether patient discomfort and postoperative morbidity are comparable in both approaches. The aim of this randomized controlled clinical trial was to compare the patient morbidity and root coverage outcomes of a SeCTG used in combination with a CAF or TT. For this single-center, randomized, clinical trial, patients were randomly assigned to receive SeCTG+CAF (control group) or SeCTG+TT (test group). Postoperative questionnaires at 3days post intervention were administered to evaluate postoperative discomfort, bleeding, and inability to masticate. Evaluation of patients' perception of pain was performed using a visual analog scale (VAS). Clinical outcomes including percentage of root coverage (RC) and complete root coverage (CRC) were recorded 12months postoperatively. Fifty patients (25 SeCTG+CAF and 25 SeCTG+TT) completed the study. Healing was uneventful for all test and control patients. The SeCTG+TT group showed a longer chair time (33.6 (3.6) and 23.6 (4.2) min for the SeCTG+TT and the SeCTG+CAF, respectively), as well as more painkiller consumption: 2736 vs. 1536mg (p<0.001). At the same time, the SeCTG+CAF group reported less pain or discomfort in all four sections of the questionnaire: pain experienced within the mouth as a whole, pain experienced throughout the day, pain experienced at night, and edema experienced after the surgery (p=0.002, p=0.001, p=0.001, and p=0001, respectively). Both treatments showed clinical efficacy in terms of root coverage as no differences per group were observed in the percentage of root coverage (87 vs. 85%, p=704) or patients with complete root coverage (60 vs. 52%, p=0.569). SeCTG+TT is associated with a greater incidence of pain and discomfort compared to SeCTG+CAF in early postoperative periods, as well as a longer chair time. Both treatments showed similar clinical efficacy in terms of root coverage. The results of this study may influence the surgeon's choice on which root coverage procedure should be performed considering the need of more chair time and more painkiller assumption with the tunneling technique.

Concentrated growth factor in the treatment of adjacent multiple gingival recessions: a split-mouth randomized clinical trial.

The aim of this study was to determine the clinical effect of concentrated growth factor (CGF) in combination with coronally advanced flap (CAF) compared to CAF alone for the treatment of multiple adjacent gingival recessions (GRs). Twenty patients with a total of 119 Miller Class I and II GRs in the maxilla were included to this study. Recessions were randomly treated according to a split-mouth design by means of CAF + CGF (test; 60 defects) or CAF (control; 59 defects). Clinical outcomes were evaluated at baseline and 6 months after surgery. The mean root coverage (MRC) was 82.06% and 86.67%, complete root coverage (CRC) was 45.8% (27/59) and 56.7% (34/60) for CAF and CAF + CGF, respectively at 6th month. Statistically no difference was demonstrated between the two groups in terms of recession depth (RD), MRC and CRC at 6th month. The increase in width of keratinized gingiva (KGW) and gingival thickness (GT) were statistically significant in the CAF + CGF group compared to the CAF group at 6th month. The use of CGF in combination with CAF did not provide additional benefits in RD, CRC and MRC. This study suggests that use of CGF + CAF may increase the success of GRs because of a significant increase in KGW and GT.

Comparative evaluation of the effectiveness of acellular dermal matrix allograft and subepithelial connective tissue to coronally advanced flap alone in the treatment of multiple gingival recessions: A clinical study.

Background:Obtaining predictable and esthetic root coverage has become an important part of periodontal therapy. Several techniques have been developed to achieve these goals with variable outcomes. The aim of this study was to appraise the effectiveness of acellular dermal matrix allograft (ADMA) and subepithelial connective tissue graft (SCTG) compared to coronally advanced flap (CAF) in the treatment of multiple gingival recessions.Materials and Methods:A total of 30 patients aged between 18 and 50 years, with multiple Miller's Class I and II recessions on labial or buccal surfaces of teeth were selected for this study. The patients were randomly assigned to CAF + ADMA, CAF + SCTG and CAF groups with 10 patients in each group. The clinical parameters assessed were probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), width of keratinized tissue, plaque index and papilla bleeding index at base line and 6 months after surgery.Results:Statistical analysis using One-way ANOVA suggested that the root coverage obtained was greater in the ADMA + CAF (89.83 ± 15.29%), when compared to SCTG + CAF (87.73 ± 17.63%) and CAF (63.77 ± 27.12%) groups. The predictability for coverage of >90% was greater in CAF + ADMA (65%) when compared with SCTG + CAF (61.66%) and CAF (31.17%). Improvements in the clinical parameters from baseline were found in all the three groups treated.Conclusion:It was concluded that all three techniques could provide root coverage in Miller's class I and II gingival recessions; but greater % root coverage and predictability for coverage of >90% could be expected with CAF + ADMA and CAF + SCTG groups when compared with CAF alone.

Clinical evaluation of coronally advanced flap with or without acellular dermal matrix graft on complete defect coverage for the treatment of multiple gingival recessions with thin tissue biotype

The objective of this study was to compare acellular dermal matrix graft (ADM) combination with coronally advanced flap (CAF) on complete defect coverage, aesthetics and patient satisfaction with CAF alone for multiple recessions with gingival thickness (GT) <0.8 mm. Forty-eight Miller Class I multiple recessions ≥3 mm were divided into test (CAF + ADM) and control (CAF) groups. At baseline and 12 months, recession height (RH), keratinized tissue height (KT), GT, mean and complete defect coverage were evaluated. Patient satisfaction, root coverage aesthetic score (RES) and the correlation between GT and defect coverage were also assessed. Baseline RH in CAF + ADM and CAF groups was 3.25 ± 0.34 mm and 3.21 ± 0.26 mm, respectively. Mean and complete defect coverage were 94.84% and 83.33% in test group, 74.99% and 50.00% in control group, respectively. Inter-group differences were found to be statistically significant for RH reduction, attachment gain, KT and GT increase, mean defect coverage and RES in favour of test group (p < 0.05). There was a significant positive correlation between GT and mean defect coverage (p < 0.05). Coronally advanced flap in association with ADM can be proposed as a valid approach for the treatment of multiple recessions with thin tissue biotype.

Predetermination of Root Coverage

A method to predetermine the maximum root coverage level (MRC) achievable with surgery was recently presented. The present study evaluates the predictability of such a method by comparing the predetermined MRC with that effectively achieved by means of root coverage surgical procedures. A total of 50 patients with single and multiple recession defects were enrolled. MRC was predetermined by an independent periodontist by assessing the ideal height of the interdental papilla. The distance from the apical reference point of a stent (StRP) and the MRC was measured 7 days before root coverage surgery. A total of 135 Miller Class I, II, and III gingival recessions were treated with the coronally advanced flap (CAF) or with the subepithelial connective tissue graft (SCTG). The distance from StRP and the gingival margin (GM) was measured by another independent periodontist 15, 30, and 90 days after surgery. In 97 (71.8%) of 135 treated gingival recessions, the StRP-MRC distance coincided exactly with the StRP-GM distance. No statistically significant difference was demonstrated in the cases with exact predetermination between gingival recessions belonging to the maxilla or mandible and between gingival defects treated with CAF or SCTG. The StRP-MRC distance measured before surgery was greater in 24 recession defects (17.7%) and lower in 14 gingival recessions (10.3%) than the StRP-GM distance measured 90 days after surgery. More cases of underestimation and fewer cases with overestimation of the level of root coverage were found in the SCTG group compared to the CAF group. The difference was statistically significant (P <0.01). The adopted method was effective in predetermining the position of the soft tissue margin 90 days after root coverage surgery. The cases with underestimation of the level of root coverage should be considered clinically and esthetically successful.

Coronally Advanced Flap With and Without Vertical Releasing Incisions for the Treatment of Multiple Gingival Recessions: A Comparative Controlled Randomized Clinical Trial

Vertical releasing incisions might damage the blood supply to the flap and result in unesthetic visible white scars. The aim of the present study was to compare root coverage and esthetic outcomes of the coronally advanced flap (CAF) with and without vertical releasing incisions in the treatment of multiple gingival recessions. Thirty-two systemically and periodontally healthy subjects with esthetic complaints due to the exposure of Miller Class I and II multiple (at least two) gingival recession defects (> or =1 mm) affecting adjacent teeth of the same quadrant of the upper jaw were enrolled in the study. Sixteen patients (with 45 gingival recessions) were randomly assigned to the control group, and the other 16 patients (with 47 recession defects) were assigned to the test group. All recessions were treated with a CAF; vertical releasing incisions were performed in the control group, whereas an envelope-type flap was used in the test group. The patient's postoperative morbidity was assessed 1 week after the surgery, whereas the esthetic evaluation, made by the patient and independent periodontist, and the clinical evaluation were made 1 year later. Surgical time was significantly shorter in the envelope-type CAF group. No statistically significant difference was demonstrated between the two groups in terms of recession reduction and clinical attachment level gain. A statistically greater probability of complete root coverage (adjusted odds ratio, 3.76; 95% confidence interval: 0.92 to 15.33; P <0.05) and a greater increase in buccal keratinized tissue height were observed with the envelope type of CAF. Patient satisfaction with esthetics was very high in both treatment groups, with no statistically significant differences between them. A better postoperative course and better results in the esthetic evaluation made by an independent periodontist were demonstrated in patients treated with the envelope type of CAF. Both CAF techniques were effective in reducing recession depth. The envelope type of CAF was associated with an increased probability of achieving complete root coverage and with a better postoperative course. Keloid formation along the vertical releasing incisions was responsible for the worst esthetic evaluation made by an independent expert periodontist.

Does placement of a connective tissue graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth? A multi‐centre, randomized, double‐blind, clinical trial

This parallel-group, multi-centre, double-blind, randomized-controlled clinical trial was undertaken to compare the clinical outcomes and patient morbidity of coronally advanced flap (CAF) alone or in combination with a connective tissue graft (CAF+CTG) in single Miller Class I and II gingival recessions. Three centres enrolled 85 patients with one recession each. Surgery was performed elevating a pedicle flap; 42 sites randomly received a graft under the flap. Measurements were taken by blind and calibrated examiners. Outcome measures included recession reduction, complete root coverage (CRC), intra-operative and post-operative morbidity, dentine sensitivity, and side effects. No differences were noted in the intra-operative and post-operative patient-related variables between the two groups. Surgical time was significantly shorter in the CAF group. Recession reduction was not statistically different between the two groups, even though a model showed a tendency towards improved outcomes in sites treated with CAF+CTG (adjusted difference 0.33 mm, 95% CI=-0.06 to 0.72, p=0.1002). Significantly greater probability of CRC was observed after CAF+CTG (adjusted OR=5.09, 95% CI=1.69-17.57, p=0.0033). Dentine hypersensitivity improved in both the groups. Both treatments were effective in providing a significant reduction of the baseline recession and dentine hypersensitivity, with only limited intra-operative and post-operative morbidity and side effects. Adjunctive application of a CTG under a CAF increased the probability of achieving CRC in maxillary Miller Class I and II defects.

The Effect of Platelet‐Rich Plasma on the Coronally Advanced Flap Root Coverage Procedure: A Pilot Human Trial

Coronally advanced flap (CAF) has been shown to effectively treat gingival recession. Platelet-rich plasma (PRP), containing autologous growth factors, has been shown to promote soft tissue healing. Therefore, the purpose of this study was to evaluate the effects of PRP in combination with CAF. Twenty-four systemically healthy patients participated in this study. A single Miller's Class I buccal recession defect per patient was treated. These patients were randomly assigned into CAF or PRP + CAF groups. Clinical parameters included recession depth (RD), recession width (RW), gingival thickness (GT), width of keratinized tissue (WKT), clinical attachment level (CAL), probing depth (PD), plaque index (PI), wound healing index (WHI), and gingival index (GI). PRP was prepared from whole blood drawn prior to surgery and applied to root surfaces. Patients were followed at 2, 4, 12, and 24 weeks post-surgery. Twenty-three patients completed the study. The RD at 24 weeks was significantly reduced from 2.9 +/- 0.5 to 0.5 +/- 0.6 mm in the CAF group (P < 0.05) and from 2.8 +/- 0.2 to 0.5 +/- 0.7 mm in the PRP + CAF group (P < 0.05). The mean root coverage was 83.5% +/- 21.8% in the CAF group and 81.0% +/- 28.7% in the CAF + PRP group (P > 0.05). Fourteen out of 23 patients (60.9%) experienced 100% root coverage at the 24-week postoperative follow-up. Based on the results of this pilot study, the application of PRP in CAF root coverage procedure provides no clinically measurable enhancements on the final therapeutic outcomes of CAF in Miller's Class I recession defects.