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

2019 ◽  
Vol 52 (1) ◽  
pp. 8
Author(s):  
Asti Rosmala Dewi ◽  
Agus Susanto ◽  
Yanti Rusyanti

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.

2018 ◽  
Vol 7 (2) ◽  
pp. 44-49
Author(s):  
Nader Abolfazli ◽  
Afsoon Asadollahi ◽  
Masoumeh Faramarzi ◽  
Fariba Saleh Saber

Background and aims. The aim of this study was to evaluate the effect of double pedicle graft (DPG) with and without plasma rich in growth factor (PRGF) in the treatment of Miller's Cl I and II gingival recessions. Materials and methods. Thirty-two bilateral buccal gingival Miller’s Cl I and II recessions were selected. Sixteen of the recessions were treated with DPG and PRGF (test group). The remaining sixteen recessions were treated with DPG (control group). The clinical parameters, including clinical probing depth (CPD), clinical attachment level (CAL), recession depth (RD), recession width (RW) and keratinized gingiva width (KGW), were measured at baseline and 1, 3 and 6 months later. Data were analyzed with paired t-test. Results. After 6 months, both groups exhibited a significant improvement in all the criteria mentioned above. However, none of the groups showed significant differences in pocket depths after 6 months. At the end of the study there were significant improvements in recession depths and widths and clinical attachment levels and keratinized gingiva width between test and control groups Conclusion. The method using DPG+PRGF resulted in more favorable clinical outcomes than only DPG.


2012 ◽  
Vol 10 (1) ◽  
pp. 7-10
Author(s):  
KV Satyanarayana ◽  
BR Anuradha ◽  
G Srikanth ◽  
P Mohan Chandra ◽  
T Anupama ◽  
...  

Background Aggressive periodontitis is a specific type of periodontitis with clearly identifiable clinical characteristics such as “rapid attachment loss, bone destruction” and “familial aggregation”. Regeneration of mineralized tissues affected by aggressive periodontitis comprises a major scientific and clinical challenge. In recent years some evidence has been provided that bioactive glass is also capable of supporting the regenerative healing of periodontal lesions. Objective The aim of this clinical and radiological prospective study was to evaluate the efficacy of bioactive glass in the treatment of intra-bony defects in patients with localized aggressive periodontitis. Methods Twelve localized aggressive periodontitis patients with bilaterally located three-walled intra-bony defect depth ? 2 mm, preoperative probing depths ? 5 mm were randomly treated either with the bioactive glass or without the bioactive glass. The clinical parameters plaque index, gingival index, probing depth, gingival recession, clinical attachment level, and mobility were recorded prior to surgery as well as 12 months after surgery. Intraoral radiographs were digitized to evaluate the bone defect depth at baseline and 12 months after the surgery. Results After 12 months, a reduction in probing depth of 3.92 + 0.313 mm (P <0.001) and a gain in clinical attachment level of 4.42+0358mm (P <0.001) were registered in the test group. In the control group, a reduction in probing depth of 2.5 +0.230mm (P <0.001) and a gain in clinical attachment level of 2.58 + 0.149 mm (P<0.001) was recorded. Radiographically, the defects were found to be filled by 2.587 + 0.218 mm (P <0.001) in the test group and by 0.1792 + 0.031mm (P <0.001) in the control group. Changes in gingival recession showed no significant differences. . Conclusion Highly significant improvements in the parameters Probing depth, Clinical attachment level, and Bone defect depth were recorded after 12 months, with regenerative material. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 11-15 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6906


PRILOZI ◽  
2020 ◽  
Vol 41 (1) ◽  
pp. 79-86
Author(s):  
Jana Milutinovic ◽  
Mirjana Popovska ◽  
Biljana Rusevska ◽  
Milan Nacevski ◽  
Stefan Anastasovski ◽  
...  

AbstractAim: The present study aimed to investigate the effectiveness of PRF in the treatment of infrabony defects in patients with chronic periodontitis by evaluating the clinical outcome through periodontal depth, clinical attachment level at the baseline, 6 and 9 months post operatively.Material and Methods: Sixty infrabony defects with probing depth ≥ 5 mm were treated. The inclusion criterion was the necessity for surgical bilateral maxillary treatment. By using split-mouth study design, each patient had one side treated with conventional flap surgery and the other side with conventional flap surgery and PRF. Clinical parameters, such as probing depth (PD) and clinical attachment lost (CAL), were recorded in both groups at baseline, 6 and 9 months post operatively.Results: Positive effects for all clinical and radiographic parameters were evident in the group with PRF. Mean PD reduction demonstrated statistically significant greater results in the test group (4.00±1.07 mm) compared to the control one (4.83±0.99 mm), p = 0.003 after 9 months postoperatively. After 9 months, there were better results in the test group compared to the control group for CAL (5.60±1.61 mm, 6.20±1.58 mm), but statistically not significant.Conclusion: Additional use of PRF in the conventional surgical treatment of infrabony defects demonstrated better parameters than the open flap debridement alone.


Odontology ◽  
2020 ◽  
Vol 109 (1) ◽  
pp. 295-302
Author(s):  
Roberto Rotundo ◽  
Luigi Genzano ◽  
Michele Nieri ◽  
Ugo Covani ◽  
David Peñarrocha-Oltra ◽  
...  

AbstractTo assess the difference in smile esthetic impact of Coronally Advanced Flap (CAF) with or without the adjunct of a collagen matrix (CMX) used as root coverage procedures. Subjects with esthetic demands showing multiple upper gingival recessions of at least 2 mm, without interproximal attachment loss and cervical abrasion no more than 1 mm were recruited and randomized to CAF plus CMX or CAF alone. The Smile Esthetic Index (SEI) was adopted to quantify the quality of the smile recorded at baseline and 12 months after treatment for each treatment group. In addition, between group difference in the SEI was calculated. 24 Patients were treated and analysed. At baseline, mean gingival recession depths were 2.3 ± 0.7 mm for Test group and 2.6 ± 1.0 mm for Control group. After 1 year, the residual recession depth was 0.3 ± 0.4 mm in the CAF + CMX group and 0.6 ± 0.3 mm in the control group. The SEI at baseline was 8.1 ± 1.0 and 7.9 ± 0.7 for Test and Control group, respectively. The between groups difference at 12 months in SEI was 0.4 (95% C.I. − 0.0 to 0.8, P = 0.0697). Twelve months after treatment, CAF + CMX provided a similar SEI compared to CAF alone and the adjunct of a collagen matrix did not show a different impact on the smile esthetic appearance.


2020 ◽  
Vol 8 (D) ◽  
pp. 7-13
Author(s):  
Omar Alaood ◽  
Mohammed Alasqah ◽  
Nawaf Alhomodi ◽  
Noorah Alqahtani ◽  
Khalid Gufran ◽  
...  

BACKGROUND: Gingival recession has been associated with dentinal hypersensitivity, root caries, and esthetic compromise. Root coverage procedures aim at providing both tangible and intangible benefits to the patients. Various procedures have been tried to obtain root coverage of single-rooted teeth. Miller Classes I and II gingival recessions hold out the best promise for root coverage as there is no interdental bone and soft-tissue loss associated with these recessions. AIM: The objective of the study was to evaluate and compare the effectiveness of coronally advanced flap (CAF) with platelet-rich fibrin (PRF) membrane with CAF + connective tissue graft (CTG) on recession coverage. MATERIALS AND METHODS: A total of 16 patients required recession coverage for a single tooth were divided into two groups. The test group received CAF + PRF while the control group got CAF + CTG. Different parameters were taken preoperatively (amount of recession, width, and thickness of attached gingiva) and repeated for the two groups 2 months after surgery. RESULTS: Comparing the two groups after 2 months from surgery showed that the PRF not only has an effect in the management of recession but also has a greater effect on tissue thickness. CONCLUSION: PRF is a minimum invasive approach and a promising material for root coverage and manipulating the gingival biotype.  


2017 ◽  
Vol 8 (4) ◽  
pp. 248-254
Author(s):  
Vitor J Spada ◽  
Patricia O Nassar ◽  
Nahana Cardoso ◽  
Khadidjia MB Caldato ◽  
Jordana H Pandini ◽  
...  

ABSTRACT Introduction Gingival recession is characterized by apical positioning of the gingival side in relation to the cementoenamel junction. Thus, this study aimed at evaluating the effectiveness of two surgical techniques for root coverage in patients with gingival recession of Miller class I or II. Materials and methods A total of 13 patients were selected, from the age group of 20 to 50 years, with bilateral gingival recession Miller class I or II, totaling 34 recessions. When the basic periodontal treatment was accomplished, every recession was included in one of both selected groups according to the surgical technique: Control group—Subepithelial connective tissue graft associated with coronally positioned flap technique and test group—Subepithelial connective tissue graft associated with the modified envelope technique. Patients were evaluated for 180 days, and the periodontal parameters were analyzed in 0, 90, and 180 days. Results The results showed that both surgeries were effective since they kept probe depths with periodontal health and clinical attachment gain (p < 0.05) in both groups, up from 90 days. The reduction was kept for 180 days, mainly for the control group that showed a clinical attachment gain that was still statistically significant at 180 days (p < 0.05). Regarding the root coverage, the control group showed a 90.2% of coverage while the test group showed 89.5%. Conclusion Thus, it can be concluded that both techniques, after 180 days, were effective for the health of periodontal tissues; however, a greater emphasis can be observed on the subepithelial connective tissue graft-associated coronally positioned flap technique because this technique demonstrated a greater significant gain in the clinical attachment level. Clinical significance The subepithelial connective tissue graft is used for gaining the clinical attachment level in the root coverage of patients with gingival recession Miller classes I and II. How to cite this article Spada VJ, Nassar PO, Cardoso N, Caldato KMB, Pandini JH, Randon DM, Nassar CA. Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques. World J Dent 2017;8(4):248-254.


2019 ◽  
Vol 11 (1) ◽  
pp. 12-20
Author(s):  
Saeed Sadat Mansouri ◽  
Omid Moghaddas ◽  
Narjes Torabi ◽  
Katayoun Ghafari

Background and aims. This study aimed to compare the clinical efficacy of vestibular incisional subperiosteal tunnel access (VISTA) with subepithelial connective tissue graft versus a coronally advanced flap (CAF) with subepithelial connective tissue graft for the treatment of gingival recession defects. Materials and methods. This randomized clinical trial was performed on 24 recession defects that were bilaterally Miller’s class I or II in the maxillary canine and premolar area. One quadrant in each patient was selected randomly to receive VISTA (test group) or CAF (control group) with connective tissue graft. Clinical parameters measured at baseline and at 3- and 6- month postoperative intervals included recession width (RW), recession depth (RD), keratinized tissue width (KTW), clinical attachment level (CAL) and probing depth (PD). Results. Healing was uneventful in both the test and control groups. At the 6-month follow-up, there was a significant decrease in RD, RW and CAL and an increase in KTW in both the test and control groups. The PD remained unchanged. At 3 and 6 months, no statistically significant differences were found between VISTA and CAF for root coverage and clinical attachment gain. Mean root coverage (MRC) was 70.69% and 67.22% in the test and control group, respectively. VISTA demonstrated higher frequency of complete root coverage (CRC) compared to CAF: 50% vs. 33% (P<0.05). The mean KTW was 2.4±0.7 mm at the test and 2.7±0.8 mm at the control sites (P>0.05) Conclusion. VISTA, as a minimally invasive approach, can enhance root coverage, KTW and clinical attachment gain; therefore, it can be used as a substitute for CAF with connective tissue graft as a gold standard for root coverage.


2021 ◽  
Author(s):  
Boroka Klara Csifo-Nagy ◽  
Eleonora Solyom ◽  
Vera Lili Bognar ◽  
Annamaria Nevelits ◽  
Ferenc Dori

Abstract Background: The aim of the study was to clinically evaluate the healing of intrabony defects after treatment with a new generation of platelet-rich fibrin (A-PRF+) respect to enamel matrix derivatives (EMD). Methods: Thirty (30) intrabony defects of 18 patients (9 males, 9 females) were randomly treated with A-PRF+ (test, n=15) or EMD (control, n=15). The following clinical parameters were recorded at baseline and 6 months after surgery: pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL). After debridement the intrabony defects were filled with A-PRF+ in the test group, respectively with EMD in the control group, and fixed with sutures to ensure wound closure and stability.Results: Both treatment methods resulted in statistically significant PD reductions, respectively CAL gains six months post-operatively. No statistically significant differences were found between the two groups as the mean CAL gain was 2.33±1.58 mm in the A-PRF+ group, respectively 2.60±1.18 mm in the EMD group (p < 0.001).Conclusion: Within the limits of this study the new-generation platelet-rich fibrin seems to be as clinically effective as EMD in the surgical treatment of intrabony defects. Treatment with A-PRF+ or EMD resulted in reliable clinical outcomes. The use of A-PRF+ as a human autologous product can give a positive impact on periodontal healing.Clinical Relevance: A-PRF+ may be suitable for the treatment of intrabony periodontal defects. Trial registration number (TRN): NCT04404374 (ClinicalTrials.gov ID)Date of registration: 19.05.2020., retrospectively registered


2003 ◽  
Vol 50 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Sasa Jankovic ◽  
Bozidar Dimitrijevic

This study was designed to compare the effectiveness and predictability of GTR and connective tissue graft in the treatment of gingival recession. 15 recessions Miller class II and III were treated with bioabsorbable barrier and coronally advanced flap. The same number of defects was treated with connective tissue graft in combination with coronally advanced flap. Clinical recordings included hygiene standards and recession depth (RD) probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT) Mean (RD) was statistically significant decreased from 5,47mm presurgery to 0.73mm with GTR (87,76%) and from 5,93mm to 0.60 with CTG (89.9%). Prevalence of complete root coverage was 40% for the GTR and 46,66% for CTG group. No statistically significant differences between treatment groups were observed in this study Treatment of gingival recessions with CTG and GTR present effective and highly predictable mucogingival plastic surgical procedures.


2017 ◽  
Vol 11 (1) ◽  
pp. 79-90 ◽  
Author(s):  
Joseph D. Everett ◽  
Jeffrey A. Rossmann ◽  
David G. Kerns ◽  
Ibtisam Al-Hashimi

The objective of this study was to examine potential benefits of using laser therapy for secular decontamination in conjunction with scaling and root planing in the treatment of chronic periodontitis. The study was performed on 173 teeth in 14 patients in a split-mouth design, one side received scaling and root planing followed by laser therapy using a carbon dioxide (CO2) laser with an ablative handpiece (test group); the contralateral side received scaling and root planing without laser (control group). Clinical and laboratory parameters were evaluated prior to treatment and at 3 and 6 months following therapy; clinical measurements were performed by two blinded examiners. The clinical parameters included measurement of gingival recession (REC), bleeding on probing (BOP), clinical attachment level (CAL), pocket depth (PD), furcation involvement (FUR), and tooth mobility (MOB). Laboratory testing to determine the levels of periodontal pathogens was performed using PCR techniques. The results of the study revealed statistically significant differences in clinical and laboratory parameters at 3 and 6 months after therapy for both test and control groups, but no significant difference was observed between the two groups. However, sites receiving laser therapy tended to show a greater decrease in probing depths, gain in clinical attachment level, and reduced bacterial levels. In conclusion, the overall results of the study suggest a potential benefit of using laser therapy in conjunction with scaling and root planing for the treatment of chronic periodontitis.


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