scholarly journals Additive Effect of Platelet Rich Fibrin with Coronally Advanced Flap Procedure in Root Coverage of Miller’s Class I and II Recession Defects—A PRISMA Compliant Systematic Review and Meta-Analysis

Materials ◽  
2020 ◽  
Vol 13 (19) ◽  
pp. 4314
Author(s):  
Saurav Panda ◽  
Anurag Satpathy ◽  
Abhaya Chandra Das ◽  
Manoj Kumar ◽  
Lora Mishra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Gingival Recession ◽  
Additive Effect ◽  
Class I ◽  
Cochrane Central Register ◽  
Root Coverage ◽  
Platelet Rich Fibrin ◽  
Gingival Thickness ◽  
Coronally Advanced Flap

Aim: This systematic review and meta-analysis aims to assess the additive effect of leukocyte and platelet-rich fibrin (L-PRF) on coronally advanced flap (CAF) procedures in root coverage of Miller’s class I and II gingival recession defects. Review methodology: A comprehensive search in MEDLINE (PubMed), Scopus and CENTRAL (the Cochrane Central Register of Controlled Trials), along with an additional hand search, provided eight randomized clinical trials to be included in this review. A total of 167 patients with 470 gingival recession defects were analyzed. A meta-analysis was carried out to assess the change in gingival thickness (GT), width of keratinized gingiva (WKG), root coverage percentage (%RC), clinical attachment level (CAL) and recession depth (RD) at all follow-ups between CAF alone and CAF + L-PRF groups for all included studies. A subgroup analysis was carried out based on recession type (single/multiple). Results: Overall, a significant improvement in GT, CAL and RD was found when treated with CAF + L-PRF. There was a trend for a positive effect in terms of an increase in WKG when using L-PRF, especially in the treatment of single recession, though significance was not achieved (p = 0.08 overall). The results of heterogeneity among the subgroups were varied and were found to be greater than 91.3% for GT and 32.8% for WKG. Conclusion: L-PRF when used in addition to CAF showed favorable results for the treatment of class I and II gingival recession defects.

scholarly journals Platelet-Rich Fibrin in Single and Multiple Coronally Advanced Flap for Type 1 Recession: An Updated Systematic Review and Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 144
Author(s):  
Leonardo Mancini ◽  
Francesco Tarallo ◽  
Vincenzo Quinzi ◽  
Adriano Fratini ◽  
Stefano Mummolo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Perception ◽  
Meta Analysis ◽  
Patient Reported Outcome Measures ◽  
Root Coverage ◽  
Platelet Rich Fibrin ◽  
Gingival Thickness ◽  
Coronally Advanced Flap ◽  
Keratinized Tissue ◽  
Patient Reported

Background and Objectives: The aim of the present systematic review and meta-analysis was to investigate the efficacy of leukocyte–platelet-rich fibrin (L-PRF) in addition to coronally advanced flap (CAF) for the treatment of both single and multiple gingival recessions (GRs) compared to the CAF alone and to the adjunct of connective tissue graft (CTG). Root coverage outcomes using platelet concentrates have gained increased interest. In particular, it has been suggested that adding L-PRF to CAF may provide further benefits in the treatment of GRs. Materials and Methods: An electronic and manual literature search was conducted to identify randomized controlled trials (RTCs) investigating root coverage outcomes with CAF + L-PRF. The outcomes of interest included mean root coverage (mRC), recession reduction, keratinized tissue width (KTW) gain, gingival thickness (GT) gain, and patient-reported outcome measures (PROms) such as pain perception and discomfort. Results: A total of 275 patients and 611 surgical sites were analyzed. L-PRF in adjunct to single CAF seems to show statistically significant results regarding clinical attachment level (CAL) with a weighted means (WM) 0.43 95% CI (−0.04, 0.91), p < 0.0001, GT (WM 0.17 95% CI (−0.02, 0.36), p < 0.0001, and mRC (WM 13.95 95% CI (−1.99, 29.88) p < 0.0001, compared to single CAF alone. Interesting results were obtained from the adjunct of PRF to multiple CAF with respect to multiple CAF alone with an increase in the mRC WM 0.07 95% CI (−30.22, 30.35), p = 0.0001, and PPD change WM 0.26 95% CI (−0.06, 0.58), p < 00001. On the other hand, no statistically significant data were obtained when L-PRF was added to single or multiple CAF combined with CTG according to the included outcomes such as mRC (p = 0.03 overall). Conclusions: L-PRF is a valid alternative to CAF alone. L-PRF compared to CTG in single and multiple CAF showed statistically significant results regarding pain perception and discomfort PROms (p < 0.0001). However, CTG remains the gold standard for treating gingival recession.

scholarly journals Comparative Evaluation of Coronally Advanced Flap with Platelet-rich Fibrin vs Amniotic Membrane for the Treatment of Gingival Recession

2017 ◽  
Vol 8 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Abhishek Gautam
Keyword(s):  
Amniotic Membrane ◽  
Comparative Evaluation ◽  
Gingival Recession ◽  
Class I ◽  
Root Coverage ◽  
Platelet Rich Fibrin ◽  
Coronally Advanced Flap ◽  
Keratinized Tissue ◽  
Probing Depth ◽  
To Receive

ABSTRACT Background The purpose of this clinical trial was to compare the outcome of gingival recession technique using the coronally advanced flap (CAF) with platelet-rich fibrin (PRF) and amniotic membrane. Materials and methods About 15 patients with bilateral Miller class I buccal gingival recessions (4–5 mm) in maxillary and mandibular canines were selected. The recessions were randomly assigned to receive either the CAF with PRF or the CAF with amniotic membrane. Recession height (RH), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), probing depth (PD), and clinical attachment level (CAL) were measured at baseline as well as 6 months postsurgery. Patient satisfaction with esthetics, root sensitivity, and postoperative pain was also evaluated. Results The average percentages of root coverage for CAF with PRF and CAF with amniotic membrane were 92.95% and 97.40% (p < 0.05) respectively, and the complete root coverage observed was 56.94% and 76.47% respectively. The CAF with amniotic membrane showed a statistically significant increase in TKT (p < 0.05). There were no significant differences between the two groups with regard to RH, RW, WKT, PD, and CAL. The esthetic condition after both treatments was considered satisfactory by the patients. Conclusion The outcome of this study reflects that CAF with PRF and amniotic membrane can be successfully used to treat class I gingival recession. How to cite this article Gautam A. Comparative Evaluation of Coronally Advanced Flap with Platelet-rich Fibrin vs Amniotic Membrane for the Treatment of Gingival Recession. J Health Sci Res 2017;8(1):31-37.

scholarly journals Platelet-Rich Fibrin in Coverage of Gingival Recession: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 14 (02) ◽  
pp. 315-326
Author(s):  
Miguel Augusto Riquelme Rodas ◽  
Bruna Luísa de Paula ◽  
Victor Fabrizio Cabrera Pazmiño ◽  
Flávia Ferraz dos Santos Lot Vieira ◽  
Joel Ferreira Santiago Junior ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Gingival Recession ◽  
Class I ◽  
Clinical Attachment Level ◽  
Platelet Rich Fibrin ◽  
Probing Depth ◽  
Significant Difference ◽  
Keratinized Mucosa ◽  
Attachment Level

AbstractThis systematic review and meta-analysis sought to evaluate the efficacy of platelet-rich fibrin (PRF) membranes versus subepithelial connective tissue grafts (SCTGs) in the coverage of Miller class I and II gingival recessions. After the inclusion and exclusion criteria were applied, the quality of seven articles (Cohen’s Kappa = 0.9) was evaluated using the Jadad scale. The MEDLINE/PubMed, Cochrane, and Web of Science databases were consulted, and manual searches were performed in the most popular periodontics journals. The studies included considered a total of 122 patients, 203 surgical fields on which SCTGs were used, and 205 surgical fields on which PRF was used. The parameters analyzed were probing depth, clinical attachment level, gingival recession, and keratinized mucosa. The minimum follow-up period accepted was 6 months. A statistically significant difference between the SCTG and PRF groups was found only in the case of keratinized mucosa. However, gingival recession, clinical attachment level, and probing depth parameters in the PRF group were found to be statistically equal to those of the SCTG group (the gold standard) (p ≥0.05). PRF membranes were determined to be a promising alternative to autogenous gingival grafts in the treatment of Miller class I and II gingival recessions.

scholarly journals Management of Multiple Recession simultaneously with Modified Coronally Advanced Flap

2017 ◽  
Vol 1 (2) ◽  
pp. 81-83
Author(s):  
Harish Kumar Shah ◽  
Shashi Kant Chaudhary ◽  
Khushboo Goel ◽  
Sajeev Shrestha
Keyword(s):  
Prognostic Factors ◽  
Gingival Recession ◽  
Class I ◽  
Root Coverage ◽  
Periodontal Health ◽  
Aesthetic Result ◽  
Coronally Advanced Flap ◽  
Flap Procedure ◽  
The Aesthetic

Gingival recession is one of the aesthetic concern for a beautiful smile. In an aesthetically driven era, root coverage requires consideration of all prognostic factors for successful results. This paper reports a case of treatment of Miller’s Class I gingival recession involving multiple teeth. A modified coronally advanced flap procedure was performed. At the postoperative follow-up visits, healing was uneventful. After 9 months, excellent aesthetic result was achieved with complete root coverage. Periodontal health was normal and the patient was satisfied with the result.

scholarly journals Platelet-rich fibrin-a cost-effective, donor less and indigenous therapy for obtaining root coverage-a case report

2017 ◽  
Vol 5 (1) ◽  
pp. 46
Author(s):  
Bharat Joshi
Keyword(s):  
Cost Effective ◽  
Gingival Recession ◽  
Class Iii ◽  
Root Coverage ◽  
Platelet Rich Fibrin ◽  
Free Gingival Graft ◽  
Coronally Advanced Flap ◽  
Attached Gingiva ◽  
Separate Clinical Entity ◽  
Rapid Healing

Among the periodontal infections, gingival recession is a separate clinical entity which demands a permanent solution plan. Treatment therapies are based on either elimination (as in case of Miller’s class I/II recession) or increasing the width of keratinized gingiva for prevention of further progression (as in case of Miller’s class III/IV recession). From the centuries, graft surgeries like free gingival graft, lateral pedicle and Coronally advanced flaps have been successful in the  treatment of gingival recession. As every technique has its own merits and demerits, clinicians have tried to stress upon addition of certain adjuncts or biomaterials to ensure rapid healing and less post-operative discomfort. Platelet concentrates are an excellent biomaterials for increasing width of attached gingiva and enhancing wound healing. They are cost effective, do not require donor tissue for harvesting and contain variety of growth factors for initiating regeneration. In this paper, Platelet-rich fibrin a 2nd generation concentrates has been used as an adjunct to Coronally advanced flap with a purpose of increasing width of keratinized gingiva, obtaining complete root coverage and achieving gingival harmony.

scholarly journals Platelet-Rich Fibrin in third molar surgery. Systematic review and meta-analysis protocol

2020 ◽  
Author(s):  
Gaston Salas ◽  
Shuheng Lai ◽  
Francisca Verdugo-Paiva ◽  
Roberto Requena
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Meta Analysis ◽  
Grey Literature ◽  
Third Molar ◽  
Risk Of Bias ◽  
Third Molar Surgery ◽  
Cochrane Central Register ◽  
Eligibility Criteria ◽  
Platelet Rich Fibrin

Objective: The objective of this systematic review is to assess the effectiveness and safety of platelet rich fibrin (PRF) in third molar surgery. Data sources: A comprehensive search strategy is meant to be used in an attempt to identify all relevant RCTs, ongoing investigation reported in specialty congresses and trials regardless of language or publication status (published, unpublished, in press, and in progress). Search will be conducted in The Cochrane Central Register of Controlled Trials (CENTRAL); PUBMED; Embase; Lilacs, and also conduct a search through trial registries of the International Clinical Trials Registry Platform (ICTRP), Word Health Organization (WHO) and the ClinicalTrials.gov, US National Institutes of Health (NIH), grey literature search and specialty congress will be reviewed. Eligibility criteria: We will include randomised trials evaluating the effect of PRF on wound healing after third molar surgery. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias using Cochrane 'risk of bias' tool. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. Ethics and dissemination: As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived. Keywords: platelet-rich fibrin; third molars; wound healing; systematic review

Evaluation of a bioabsorbable collagen membrane in the treatment of localized gingival recession – a case series”

2017 ◽  
Vol 9 (2) ◽  
pp. 37-43
Author(s):  
Harsha. M B
Keyword(s):  
Tissue Regeneration ◽  
Case Series ◽  
Gingival Recession ◽  
Class Ii ◽  
Guided Tissue Regeneration ◽  
Class I ◽  
Collagen Membrane ◽  
Root Caries ◽  
Root Coverage ◽  
Coronally Advanced Flap

BACKGROUND: Gingival recession (GR), often an aesthetic concern to the patient, is also associated with root sensitivity, and has a predilection to root caries. The purpose of this case series was to evaluate a bioabsorbable collagen membrane for root coverage with guided tissue regeneration (GTR) procedure, in localized gingival recession defects. METHODS: Three cases presented in this case series, showing a localized Miller’s Class I or Class II gingival recession were treated for root coveragewith GTR-based collagen membrane. The graft was completely covered with coronally advanced flap and followed up to 6th month postoperatively. RESULTS: Six months following the procedure, the root coverage was found to be 100% in all three cases. The root coverage obtained appeared structurally and functionally stable. CONCLUSION: It may be concluded that the resorbable collagen membrane could be reliably used in the treatment of gingival recession.

scholarly journals Tunnel/Pouch versus Coronally Advanced Flap Combined with a Connective Tissue Graft for the Treatment of Maxillary Gingival Recessions: Four-Year Follow-Up of a Randomized Controlled Trial

2020 ◽  
Vol 9 (8) ◽  
pp. 2641
Author(s):  
Souheil Salem ◽  
Leila Salhi ◽  
Laurence Seidel ◽  
Geoffrey Lecloux ◽  
Eric Rompen ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Test Group ◽  
Gingival Recession ◽  
Root Coverage ◽  
Gingival Thickness ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue

Background: The long-term stability after soft tissue graft for covering gingival recession remains a pivotal goal for both patient and periodontist. Therefore, the aim of this study was to compare the four-year outcomes of the coronally advanced flap (CAF) versus the pouch/tunnel (POT) technique, both combined with connective tissue graft (CTG), for gingival recession treatment. Methods: Forty patients were initially randomly assigned to the control group (CAF + CTG; N = 20) and the test group (POT + CTG; N = 20). Clinical outcomes included mean root coverage (MRC) and complete root coverage (CRC), gingival thickness (GT), and keratinized tissue (KT) gain. Esthetic outcomes were also analyzed using the pink esthetic score (PES) and patient-reported outcome measures (PROMs). All outcomes initially assessed at six months were extended to four years post-surgery. Results: No significant differences were observed between the two patient groups in terms of MRC and CRC. At four years, significantly greater GT and KT gain were noted in the POT + CTG group, and tissue texture enhancement was also more prominent in the test group. Conclusions: The POT + CTG technique allows for long-term clinical coverage of gingival recessions comparable to that of the CAF + CTG technique, but it potentially improves gingival thickness, keratinized tissue and esthetic results.

scholarly journals Platelet-Rich Fibrin in Third Molar Surgery: Systematic Review and Meta-Analysis Protocol

2021 ◽  
pp. 194338752110162
Author(s):  
Gaston A. Salas ◽  
Shuheng A. Lai ◽  
Francisca Verdugo-Paiva ◽  
Roberto A. Requena
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Third Molar ◽  
Risk Of Bias ◽  
Third Molar Surgery ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Eligibility Criteria ◽  
Platelet Rich Fibrin

Objective: The objective of this systematic review is to assess the effectiveness and safety of platelet-rich fibrin (PRF) in third molar surgery. Data Sources: A comprehensive search strategy is meant to be used in an attempt to identify all relevant randomized controlled trials (RCTs), ongoing investigation reported in specialty congresses and trials regardless of language or publication status (published, unpublished, in press and in progress). Searches will be conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov , US National Institutes of Health (NIH), grey literature and in specialized congresses and conferences. Eligibility Criteria: We will include randomized trials evaluating the effect of PRF on wound healing after third molar surgery. Two reviewers will independently screen each study for eligibility, data extraction and risk of bias assessment using Cochrane “risk of bias” tool. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. Ethics and Dissemination: As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived.

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