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 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 as Wound Coverage of Donor Site in Free Gingival Graft

2018 ◽  
Vol 2 (1) ◽  
pp. 26-29
Author(s):  
Shweta Agrawal ◽  
Pramod Kumar Koirala ◽  
Shalini Pradhan ◽  
Ranjita Shrestha Gorkhali
Keyword(s):  
Wound Healing ◽  
Pain Perception ◽  
Donor Site ◽  
Gingival Recession ◽  
Root Coverage ◽  
Wound Coverage ◽  
Platelet Rich Fibrin ◽  
Free Gingival Graft ◽  
Keratinized Tissue ◽  
Gingival Graft

Free gingival graft is one of the technique used for root coverage so as to increase the inadequate keratinized tissue. The donor tissue is most frequently taken from the palate and generally the donor site is not covered or protected. Platelet rich fibrin is one of the good option for the wound coverage of donor site after free gingival graft so as to reduce the pain perception to patient and faster wound healing. The case report includes two cases with gingival recession, treated on the same day with free gingival graft with the use of platelet rich fibrin in the donor site in case 1 and without platelet rich fibrin in case 2 respectively which were compared for pain perception and wound healing postoperatively at 24 hours, 3 days, 5 days, 7 days and 14 days. There was less pain perception and discomfort in the donor site with the use of platelet rich fibrin and enhanced healing compared to donor site without platelet rich fibrin.

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 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 Development of an Item Bank to Measure Medication Adherence: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Yu Heng Kwan ◽  
Livia Jia Yi Oo ◽  
Dionne Hui Fang Loh ◽  
Jie Kie Phang ◽  
Si Dun Weng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Meta Analysis ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Item Bank ◽  
Cochrane Library ◽  
Measurement Information ◽  
Adaptive Tests ◽  
Patient Reported

BACKGROUND Medication adherence is important in managing the progression of chronic diseases. A promising approach to reduce cognitive burden when measuring medication adherence lies in the use of computer‐adaptive tests (CATs) or in the development of shorter patient-reported outcome measures (PROMs). However, the lack of an item bank currently hampers this progress. OBJECTIVE We aim to develop an item bank to measure general medication adherence. METHODS Using the preferred reporting items for systematic review and meta-analysis (PRISMA), articles published before October 2019 were retrieved from PubMed, Embase, CINAHL, the Cochrane Library, and Web of Science. Items from existing PROMs were classified and selected (“binned” and “winnowed”) according to standards published by the Patient-Reported Outcomes Measurement Information System (PROMIS) Cooperative Group. RESULTS A total of 126 unique PROMs were identified from 213 studies in 48 countries. Items from the literature review (47 PROMs with 579 items for which permission has been obtained) underwent binning and winnowing. This resulted in 421 candidate items (77 extent of adherence and 344 reasons for adherence). CONCLUSIONS We developed an item bank for measuring general medication adherence using items from validated PROMs. This will allow researchers to create new PROMs from selected items and provide the foundation to develop CATs.

scholarly journals Medial stabilised total knee arthroplasty achieves comparable clinical outcomes when compared to other TKA designs: a systematic review and meta-analysis of the current literature

2020 ◽  
Author(s):  
Sohail Nisar ◽  
Kashif Ahmad ◽  
Jeya Palan ◽  
Hemant Pandit ◽  
Bernard van Duren
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Implant Design ◽  
Cochrane Central Register ◽  
Rotating Platform ◽  
Level Of Evidence ◽  
Patient Reported

Abstract Purpose The purpose of this study was to perform a systematic review and meta-analysis to compare clinical and patient-reported outcome measures of medially stabilised (MS) TKA when compared to other TKA designs. Methods The Preferred Reporting Items for Systematic Review and Meta-Analyses algorithm was used. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and EMCARE databases were searched to June 2020. Studies with a minimum of 12 months of follow-up comparing an MS TKA design to any other TKA design were included. The statistical analysis was completed using Review Manager (RevMan), Version 5.3. Results The 22 studies meeting the inclusion criteria included 3011 patients and 4102 TKAs. Overall Oxford Knee Scores were significantly better (p = 0.0007) for MS TKA, but there was no difference in the Forgotten Joint Scores (FJS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS)-Knee, KSS-Function, and range of motion between MS and non-MS TKA designs. Significant differences were noted for sub-group analyses; MS TKA showed significantly worse KSS-Knee (p = 0.02) and WOMAC (p = 0.03) scores when compared to Rotating Platform (RP) TKA while significantly better FJS (p = 0.002) and KSS-knee scores (p = 0.0001) when compared to cruciate-retaining (CR) TKA. Conclusion This review and meta-analysis show that MS TKA designs result in both patient and clinical outcomes that are comparable to non-MS implants. These results suggest implant design alone may not provide further improvement in patient outcome following TKA, surgeons must consider other factors, such as alignment to achieve superior outcomes. Level of evidence III.

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