scholarly journals Clinical Evaluation of the Efficacy of Coronally Advanced Flap in Combination with Platelet-Rich Fibrin Membrane in the Treatment of Miller Class I Gingival Recessions

2020 ◽  
Vol 8 (D) ◽  
pp. 7-13
Author(s):  
Omar Alaood ◽  
Mohammed Alasqah ◽  
Nawaf Alhomodi ◽  
Noorah Alqahtani ◽  
Khalid Gufran ◽  
...  
Keyword(s):  
Test Group ◽  
Gingival Recession ◽  
Tissue Loss ◽  
Control Group ◽  
Root Coverage ◽  
Invasive Approach ◽  
Platelet Rich Fibrin ◽  
Coronally Advanced Flap ◽  
Attached Gingiva ◽  
Soft Tissue Loss

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.  

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 Smile esthetic evaluation of mucogingival reconstructive surgery

Odontology ◽  
2020 ◽  
Vol 109 (1) ◽  
pp. 295-302
Author(s):  
Roberto Rotundo ◽  
Luigi Genzano ◽  
Michele Nieri ◽  
Ugo Covani ◽  
David Peñarrocha-Oltra ◽  
...  
Keyword(s):  
Treatment Group ◽  
Test Group ◽  
Collagen Matrix ◽  
Gingival Recession ◽  
Control Group ◽  
Root Coverage ◽  
Coronally Advanced Flap ◽  
The Difference ◽  
And Control

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.

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
Keyword(s):  
Platelet Rich Plasma ◽  
Test Group ◽  
Gingival Recession ◽  
Control Group ◽  
Clinical Parameters ◽  
Clinical Attachment Level ◽  
Platelet Rich Fibrin ◽  
Coronally Advanced Flap ◽  
And Control ◽  
Attachment Level

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.

scholarly journals Vestibular incisional subperiosteal tunnel access versus coronally advanced flap with connective tissue graft for root coverage of Miller’s class I and II gingival recession: A randomized clinical trial

2019 ◽  
Vol 11 (1) ◽  
pp. 12-20
Author(s):  
Saeed Sadat Mansouri ◽  
Omid Moghaddas ◽  
Narjes Torabi ◽  
Katayoun Ghafari
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Control Group ◽  
Root Coverage ◽  
Control Groups ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Subepithelial Connective Tissue Graft ◽  
And Control

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.

scholarly journals Efficacy of a New-generation Platelet-rich Fibrin in the Treatment of Periodontal Intrabony Defects: a Randomized Clinical Trial

2021 ◽  
Author(s):  
Boroka Klara Csifo-Nagy ◽  
Eleonora Solyom ◽  
Vera Lili Bognar ◽  
Annamaria Nevelits ◽  
Ferenc Dori
Keyword(s):  
Positive Impact ◽  
Test Group ◽  
Gingival Recession ◽  
Control Group ◽  
Intrabony Defects ◽  
Pocket Depth ◽  
Platelet Rich Fibrin ◽  
Registration Number ◽  
Enamel Matrix Derivatives ◽  
New Generation

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

scholarly journals Combination of orthodontic movement and periodontal therapy for full root coverage in a miller class iii recession: a case report with 12 years of follow-up

2012 ◽  
Vol 23 (6) ◽  
pp. 758-763 ◽  
Author(s):  
Rafael Scaf de Molon ◽  
Érica Dorigatti de Avila ◽  
João Antonio Chaves de Souza ◽  
Andressa Vilas Boas Nogueira ◽  
Carolina Chan Cirelli ◽  
...  
Keyword(s):  
Case Report ◽  
Gingival Recession ◽  
Periodontal Therapy ◽  
Treatment Modalities ◽  
Class Iii ◽  
Root Coverage ◽  
Free Gingival Graft ◽  
Coronally Advanced Flap ◽  
Orthodontic Movement ◽  
Attached Gingiva

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.

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.

Treatment of Gingival Recession with Hypersensitivity using Free Soft-tissue Graft Procedures

2020 ◽  
Vol 1 (1) ◽  
pp. 01-06
Author(s):  
Deliverska E
Keyword(s):  
Soft Tissue ◽  
Treatment Options ◽  
Gingival Recession ◽  
Control Group ◽  
Root Coverage ◽  
Free Gingival Graft ◽  
Coronally Advanced Flap ◽  
Tissue Graft ◽  
Soft Tissue Graft ◽  
Gingival Graft

Background The main goal of root coverage procedure is complete coverage of the recession defect with a good esthetic result related to the adjacent soft tissues and minimal probing depth after the healing process. Purpose The aim of this study was to compare the efficiency of surgical and nonsurgical treatment options in patients with gingival recession and dentin hypersensitivity (DH). Material and methods 60 patients with gingival recession Miller Class I and II with hypersensitivity and esthetic concerns were included. 30 of them were treated with free soft-tissue graft procedures and control group of 30 people were treated with anti-hypersensitivity gel. Surgically treated patients were separated in two groups: 20 of them- with coronally advanced flap with sub-epithelial connective tissue graft and 10 of them- with free gingival graft. Results We achieved full coverage on the exposed root surfaces in 18 patients treated with coronally advanced flap and de-epithelized graft and partial root coverage in two of them. Patients treated with free gingival graft procedure achieved full root coverage in 6 of them and partial on 4 of them (GR=1 mm after surgery). Surgical treatment led to resolution of the esthetic issues of the patients and elimination or reduction of the DH. In control group there were partial elimination of root sensitivity. Conclusion: In surgical treated group with both techniques we achieved resolution of DH and coverage of the root surface with healthy keratinized tissues. Surgery may be considered for treatment options of DH depending on the indications.

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 Efficacy of a new-generation platelet-rich fibrin in the treatment of periodontal intrabony defects: a randomized clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Boróka Klára Csifó-Nagy ◽  
Eleonóra Sólyom ◽  
Vera Lili Bognár ◽  
Annamária Nevelits ◽  
Ferenc Dőri
Keyword(s):  
Positive Impact ◽  
Test Group ◽  
Gingival Recession ◽  
Enamel Matrix Derivative ◽  
Control Group ◽  
Intrabony Defects ◽  
Pocket Depth ◽  
Platelet Rich Fibrin ◽  
Registration Number ◽  
New Generation

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 derivative (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 during 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).

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