L-PRF Versus Connective Tissue Graft Associated to Coronally Advanced Flap in Gingival Recession Treatment

Summary

Background: Nowadays, the use of connective tissue graft associated to the coronally advanced flap is considered the "gold standard" for localized gingival recession treatment. However, this technique requires a donor site, which can be associated with greater morbidity. The use of platelet concentrates, particularly the Leukocytes- and Platelets Rich Fibrin (L-PRF), it has emerged as an alternative for gingival recession treatment, due to its properties which enhance the regenerative process. Therefore, the purpose of this study was to evaluate and to compare the effect obtained with L-PRF versus connective tissue graft (CTG) associated to the Coronally Advanced Flap (CAF) in the treatment of Miller class I or II localized gingival recessions.

Methods: A randomized controlled clinical trial of parallel groups (1:1) with 17 recessions in each group was performed. Control group (CAF + CTG) and test group (CAF + L-PRF). In each group the following variable were measured: postoperative pain and incidence of post-surgical complications at 24-48-72 hours, gingival recession depth (RD), gingival recession width (RW), gingival thickness (GT), probing depth (PD), clinical insertion level (NIC), keratinized tissue height (KTH) before treatment and after 1, 3 and 6 months of root covering surgery and the root coverage esthetic score (RES) at 6 months after treatment.

Conditions

• Gingival Recession, Localized

Interventions

PROCEDURE

Leukocyte and Platelet Rich Fibrin plus Coronally Advanced Flap

The Coronally advanced flap was made following the protocol described by Zucchelli et al. in 2007. (39). When the margin of the flap was able to passively extend until more coronal of the CEJ the coronal mobilization of the flap was considered satisfactory. A double L-PRF membrane was positioned at the level of CEJ, getting the stabilization with 5-0 resorbable suture. After that, the flap was coronally advanced and stabilized with interrupted sutures (5-0 resorbable) anchored to incisal contact points (mesial and distal) created with a flowable, light-curing resin material in the treated tooth. Finally, gentle pressure over the area with a moistened gauze with saline solution was performed.

PROCEDURE

Connective tissue graft plus Coronally Advanced Flap

The Coronally advanced flap was made following the protocol described by Zucchelli et al. in 2007. (39). When the margin of the flap was able to passively extend until more coronal of the CEJ the coronal mobilization of the flap was considered satisfactory. Then connective tissue graft obtained from the palate was positioned at the level of CEJ, getting the stabilization with 5-0 resorbable suture. After that, the flap was coronally advanced and stabilized with interrupted sutures (5-0 resorbable) anchored to incisal contact points (mesial and distal) created with a flowable, light-curing resin material in the treated tooth. Finally, gentle pressure over the area with a moistened gauze with saline solution was performed.

Sponsors & Collaborators

• Universidad de los Andes, Chile

  lead OTHER

Principal Investigators

• Catherine Andrade · Universidad de Los Andes

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2017-04-01

Primary Completion

2019-10-15

Completion

2019-10-15

Countries

• Chile

Study Locations