 |
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2025, vol. 31, issue1
Subject Area: Dental Medicine
-
DOI: 10.5272/jimab.2025311.6085
Published online: 26 March 2025
Original article
J of IMAB. 2025 Jan-Mar;31(1):6085-6090
COMPARISON OF THE EFFECTIVENESS OF CORONALLY ADVANCED FLAP ALONE AND IN COMBINATION WITH PLATELET-RICH FIBRIN MEMBRANE FOR TREATMENT OF GINGIVAL RECESSIONS
Dimitar Dimitrov
, Denislav Emilov, Ivan Ivanov, Antoaneta Mlachkova,
Department of Periodontology, Faculty of Dental Medicine, Medical University – Sofia, Bulgaria.
ABSTRACT:
Purpose: To compare the effectiveness between the coronally advanced flap alone and in combination with a platelet-rich fibrin membrane for the treatment of gingival recessions Miller class I and II.
Materials and methods: 30 gingival recessions Miller Class I /II were surgically treated randomly divided into 2 groups: 15 recessions in the test group (CAF + PRF) and 15 recessions in the control group (CAF). Before the surgical intervention and on the 6th month postoperatively, the following clinical parameters were evaluated: depth (RD) and width (RW) of gingival recession, probing pocket depth (PPD), clinical attachment level (CAL), amount of keratinized gingiva (KTH) and gingival thickness (GT). In the 6th month, the achieved mean root coverage in percentage (MRC, %) was evaluated.
Results: A similar success of both techniques was demonstrated in terms of achieved MRC % - 88.44 % ± 16.99 % in the CAF + PRF group vs. 84.44% ± 20.38% in the CAF group (p = 0.56), as well as in the improvement of the following parameters: RD, RW, PPD, CAL and KTH. The additional use of PRF membrane to CAF resulted in a statistically significant increase in gingival thickness when the results were assessed 6 months after the surgical treatment of the recessions in the CAF + PRF group compared to CAF - a mean increase of 0.32 mm vs. 0.06 mm (p < 0.01).
Conclusions: Combining CAF with PRF membrane is a more effective approach to increase soft tissue thickness and achieve stable root coverage to maintain periodontal health in patients with sufficient keratinized gingiva in gingival recessions Miller class I and II.
Keywords: gingival recessions, PRF membrane, coronally advanced flap, gingival thickness, complete root coverage, mean root coverage,
- Download FULL TEXT /PDF 915 KB/
Please cite this article as: Dimitrov D, Emilov D, Ivanov I, Mlachkova A. Comparison of the effectiveness of coronally advanced flap alone and in combination with platelet-rich fibrin membrane for treatment of gingival recessions. J of IMAB. 2025 Jan-Mar;31(1):6085-6090. [Crossref - 10.5272/jimab.2025311.6085]
Correspondence to: Dimitar Dimitrov, Department of Periodontology, Faculty of Dental Medicine, Medical University – Sofia; 1, Georgi Sofiyski Str., 1431 Sofia, Bulgaria; E-mail: d.dimitrov@fdm.mu-sofia.bg
REFERENCES:
1. Emilov D, Deliverska E. Surgical treatment of gingival recession with soft tissue graft procedure. J of IMAB. 2018 Jul-Sep;24(3):2149-2159. [Crossref]
2. Emilov DK, Deliverska-Aleksandrova EG. Treatment of gingival recession with hypersensitivity using free soft-tissue graft procedures. Folia Medica (Plovdiv) 2022 Apr 30;64(2):321-326. [PubMed]
3. Zucchelli G, Tavelli L, Ravidà A, Stefanini M, Suárez-López Del Amo F, Wang HL. Influence of tooth location on coronally advanced flap procedures for root coverage. J Periodontol. 2018 Dec;89(12):1428-1441. [PubMed]
4. Zucchelli G, Tavelli L, Barootchi S, Stefanini M, Wang HL, Cortellini P. Clinical remarks on the significance of tooth malposition and papillae dimension on the prediction of root coverage. Int J Periodontics Restorative Dent 2020 Nov-Dec;40(6):795–803. [PubMed]
5. Stefanini M, Barootchi S, Tavelli L, Marzadori M, Mazzotti C, Mounssif I, et al. Difficulty score for the treatment of isolated gingival recessions with the coronally advanced flap: a preliminary reliability study. Clin Oral Invest. 2022 Oct 12;27(2):559–569. [PubMed]
6. Li R, Liu Y, Xu T, Zhao H, Hou J, Wu Y, et al. The Additional Effect of Autologous Platelet Concentrates to Coronally Advanced Flap in the Treatment of Gingival Recessions: A Systematic Review and Meta-Analysis. Biomed Res Int. 2019 Jul 25;2019:2587245. [PubMed]
7. Kirilova JN, Kosturkov D. Direct Pulp Capping with Advanced Platelet-Rich Fibrin: A Report of Two Cases. Medicina. 2023; 59(2):225. [Crossref]
8. Kirilova J, Kirov D, Yovchev D, Topalova-Pirinska S, Deliverska E. Endodontic and surgical treatment of chronic apical periodontitis: a randomized clinical study. BiotechnolBiotechnol Equip. 2022 Sep 8;36(1):737–744. [Crossref]
9. Kirilova J, Kirov D, Yovchev D, Deliverska E. Treatment of an apical cyst with platelet concentrate – a case report. Folia Medica (Plovdiv) 2023 Dec 31;65(6):1005-1010. [PubMed]
10. Miron RJ, Zucchelli G, Pikos MA, Salama M, Lee S, Guillemette V, et al. Use of platelet-rich fibrin in regenerative dentistry: a systematic review. Clin Oral Investig. 2017 Jul;21(6):1913-1927. [PubMed]
11. Thamaraiselvan M, Elavarasu S, Thangakumaran S, Gadagi JS, Arthie T. Comparative clinical evaluation of coronally advanced flap with or without platelet rich fibrin membrane in the treatment of isolated gingival recession. J Indian Soc Periodontol. 2015 Jan-Feb;19(1):66-71. [PubMed]
12. Banthia R, Gupta S, Singh P, Banthia P, Raje S, Aggarwal N. Clinical evaluation and comparison of the efficacy of coronally advanced flap alone and in combination with platelet rich fibrin membrane in the treatment of Miller class I and II gingival recessions. Contemp Clin Dent. 2015 Apr-Jun;6(2):153-160. [PubMed]
13. Miron RJ, Moraschini V, Del Fabbro M, Piattelli A, Fujioka-Kobayashi M, Zhang Y, et al. Use of platelet-rich fibrin for the treatment of gingival recessions: a systematic review and meta-analysis. Clin Oral Investig. 2020 Aug;24(8):2543-2557. [PubMed]
14. Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D. Clinical evaluation of a modified coronally advanced flap alone or in combination with a platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: a 6-month study. JPeriodontol. 2009 Feb;80(2):244–52. [PubMed]
15. Zucchelli G, Tavelli L, Barootchi S, Stefanini M, Rasperini G, Valles C, et al. The influence of tooth location on the outcomes of multiple adjacent gingival recessions treated with coronally advanced flap: A multicenter re-analysis study. J Periodontol. 2019 Nov;90(11):1244-1251. [PubMed]
16. Rodas MAR, Paula BL, Pazmiño VFC, Lot Vieira FFDS, Junior JFS, Silveira EMV. Platelet-rich fibrin in coverage of gingival recession: a systematic review and meta-analysis. Eur J Dent. 2020 Mar;14(2):315-326. [PubMed]
17. Padma R, Shilpa A, Kumar PA, Nagasri M, Kumar C, Sreedhar A. A split mouth randomized controlled study to evaluate the adjunctive effect of platelet-rich fibrin to coronally advanced flap in Miller's class-I and II recession defects. J Indian Soc Periodontol. 2013 Sep;17(5):631-6. [PubMed]
18. Mufti S, Dadawala SM, Patel P, Shah M, Dave DH. Comparative Evaluation of Platelet-Rich Fibrin with Connective Tissue Grafts in the Treatment of Miller's Class I Gingival Recessions. Contemp Clin Dent. 2017 Oct-Dec;8(4):531-537. [PubMed]
Received: 18 November 2024
Published online: 26 March 2025