Clinical evaluation of coronally advanced flap with or without platelet rich fibrin for the treatment of multiple gingival recessions

The objective of this controlled study was to assess the clinical effectiveness of platelet rich fibrin (PRF) in combination with coronally advanced flap on root coverage, aesthetics and patient satisfaction compared to coronally advanced flap (CAF) alone for the treatment of multiple Miller Class I gingival recession defects. A total of 20 patients (10 females and 10 males) with 49 Miller Class I multiple recessions ≥3 mm were included and divided into CAF + PRF and CAF groups. At baseline and 6 months after the surgery, plaque and gingival indices, bleeding on probing, probing depth, clinical attachment level, recession height (RH), keratinized tissue height, gingival thickness (GT), and mean and complete defect coverage were evaluated. Patient satisfaction and root coverage aesthetic scores were also assessed. Baseline RH in CAF+PRF and CAF groups was 3,20 ± 0,26 mm and 3,36 ± 0,34 mm, respectively. Intragroup comparisons revealed statistically significant differences at 6 months for all parameters (p<0.05). Gingival thickness increased from 0,78 ± 0,06 mm to 1,31 ± 0,07 mm in CAF + PRF group, and from 0,73 ± 0,07 mm to 0,8 ± 0,08 mm in CAF group. Mean root coverage was 79,02% (RH reduction: 2,5±0,53 mm) in CAF + PRF group, and 74,63% (RH reduction: 2,51±0,33 mm) in CAF group. Complete root coverage was achieved 36% of the teeth (9 out of 25 sites) for the CAF + PRF group, while it occurred 33.3% of the teeth (8 out of 24 sites) for the CAF group. Intergroup differences were found to be significant only for GT gain (p<0.05). Both techniques were successful in the treatment of multiple Miller Class I gingival recession defects. Tissue thickness significantly increased with the use of PRF graft in CAF + PRF group.