Retrospective evaluation of the treatment of gingival recession associated with non-carious cervical lesions with connective tissue graft or titanium-platelete-rich fibrin

Gingival recession associated with non-carious cervical lesions is frequently encountered in clinical routine. Connective tissue graft (CTG) is considered the gold standard for root surface coverage due to its high predictability. In recent years, platelet concentrates have been used to cover root surfaces. It has been supported by various studies that a tighter fibrin network structure is formed by using titanium instead of silica in platelet activation, and that this tighter fibrin structure enables the Titanium-Platelet Rich Fibrin (T-PRF) membrane to be used as an autogenous graft material by increasing the resorption time in the tissue. The aim of this study is to compare the clinical, aesthetic and post-surgical advantages and/or disadvantages of CTG and T-PRF used in root closure procedures in non-carious cervical lesions. In our study, the patient follow-up forms of a total of 13 patients, 6 men and 7 women between the ages of 23-55, who had splith mouth, non-carious cervical lesions that did not require restoration in the lower or upper jaw canine or premolar teeth, and gingival recession that met Cairo et al.'s Type-1 gingival recession classification, were examined. In order to cover the root surface of these patients, Tunneled Coronally Advanced Flap (TCAF) combined with connective tissue graft obtained by deepithelization of the free gingival graft was applied to the teeth in one jaw, and TCAF procedures combined with T-PRF were applied to the teeth in the other jaw. In these forms, for the 6th and 12th months; clinical parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD), amount of keratinized gingiva (KGA), Distance Between Incisal Margin and Gingival Margin (IM-GM distance), Transgingival Probing Amount (TPA) ) and Dentin Sensitivity (DS) scores, as well as the aesthetic evaluations of the patient and the physician, and the visual analogue scale (VAS) pain scores recorded on days 1, 3 and 7 after both operations, were evaluated statistically. When the results of our study are examined; There was no statistically significant difference between the groups before and after the operation in terms of all parameters examined (p>0.05). In the intra-group examinations, there was a statistically significant increase in the amount of keratinized gingiva and the amount of transgingival probing in both the CTG and T-PRF groups at the 6th month (p:0.002) and 12th month (p:0.002) compared to the preoperative values. The decreases in the distance between the incisal margin and gingival margin at the 6th month (p:0.002) and 12th month (p:0.002) compared to the preoperative period are statistically significant for both groups (p<0.05). When dentin sensitivity is examined; While it was observed in 53.8% of the cases before the operation in the CTG group, dentin sensitivity was not observed in any of the cases at 6 and 12 months. While dentin sensitivity was observed in 61.5% of the cases before the operation in the T-PRF group, it was determined that dentin sensitivity was observed in 1 case (7.7%) at the 6th and 12th months. It was determined that the change in pain levels on the 1st day, 3rd day and 7th day in both groups was statistically significant (p:0.001; p<0.05). When the clinical and post-operative parameters of our study are evaluated, our study results point out that T-PRF can be used as an alternative to CTG in the treatment of gingival recession.