Patient-centered evaluation of microsurgical management of gingival recession using coronally advanced flap with platelet-rich fibrin or amnion membrane: A comparative analysis

Sumit Kumar Agarwal; Rajesh Jhingran; Vivek Kumar Bains; Ruchi Srivastava; Rohit Madan; Iram Rizvi

doi:10.4103/1305-7456.175686

European Journal of Dentistry, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Eur J Dent 2016; 10(01): 121-133
DOI: 10.4103/1305-7456.175686

Original Article

Dental Investigation Society

Patient-centered evaluation of microsurgical management of gingival recession using coronally advanced flap with platelet-rich fibrin or amnion membrane: A comparative analysis

Sumit Kumar Agarwal

¹Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India

,

Rajesh Jhingran

¹Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India

,

Vivek Kumar Bains

¹Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India

,

Ruchi Srivastava

¹Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India

,

Rohit Madan

¹Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India

,

Iram Rizvi

¹Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India

› Institutsangaben

Abstract

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ABSTRACT

Objective: To evaluate the efficacy of coronally advanced flap (CAF) procedure under microsurgical approach for the management of Miller's Class I and II gingival recession defects with the use of either platelet-rich fibrin (PRF) or amnion membrane (AM) in comparison to CAF alone. Materials and Methods: A total of 45 sites with Miller's Class I or II gingival recession defect were randomly distributed for: Experimental Group I (CAF with PRF) sites (n = 15) which were treated with the microsurgical approach using CAF along with PRF; experimental Group II (CAF with AM) sites (n = 15) were treated with the microsurgical approach using CAF along with AM; control Group III (CAF alone) sites (n = 15) were treated with the microsurgical approach using CAF alone. Vertical gingival recession (VGR), horizontal gingival recession (HGR), gingival thickness (GT) (using transgingival probing [TGP] and ultrasonography [USG]) and patients’ response and acceptance were documented at baseline, 3 months and 6 months after surgical interventions. Results: CAF alone and in combination with PRF or AM, were effective techniques for root coverage with average VGR values of 1.47 ± 0.92 mm (56%), 0.67 ± 1.23 mm (36%) and 0.60 ± 1.06 mm (33%) in Group I (CAF with PRF), Group II (CAF with AM), and Group III (CAF alone), respectively. Complete coverage (100%) was obtained in 33.3% sites of Group I (CAF with PRF), 26.6% sites of Group II (CAF with AM) and 13.3% in Group III (CAF alone). Patients’ response and acceptance for surgical treatment modality in terms of patient esthetic score and decrease in hypersensitivity score was highest for Group I (CAF with PRF), whereas patient comfort score was highest for Group II (CAF with AM). At 6 months follow-up, significant increase in GT measurements (using TGP and USG) in Group I (CAF with PRF), whereas, nonsignificant increase for Group II (CAF with AM) and no change or decrease for Group III (CAF alone) as compared to baseline was observed. Conclusion: The present study observed enhancement in root coverage when PRF or AM are used in conjunction with CAF as compared to CAF alone. These results are based on 6-month followup. Therefore, the long-term evaluation may be necessary to appreciate the clinical effect of autologous PRF and AM.

Key words:

Amnion - gingival recession - gingival thickness - ultrasonography - wound healing

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Referenzen

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