Comparison Between the Use of Advanced Platelet-Rich Fibrin (A-PRF) and Connective Tissue Graft in the Treatment of Cairo Type 1 Gingival Recession Associated with the Coronally Advanced Flap

Abstract

The effects of Advanced Platelet Rich Fibrin (A-PRF) are promising in periodontal surgeries because of the high number of cells and growth factors due to slower centrifugation. Then, the aim of the present study was to evaluate the efficacy of A-PRF in combination with Coronally Advanced (CAF) and compare it with the use of Connective Tissue Graft (CTG) also associated with CAF in Cairo type 1 gingival recession. The study was approved by the Human Research Ethics Committee of the University and patients signed the informed consent. Forty gingival recessions were selected, with 20 belonging to the CAF + A-PRF group (test group) and 20 to the CAF + CTG group. The height of the gingival recession, height, and thickness of the attached gingiva, probing depth, level of clinical insertion, and tooth sensitivity were evaluated at the beginning and 6 months after surgery. GraphPad Prism 8.0 program® was used for statistical analysis. The normality was assessed through Shapiro-Wilk. T-student was performed for the parametric data and MANN-WHITNEY test for the non-parametric. The significance level was set at 5%. There was a gain in gingival height of 1.45±0.96 mm in the CAF + CTG group and 1.04±0.95 mm in the CAF + A-PRF group, resulting in a coverage of 54.3% in the test group and 73% in the control group. Complete coverage (100%) of the recessions was found at 7 sites (35%) in the group with A-PRF and 10 sites (50%) with the CTG. In both groups, there was a significant improvement in tooth sensitivity (p<0.05). Regarding the other clinical parameters evaluated, there was no statistically significant difference; however, slightly higher rates of gum gain were observed in both height and thickness in the control group. After 180 days, both techniques showed significant improvement in the evaluation + ed periodontal parameters, concluding that both can be used for treating Cairo type I gingival recessions.