“Comparative Evaluation of Clinical Efficacy of Subepithelial Connective Tissue Graft (SCTG) and Advanced Platelet Rich Fibrin (A-PRF) in the Management of Gingival Recession Defects-A Randomized controlled trialâ€

Gingival recession is described as apical migration of the free gingival margin relative to the cemento enamel junction leading to root exposure. The prevalence of mid-buccal recession defects was 91.6% as indicated in a recent epidemiological study conducted by NHANES 2020.Gingival recession is often associated with dentinal hypersensitivity, esthetic issues and also root caries. Periodontal plastic procedures aim to achieve complete root coverage while enhancing aesthetics by integrating mucosa and keratinized gingiva with adjacent tissues.

Periodontal wound healing is a complex biological mechanism where multiple cellular events occur concurrently leading to repair or regeneration.Platelets are the initial cells involved in the wound healing process. Upon activation, they release various bioactive molecules, cytokines, and adhesive proteins stimulating inflammatory cells to populate in the surgical area thereby setting the pace for the wound healing process.

A-PRF obtained by centrifugation protocol of 1500rpm for 14min at 200G, exhibited porous fibrin structure with larger interfibrinous space incorporating quantitatively more platelets and inflammatory cells, evenly distributed all through the matrix releasing significantly increased growth factor proteins (VEGF, PDGF, TGF-β, IGF and EGF). A-PRF was found to contain increased levels of VEGF, responsible for neoangiogenesis, monocytes as a source for BMP’s and fibronectin for extracellular matrix formation. The potential benefit of advanced platelet rich fibrin in management of gingival recession has not yet been established. The aim of this clinical study was to evaluate and compare the clinical efficacy of conventional gold standard connective tissue graft and A-PRF in the treatment of gingival recession defects.