Evaluation of Patient Centered outcome with Platelet Rich Fibrin Membrane and Sub-Epithelial Connective Tissue Graft for the Treatment of Gingival Recession

Gingival recession is exposure of the root surface due to apical migration of the gingival margin. It is a common problem in the general population and often leads the patient to seek treatment. Mucogingival therapy may be required to prevent further recession, correct esthetic problems, aid plaque control, and reduce dentin hypersensitivity. The patients today are increasingly conscious of personal appearance and much attention has been focused on denuded roots that are exposed during smiling which look unaesthetic. CAF with SCTG is accepted as the gold standard and has shown greater predictability for obtaining complete root coverage. However, the SCTG technique has some disadvantages. It is time consuming, increases morbidity, requires a second surgery, and leads to postoperative pain and bleeding, and the supply of donor tissue is limited.

PRF is a second-generation platelet concentrate prepared from centrifuged blood. It is a modification of PRP and has some advantages, such as ease of preparation/application, minimal expense, and lack of biochemical modification (no bovine thrombin or anticoagulant is required). Because of PRF’s natural fibrin framework properties, growth factors can maintain their activity for a relatively longer period and effectively stimulate cell migration, wound healing, and tissue regeneration. Recent studies have demonstrated that PRF has a significant slow, sustained release of key growth factors for at least 1 week  and up to 28 days, which means that PRF could stimulate its environment for a significant time during wound healing. It activates the vascular system and releases growth factors involved in soft tissue healing. The PRF membrane can be considered as an effective healing biomaterial. It features all the essential parameters permitting optimal healing. PRF membrane consists of a fibrin 3D mesh polymerized in a specific structure; the incorporation of platelets, leukocytes, and growth factors; and the presence of circulating stem cells. Furthermore, to our knowledge, only one study has tried to compare professional and patient esthetic satisfaction after root-coverage procedures. The results of this study showed that esthetic judgment of the periodontists may not always be consistent with patient satisfaction. Patients were influenced more by the soft-tissue integration variables than by the percentage of root coverage; and patients appeared to rate the cosmetic results more favorably than did the professionals.

             Therefore, the present study will be undertaken to compare the patient related esthetic outcome following Platelet rich fibrin (PRF) membrane with that of Sub epithelial connective tissue graft (SCTG) in Miller Class I and II multiple Gingival recession defects.