To compare the effectiveness of Root Plastique Technique with or without I-PRF on root coverage and gingival phenotype in subjects with Non Carious Cervical lesions – A Randomized Control Trial

The term gingival phenotype has been introduced to address the common clinical observation of great variation in the thickness and width of facial keratinized tissue. Gingival biotype is described as the thickness of the gingiva in the faciopalatal / faciolingual dimension. The term periodontal biotype introduced by Seibert and Lindhe categorised the gingiva into thick-flat and thin scalloped biotypes. Gingival thickness, keratinized tissue width, and bone morphotype are three important parameters used to categorise periodontal health. Thin gingival phenotype may contribute to periodontal tissue breakdown and recession development. Gingival recession (GR) is defined as the apical shift of the gingival margin with a consequent exposure of the root surface. Various factors responsible for the etiopathogenesis of GR include toothbrushrelated trauma, inflammation induced by plaque accumulation, orthodontic tooth movement, and lack of keratinized tissue thickness (KTT). GRs presents with wedge-shaped, concave, flattened, and irregular defects in the cervical area of the teeth known as non-carious cervical lesions (NCCLs). The presence of an NCCL leads to alterations in both crown and root surface that often develop into root concavities (or steps) of variable extensions and depths. There is relatively high frequency of non-carious cervical lesions among subjects of different age. Premolars are the most frequently affected teeth, therefore addressing this becomes very crucial for the clinician which if left untreated may lead to periodontitis which induces the destruction of tooth supporting tissues. There are various treatment modalities for recession coverage one of it being Platelet-rich fibrin (PRF). PRF is developed by centrifugation of blood obtained in glass tubes without anticoagulants and activators. Injectable platelet-rich fibrin (i-PRF) is produced by changing the type of the tube, centrifugation time and speed. I-PRF is prepared according to low-speed centrifugation concept which provides a significant advantage for the regeneration process, as it is rich in platelets, leucocytes and growth factors thereby increasing vascularization.The other one is a minimally invasive procedure Root plastique technique which is simple and time efficient, involves the invasion of supra-crestal tissue attachment, the stimulation of bleeding. This is performed to eliminate any obstacle to the ascent of the gingival tissue and, at the same time, to create the space needed for the thickening of the soft tissues, a space that was initially filled only by the blood clot. This provides a concave space for the formation and stability of a blood clot that will eventually lead to increased tissue thickness and keratinized tissue width.Considering these two treatment modalities, the present study aims at comparing the effectiveness of root plastique technique versus injectable PRF as an adjunct to root plastique technique in subjects with NCCLs and recession.