Comparison of connective tissue graft(CTG) OR Albumin- platelet rich fibrin (ALB-PRF)with coronally advanced flap in the management of RT1 type gingival recession:A Randomized Control Trial

Gingival recession is defined as the displacement of marginal gingiva apical to cement-enamel junction causing root exposure. Connective tissue graft (CTG) with coronally advanced flap is currently the gold standard for recession coverage. However, soft tissue graft substitutes are alternative option to autogenous grafts, especially in clinical scenarios  like insufficient tissue to harvest from the palate, the need for multiple surgical procedures to harvest from the same donor site in a short time period, patient morbidity, and medical contraindications to graft harvesting.  Platelets initiate regeneration by releasing growth factors .  Hence platelet rich fibrin has emerged as an interesting surgical additive due to its angiogenesis, immunomodulatory and antimicrobial properties.Several modifications of original platelet rich fibrin (PRF) protocol have been proposed; however, all the membrane generated such as Advanced–PRF(A-PRF) and A-PRF+ have desorption time of only 10-14 days in vivo.A novel technique was proposed by Richard J. Miron in 2020 wherein for 10min platelet poor plasma (PPP) was heated at 750 C causing denaturation and clumping of proteins in gel form to which the upper layer of buffy-coat rich in growth factors was aspirated and mixed with gel to produce albumin PRF (Alb-PRF).  This extended PRF was degraded in 4-6 months,overcoming the drawbacks of previous  PRF membranes formed.In this study the gold standard technique of Coronally advanced flap and  connective tissue graft is compared with coronally advanced flap and Albumin Platelet rich fibrin for management of RT1 Type gingival recession.