Adjunctive use of iPRF with or without Erbium Root Biomodification in the management of gingival recession coverage using a coronally advanced flap A randomized controlled trial

Gingival Recession is the apical migration of marginal gingiva as well as the fact that the latter is gradually displaced away from the cementoenamel junction, thereby exposing the root surface to the oral environment. Treatment options for this condition include coronally advanced flaptechnique and the lateral pedicle flap procedure,free gingival grafts etc  which aim to restore the gingival tissue. While healing occurs with the formation of a long junctional epithelium (JE), the risk of recurrence remains high. Efforts to facilitate true regeneration of the gingival tissue are ongoing. One such approach is root biomodification, which involves exposing the root collagen proteins to regenerating cells to promote true regeneration of epithelium and facilitate healing. This is typically done with agents like citric acid,enamel matrix proteins and fibronectin etc  though no agent has yet been identified as ideal or fully satisfactory.For successful regeneration, it is essential to have an intact fibrin attachment, which is critical for enabling true attachment of the periodontal tissue to the root surface. In Erbium-laser root biomodification, the use of the erbium laser facilitates the modification of the root surface, making it more conducive for fibroblast attachment, which is essential for periodontal healing. This technique enhances the root surface, improving its ability to support the attachment of regenerating cells, specifically fibroblasts, which play a crucial role in tissue repair and regeneration.When combined with iPRF (Injectable Platelet-Rich Fibrin), a form of platelet-rich fibrin derived from the patient’s own blood, this treatment approach may  show enhanced outcomes. iPRF  may provides fibrin  that support tissue healing and regeneration, stimulating fibroblast activity and accelerating the repair of periodontal tissues. The CAF technique can effective soft tissue coverage, while Erbium-laser root  biomodification may  optimise the root surface for fibroblast attachment and  may promotes tissue regeneration.Together, these three treatment modalities may  create a synergistic effect that supports more effective periodontal regeneration, reduces inflammation, and facilitates true attachment to the root surface.