Comparison of root coverage using mixed thickness tunnel technique with albumin platelet rich fibrin or albumin PRF with bone graft biobone in RT1 recession a randomized control study

The displacement of the gingival margin apical to the cementoenamel junction results in gingival recession, accompanied by clinical attachment loss and bone loss, causing dentinal hypersensitivity, cervical root abrasion, problems with plaque removal, and aesthetic difficulties.

To address these concerns numerous conventional therapeutic approaches, such as the coronally advanced flap, laterally placed flap, and double papilla flap, have been used however these techniques often require vertical releasing incisions and papillae incisions, leading to postoperative morbidity and prolonged surgical time.

To overcome these drawbacks minimally invasive techniques such as envelope technique, pouch and tunnel technique, pinhole technique, vestibular incision subperiosteal tunnel approach, and recently mixed thickness tunnel access (MiTT) have been utilized which minimizes tissue trauma, reduce scarring, maintain blood supply and also enhances tissue adaptability. Top of Form

To sustain space for cell proliferation and to retain long-term clinical efficacy additives such as connective tissue grafts, platelet concentrates, or commercially available guided tissue regeneration (GTR) membranes are used along with root coverage surgical procedures.

While connective tissue grafting remains the gold standard for treating gingival recession, other options are being used as it requires a second surgical site and causes discomfort to the patient.Autologous Platelet concentrates, which are a highly concentrated reservoirs of growth factors and is crucial for tissue healing and regeneration, obtained via gradient density centrifugation. However, despite their profound healing potential, conventional platelet concentrates often face the challenge of faster resorption during the healing process.

The novel heat-compressed Albumin-PRF (Alb-PRF) addresses these limitations by exhibiting an extended resorption period exceeding 4 -6 months, along with enhanced tissue regeneration and prolonged release of growth factors.

Achieving comprehensive root coverage necessitates the regeneration of soft tissue and as well as hard tissues. This can be accomplished through the synergistic combination of Alb-PRF with particulate bone graft results in the formation of a cohesive mass i.e., bio bone. This structure offers mechanical scaffolding support by entwining particulate bone powders, platelets, and leukocytes within a fibrin network. It imped soft tissue ingrowth into the graft also accelerates tissue healing and mitigates bone loss during the healing phase.

To our best knowledge, till date no study has been conducted to assess and compared the efficacy of Alb-PRF and Alb-PRF+ bone graft (Bio bone) for root coverage. Hence, the aim of this study is to evaluate and compare the efficacy Alb-PRF and Alb-PRF+ bone graft (Bio bone) for root coverage with mixed thickness tunnel technique (MiTT).