Comparative evaluation of coronally advanced flap technique and Zucchelli’s technique utilizing Titanium prepared platelet rich fibrin in the treatment of multiple gingival recession A Randomized Controlled Trial

Gingival recession, characterized by the displacement of the marginal gingiva from its usual position on the tooth crown to levels beyond the cemento-enamel junction on the root surface, is associated with a spectrum of adverse effects, including dentine hypersensitivity, root caries, abrasion, erosion, and increased dental plaque accumulation. Consequently, there exists a need to explore and compare treatment modalities for addressing single or multiple recessions. While the conventional gold standard for recession treatment typically involves the application of connective tissue graft (CTG) in conjunction with the Coronally Advanced Flap (CAF) technique, recent modifications such as Zucchelli’s technique have emerged, offering potential advantages in terms of biology and clinical outcomes. Zucchelli’s technique, distinguished by its envelope-type flap devoid of vertical release incisions, ensures preserved blood supply and minimized scarring along the incision line, thereby mitigating some of the drawbacks associated with traditional approaches. Furthermore, the advent of autologous platelet concentrates (APCs) as promising adjunctive materials in restorative procedures has broadened treatment possibilities. The evolution from first-generation platelet-rich plasma (PRP) to second-generation platelet-rich fibrin (PRF), and subsequently to Titanium-prepared Platelet rich Fibrin (T-PRF)to third generation advanced platelet rich fibrin , underscores ongoing efforts to optimize treatment efficacy and patient outcomes. T-PRF, characterized by its similarity to Leukocyte-prf(L-PRF) in growth factor release and platelet activation, offers additional benefits owing to its enhanced hemocompatibility facilitated by the utilization of titanium tubes in its preparation. This study aims to comprehensively evaluate and compare the clinical outcomes concerning root coverage, aesthetics, sensitivity reduction, gingival marginal thickness, as well as postoperative factors including patient comfort, healing progression, and long-term stability. The intent of the present study is to generate robust evidence that informs clinical decision-making, thereby advancing the standard of care for patients presenting with gingival recession. By elucidating the relative effectiveness of these innovative techniques and materials, the study endeavors to contribute to enhanced treatment outcomes and long-term oral health for individuals afflicted with gingival recession.