Comparative Evaluation of clinical effectiveness of titanium-prepared platelet-rich fibrin and connective tissue graft in papilla reconstruction

Rationale:

Interdental papilla morphology is determined by factors such as age, shape of crown, contact position and angle between the roots of adjacent teeth, alveolar crest-interdental contact point distance, interdental embrasure volume, crestal bone height, soft tissue appearance, periodontal disease and history of periodontal surgery. Interdental papilla loss which leads to appearance of black triangles between teeth can cause aesthetic disorders, phonetic problems, and food accumulation (Chow et al, 2010, Sharma et al, 2010; Tarnow, 1992).

 Though various non-surgical approaches through prosthetic, restorative, and orthodontic procedures have been used for papilla reconstruction, they have not always yielded satisfactory results. Several full or partial thickness, free or pedicle tissue management surgical techniques including roll, rotated, or advanced flaps have been proposed for papilla reconstruction (Deepalakshmi, 2007; De Castro Pinto, 2010). Several studies state that Connective tissue grafts provide better results than conventional Platelet rich fibrin despite their disadvantages such as presence of a second wound site and variable papilla reconstruction outcomes.

 Tunali et al., in 2013 harnessed titanium biomedical tubes for the construction of Titanium coated titanium platelet‑rich fibrin (T‑PRF). Titanium has been more useful in stimulating platelets compared to glass tubes and forms a thicker fibrin clot exhibiting longer resorption span and profuse fibrin meshwork provoking increase cellularity at the prescribed loci thereby inducing periodontal genesis (Tunali, 2014).

 Need for the study:

With Titanium having one of the greatest bio-compatibility, the application of titanium-prepared platelet-rich fibrin involves minimally invasive technique with low risk and satisfactory clinical outcomes, but limited research is done on titanium-prepared platelet-rich fibrin. To the best of our knowledge, no studies are done to evaluate the success of titanium-prepared platelet-rich fibrin in papilla reconstruction.