Recession, Gingival Clinical Trial
Official title:
Comparative Evaluation of Recession Coverage Obtained Using Pinhole Surgical Technique, With and With Out Platelet Rich Fibrin : A Randomized Controlled Clinical Trial
The current study is a prospective randomised split mouth study to evaluate the effect of Platelet Rich Fibrin as an adjunct to the minimally invasive pinhole surgical technique.
Gingival recession is defined as denudation of the tooth root surface due to the apical
movement of the gingiva. The occurrence of gingival recession as a periodontal finding has
been estimated to be 78.6%. It is multi-factorial and poses problems from different aspects
to the patient.Various etiological factors documented over the years include, (in the
decreasing order of frequency) toothbrush trauma, malalignment, local factors, occlusal
trauma, high frenum attachment, cervical fillings and crown impingement. Recession levels are
also influenced by various other factors such as age, sex, teeth and surfaces of teeth, etc.
Over the years, several authors have presented their views on the etiology, types, treatment
modalities and prognosis of gingival recession ranging from the direct lateral sliding flap
to the most recent minimally invasive techniques. The1970s saw Harvey and Bernimoulin
individually demonstrated the use of coronal advancement of the flap along with the use of
grafts with the coronal advancement performed 2 months after the grafting was done on the
denuded root surface. Subsequently, over the next 3 decades connective tissue grafts along
with coronally advanced flap was established as the gold standard for recession coverage.
Lien-Hui Huang (2005) pioneered the use of blood derivatives in the form of Platelet rich
Plasma (PRP) for root coverage but with limited or no substantial improvement over existing
techniques. More studies were done on blood derivatives and their efficacy which led to the
introduction of the second generation of platelet concentrates, Platelet rich Fibrin, as an
alternative. Platelet rich Fibrin was first developed by Choukroun in the year 2001 and has
been followed by several studies which have revealed that the slow and sustained release of
key growth factors makes it a useful bio-healing material. Comparisons with platelet rich
plasma have also proved that, platelet rich fibrin has a better release of growth factors and
the presence of leukocytes, which offers quicker and more efficient healing with better
regenerative potential.
The recent years have seen newer techniques which are aimed at making it a minimally invasive
procedure. One such technique was the pinhole surgical technique given by Chao in the year
2012 which involved a tunnelling procedure along with the usage of a bioresorbable membrane
which satisfied the expectations of the trial.6Better outcomes can be achieved with the use
patient's own products instead of a foreign graft material. Therefore, the present study
compares the effectiveness of Platelet Rich Fibrin as an adjunct to the surgical technique
for root coverage
;
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