Comparative Clinical Evaluation of Modified Coronally Advanced Flap with and without Platelet Rich Fibrin in the Treatment of Multiple Adjacent Miller's Class I and Class II Gingival Recession Defects: A Randomized Clinical Trial

Background and aim: Coronally advanced flaps, along with their modifications, are the simplest and most predictable procedures for root coverage. The addition of an inter-positional material is considered to achieve better outcomes. Therefore, this study aimed to assess the potential benefits of adding platelet-rich fibrin (PRF) membrane to the modified coronally advanced flap (MCAF) procedure in terms of change in vertical recession depth (VRD) and mean root coverage percentage ( MRC%).
Materials and methods: A total of twelve systemically healthy subjects with thirty-four Miller's class I and II gingival recession defects were randomly assigned to a control (MCAF) or test (MCAF + PRF) group with seventeen defects in each. Vertical recession depth, gingival thickness (GTH), width of keratinized gingiva (WKG), probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, one month and three months, mean root coverage percentage (MRC%) at one month and three months and VAS score for pain at ten days post-operative.
Results: MRC% was 75.96±21.01 and 83.23±18.28 % in the control and test groups at three months with no statistically significant difference (p>0.05). However, a statistically significant difference (p<0.05) was obtained concerning GTH gain at one and three months and decreased VAS score for pain at ten days in the test group compared to the control group.
Conclusions: Increase in GTH appears to justify using PRF and MCAF for treating multiple adjacent Miller's class I and II gingival recession defects. PRF membrane might be an alternative to different grafting materials in root coverage procedures.