Platelet Rich Fibrin in the Treatment of Multiple Gingival Recessions; A Split Mouth Randomized Clinical Trial

Objectives: Harvesting a large connective tissue graft (CTG), when possible, for the treatment of multiple gingival recessions (MGR) raises both operation time and post-operative pain. Platelet rich fibrin (PRF) is a blood-derived biomaterial which enhances tissue healing and requires no donor site. Combination use of PRF with CAF is a novel approach in the treatment of MGR. Aim of this study was to compare the clinical outcomes of PRF with CAF versus CTG with CAF on MGR.
Methods: Ten patients with bilateral with Miller Class 1 or 2 MGR were enrolled to the study. Sites are distributed randomly into test (PRF+CAF) and control (CTG+CAF) groups. Clinical variables [recession depth (RD), percentage of root coverage (PRC), complete root coverage (CRC), keratinized tissue height (KTH), gingival thickness (GT) were evaluated at baseline, 6 weeks, 3 months and 6 months after treatment.
Results: The mean RD were significantly decreased at 6 month compared to baseline in PRF+CAF and CTG+CAF groups (2.5±0.5 mm to 0.6±0.6 mm and 2.7±0.7mm to 0.4±0.5mm respectively) (p=0.005). PRF+CAF and CTG+CAF groups showed similar PRC (75.9% and 82.9% respectively) (p=0.353). Moreover, CRC was achieved in 13 of 25 teeth in PRF+CAF and 12 of 24 teeth in CTG+CAF group, the difference between groups was not significant (p=0.889). KTH changes from baseline to 6 months showed no significant difference between two groups (p=0.105). Although GT was significantly increased in CTG+CAF group (1.2±0.4 mm to 1.5±0.2 mm) (p=0.012), no change was observed in PRF+CAF group (1.01±0.3 mm to 0.97±0.2 mm) (p=0.59).
Conclusions: In the treatment of MGR, PRF+CAF can be used as an alternative technique to CTG+CAF since they have similar PRC and CRC. However, PRF+CAF showed no effect on the GT which is in accordance with the literature.