Horizontal platelet-rich fibrin versus advanced platelet-rich fibrin plus in gingival recession management.

Abstract

Background: Newer generation platelet concentrates, such as advanced platelet-rich fibrin plus (A-PRF+) obtained following low-speed centrifugation concept and horizontal platelet-rich fibrin (H-PRF) obtained from swing out and bucket system, showed increased platelet entrapment and growth factor release in the in-vitro studies. This prospective study aimed to evaluate and compare the clinical outcomes of A-PRF+ and H-PRF membranes in the treatment of gingival recession defects. The objectives of this study were to compare the changes in the recession height (RH) and the mean root coverage percentage (MRC%) between and within the research groups.

Methods: Forty-four systemically healthy patients diagnosed with 84 Cairo's RT 1 and RT 2 gingival recession defects in the maxillary anterior and premolars were randomly treated with a combination of the coronally advanced flap (CAF) and A-PRF+ membrane (n = 22 subjects) or H-PRF membrane (n = 22 subjects). Patients were reviewed at 3 and 6 months postoperatively. Parameters including RH, MRC%, complete root coverage (CRC), gingival thickness, keratinized tissue height, and root coverage esthetic scores were documented.

Results: Both treatments resulted in a significant reduction in RH (p < 0.001). The CAF + A-PRF+ group demonstrated a reduction in RH from 2.47 ± 1.00 mm to 0.59 ± 0.52 mm and the MRC% was 76.33 ± 22.54%, at 6 months. In the CAF+H-PRF group, the mean RH decreased from 2.43 ± 1.01 mm to 0.38 ± 0.59 mm and the MRC% was 85.51 ± 19.87%. Three- and six-month intergroup analysis revealed statistically insignificant differences in the observed clinical parameters between the groups (p > 0.05).

Conclusions: The study found that both CAF + H-PRF and CAF + A-PRF+ protocols resulted in similar clinical outcomes while treating maxillary gingival recession defects.

Plain language summary: Numerous modifications have been proposed to improve the growth factor content in the platelet concentrates and thereby therapeutic potential. This study compared platelet-derived membranes obtained by two different spin protocols in the treatment of gum recession. Forty-four patients were treated with either platelet-derived membrane obtained by horizontal spin protocol (test group) or low-speed spin concept (control group). Both treatment methods resulted in satisfactory healing. At the end of 6 months, no differences were noted with regard to the changes in clinical measurements and root coverage percentage indicating similar clinical efficacy of both preparatory techniques.