Evaluation of root biomodification as an adjunct to platelet-rich fibrin versus amniotic membrane and coronally advanced flap in class I and class II gingival recession defects: A randomized controlled study

Aim: This study aimed to compare the effects of root bio modification only with coronally advanced flap (CAF; control group) versus placement of either platelet-rich fibrin (PRF) or amniotic membrane (AM) after root biomodification (test groups) using the CAF technique in class I or class II gingival recession defects. Hence, this study evaluated the role of root biomodification alone and as an adjunct with PRF or AM membrane in class I and class II gingival recessions. Materials and Methods: This was a randomized, parallel-arm, clinical trial conducted on 24 patients. Subjects were equally divided into three groups. Patients in group 3 (control group) were treated with CAF alone and hyaluronic acid (HA) root conditioning and those in group 2 underwent CAF with AM and HA root conditioning whereas those in group 1 underwent CAF with PRF and HA root conditioning for class I or class II gingival recessions. The clinical variables were assessed pre and 3 months and 6 months postsurgery. The visual analog scale (VAS) was assessed on the 10th and 30th day, postsurgery. Intragroup analysis was done by repeated one-way analysis of variance test followed by Bonferoni’s multiple comparisons test. Intergroup comparison used repeated two-way analysis of variance test for continuous data. All P value less than 0.05 were considered statistically significant. Results: A comparison within the groups yielded insignificant results in group 3 (control group), whereas in group 1 (PRF + HA root conditioning) the probing depth (PD) and percentage root coverage (PRC) values did not improve significantly and in group 2 (AM + HA root conditioning) the PRC values did not show significant improvement. Between the groups, however, it was observed that the test groups 1 and 2 performed better than the control group related to all the clinical parameters and the VAS scores reflected superior results in group 2. Conclusion: CAF was effective as a treatment modality. The test group yielded a better percentage of root coverage than the control group, though statistically insignificant.