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      Vestibular Incision Subperiosteal Tunnel Access Technique with Platelet-Rich Fibrin Compared to Subepithelial Connective Tissue Graft for the Treatment of Multiple Gingival Recessions: A Randomized Controlled Clinical Trial

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          Abstract

          Background:

          The aim of this study was to compare the effectiveness of root coverage through vestibular incision subperiosteal tunnel access (VISTA) technique using platelet rich fibrin (PRF) or subepithelial connective tissue graft (SCTG) in multiple gingival recessions.

          Materials and Methods:

          A total of 20 patients with multiple gingival recessions were included, and 10 subjects were randomly allocated to test group (VISTA with PRF) and 10 patients to control group (VISTA with SCTG). Clinical parameters were recorded at baseline, 3 months, and 6 months. Patient's response toward the treatment was also assessed by questionnaire.

          Results:

          All the clinical parameters in the study have showed better results in test group when compared to control group after a follow up period of 6 months with statistical significance.

          Conclusion:

          The results of the present study suggested that multiple gingival recessions can be successfully treated with both procedures, but better root coverage and a greater increase in keratinized tissue were achieved with the VISTA technique with SCTG. All the patients in both groups felt it was worth undergoing the treatment.

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          Most cited references24

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          PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION.

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            Subepithelial connective tissue graft technique for root coverage.

            This article describes the use of the subepithelial connective tissue graft as a donor source for root coverage. The success of these grafts has been attributed to the double-blood supply at the recipient site from the underlying connective tissue base and the overlying recipient flap. Four cases have been illustrated to demonstrate the versatility of this procedure for areas of single or multiple root coverage especially in the maxillary arch, coverage of existing crown margins and areas requiring a combination of ridge augmentation and root coverage. An increase of 2 to 6 mm of root coverage has been achieved in 56 cases over 4 years with minimal sulcus depth and no recurrence of recession. The donor site is a closed wound which produces less postoperative discomfort.
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              Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing.

              Platelet-rich fibrin (PRF) belongs to a new generation of platelet concentrates, with simplified processing and without biochemical blood handling. In this fourth article, investigation is made into the previously evaluated biology of PRF with the first established clinical results, to determine the potential fields of application for this biomaterial. The reasoning is structured around 4 fundamental events of cicatrization, namely, angiogenesis, immune control, circulating stem cells trapping, and wound-covering epithelialization. All of the known clinical applications of PRF highlight an accelerated tissue cicatrization due to the development of effective neovascularization, accelerated wound closing with fast cicatricial tissue remodelling, and nearly total absence of infectious events. This initial research therefore makes it possible to plan several future PRF applications, including plastic and bone surgery, provided that the real effects are evaluated both impartially and rigorously.
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                Author and article information

                Journal
                Contemp Clin Dent
                Contemp Clin Dent
                CCD
                Contemporary Clinical Dentistry
                Wolters Kluwer - Medknow (India )
                0976-237X
                0976-2361
                Jul-Sep 2020
                26 November 2020
                : 11
                : 3
                : 249-255
                Affiliations
                [1] Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
                Author notes
                Address for correspondence: Dr. Bukkapatnam Subbareddy, Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India. E-mail: subbareddybv1989@ 123456gmail.com
                Article
                CCD-11-249
                10.4103/ccd.ccd_405_19
                7989760
                33776351
                352afdf1-0f82-43b6-bd4c-026bc220f175
                Copyright: © 2020 Contemporary Clinical Dentistry

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 19 November 2019
                : 16 April 2020
                : 28 May 2020
                Categories
                Original Article

                Dentistry
                gingival recession,platelet-rich fibrin,root coverage,subepithelial connective tissue graft,vestibular incision subperiosteal tunnel access

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