Jagtap Anuja, Mangalekar Sachin B, Kamble Pallavi
Department of Periodontology, Bharati Vidyapeeth Dental College and Hospital, Sangli, IND.
Cureus. 2023 Feb 13;15(2):e34919. doi: 10.7759/cureus.34919. eCollection 2023 Feb.
Periodontal treatment focuses on maintaining a patient's natural teeth and gums. The gingival margin recedes to a point apical to the tooth in 20%-100% of people. Coronally advanced flap (CAF) is one of several effective treatments for this condition. This surgery covers the tooth root with gingiva. The predictability of this surgery depends on the blood supply, donor tissue, and surgical skills. Platelet concentrates, which include platelet-rich fibrin (PRF), majority of the time is used for various regenerative therapies. Since no bovine thrombin or anticoagulant is needed, its manufacturing is simpler, cheaper, and less biochemically modified than PRP. Platelet-rich fibrin (PRF) is a fibrin matrix that progressively releases platelet cells and cytokines.
The present study aimed to evaluate the efficacy of CAF with and without A-PRF in the treatment of Miller's class-II localized gingival recession.
Twenty patients were chosen who had Miller's class-II localized gingival recession. A random number generator was used to place patients into either the "test" or "control" group. Treatment for both Groups A and B included a coronally advanced flap, but only Group A additionally got autologous platelet-rich fibrin (A-PRF). After receiving a detailed explanation of the treatment process, the patient signed an informed consent form. Complete medical and dental histories were taken to see whether there were any absolute or relative contraindications.
Following treatment with either method in the current study, gingival thickness improved considerably. The percentage of root coverage did not change considerably between the two groups. The clinical result might likely have been different if other factors, such as platelet concentration and PRF consistency, had been examined in the current investigation. Furthermore, there was no histological examination of the healing process. As a result, we are unsure of the extent to which PRF affects how effectively connective tissue attaches.
The additional use of A-PRF membrane did not provide additional benefits in terms of root coverage outcomes compared with CAF alone. The use of A-PRF membranes significantly reduced the recession depth.
牙周治疗的重点是维护患者的天然牙齿和牙龈。在20%至100%的人群中,牙龈边缘会退缩到牙齿根尖的位置。冠向推进瓣(CAF)是治疗这种情况的几种有效方法之一。该手术用牙龈覆盖牙根。此手术的可预测性取决于血液供应、供体组织和手术技巧。血小板浓缩物,包括富血小板纤维蛋白(PRF),大多用于各种再生治疗。由于不需要牛凝血酶或抗凝剂,其制造比富血小板血浆(PRP)更简单、更便宜,且生化修饰更少。富血小板纤维蛋白(PRF)是一种纤维蛋白基质,可逐渐释放血小板细胞和细胞因子。
本研究旨在评估使用和不使用自体富血小板纤维蛋白(A-PRF)的冠向推进瓣(CAF)治疗米勒二类局限性牙龈退缩的疗效。
选择20例患有米勒二类局限性牙龈退缩的患者。使用随机数生成器将患者分为“试验”组或“对照”组。A组和B组的治疗均包括冠向推进瓣,但只有A组额外接受了自体富血小板纤维蛋白(A-PRF)治疗。在患者详细了解治疗过程后,签署知情同意书。采集完整的医学和牙科病史,以查看是否存在任何绝对或相对禁忌证。
在本研究中,采用任何一种方法治疗后,牙龈厚度均有显著改善。两组之间的牙根覆盖百分比没有显著变化。如果在本次研究中检查其他因素,如血小板浓度和PRF稠度,临床结果可能会有所不同。此外,对愈合过程没有进行组织学检查。因此,我们不确定PRF在多大程度上影响结缔组织附着的有效性。
与单独使用冠向推进瓣(CAF)相比,额外使用A-PRF膜在牙根覆盖结果方面并未提供额外益处。使用A-PRF膜可显著降低退缩深度。