Randomized Controlled Trial
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Jul 20, 2022; 12(4): 68-91
Published online Jul 20, 2022. doi: 10.5493/wjem.v12.i4.68
Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage
Laxmikanta Patra, Subash Chandra Raj, Neelima Katti, Devapratim Mohanty, Shib Shankar Pradhan, Shaheda Tabassum, Asit Kumar Mishra, Kaushik Patnaik, Annuroopa Mahapatra
Laxmikanta Patra, Subash Chandra Raj, Neelima Katti, Devapratim Mohanty, Shib Shankar Pradhan, Shaheda Tabassum, Asit Kumar Mishra, Kaushik Patnaik, Annuroopa Mahapatra, Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
Author contributions: Raj SC, Patra L, Mohanty D, and Katti N contributed to the conceptualization; Patra L, Pradhan SS, Tabassum S, and Mishra AK contributed to the formal analysis and investigations; Mahapatra A and Patnaik K contributed to the methodology; Raj SC contributed to the project administration; Raj SC and Patra L contributed to the writing-original draft; Raj SC, Patra L, Mahapatra A, and Patnaik K contributed to the writing, review, and editing.
Institutional review board statement: The study was recommended by the Institutional Ethics Committee (IEC), under IEC/SCBDCH/049/20189 dated 17/09/2019 before its commencement and was conducted in accordance with the declaration of Helsinki of 1975, as revised in 2000.
Clinical trial registration statement: The study was prospectively registered with clinical trials registry (CTRI/2020/06/026141).
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at drsubash007@gmail.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Subash Chandra Raj, MDS, Associate Professor, Department of Periodontics, SCB Dental College and Hospital, Mangalabag Road, Cuttack, Odisha 753007, India. drsubash007@gmail.com
Received: December 18, 2021
Peer-review started: December 18, 2021
First decision: April 13, 2022
Revised: April 26, 2022
Accepted: June 23, 2022
Article in press: June 23, 2022
Published online: July 20, 2022
Processing time: 212 Days and 14.7 Hours
Abstract
BACKGROUND

Collagen membrane and platelet-rich fibrin (PRF) have emerged as vital biomaterials in the field of periodontal regeneration. Minimally invasive techniques are being preferred by most periodontists, as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques. Thus, in this study we have evaluated the effect of injectable PRF (i-PRF) with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access (VISTA) technique for gingival recession coverage.

AIM

To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage.

METHODS

A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study. The sites were randomly assigned to control group (VISTA using collagen membrane alone) and the test group (VISTA using collagen membrane with i-PRF). The clinical parameters assessed were pocket depth, recession depth (RD), recession width (RW), relative attachment level, keratinised tissue width (KTW), keratinised tissue thickness (KTT), and percentage root coverage.

RESULTS

RD showed a statistically significant difference between the test group at 3 mo (0.5 ± 0.513) and 6 mo (0.9 ± 0.641) and the control group at 3 mo (0.95 ± 0.51) and 6 mo (1.5 ± 0.571), with P values of 0.008 and 0.04, respectively. RW also showed a statistically significant difference between the test group at 3 mo (1 ± 1.026) and 6 mo (1.65 ± 1.04) and the control group at 3 mo (1.85 ± 0.875) and 6 mo (2.25 ± 0.759), with P values of 0.008 and 0.001, respectively. Results for KTW showed statistically significant results between the test group at 1 mo (2.85 ± 0.489), 3 mo (3.5 ± 0.513), and 6 mo (3.4 ± 0.598) and the control group at 1 mo (2.45 ± 0.605), 3 mo (2.9 ± 0.447), and 6 mo (2.75 ± 0.444), with P values of 0.04, 0.004, and 0.003, respectively. Results for KTT also showed statistically significant results between test group at 1 mo (2.69 ± 0.233), 3 mo (2.53 ± 0.212), and 6 mo (2.46 ± 0.252) and the control group at 1 mo (2.12 ± 0.193), 3 mo (2.02 ± 0.18), and 6 mo (1.91 ± 0.166), with P values of 0.001, 0.001, and 0.001, respectively. The test group showed 91.6%, 81.6%, and 67% root coverage at 1 mo, 3 mo, and 6 mo, while the control group showed 82.3%, 66.4%, and 53.95% of root coverage at 1 mo, 3 mo, and 6 mo, respectively.

CONCLUSION

The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.

Keywords: Vestibular incision subperiosteal tunnel access; Injectable platelet-rich fibrin; Collagen membrane; Gingival recessions; Treatment

Core Tip: The use of minimally invasive vestibular incision subperiosteal tunnel access technique, along with collagen membrane acting as scaffold and chemoattractant with added benefit of injectable form of platelet-rich fibrin has the capacity of releasing more growth factors and regenerative cells responsible for tissue regeneration, can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.