Platelet-rich fibrin-a cost-effective, donor less and indigenous therapy for obtaining root coverage-a case report

  • Authors

    • Bharat Joshi Bhojia dental college baddi
  • Fibrin, Coronally Advanced Flap, Healing, Platelets, Growth Factors
  • Among the periodontal infections, gingival recession is a separate clinical entity which demands a permanent solution plan. Treatment therapies are based on either elimination (as in case of Miller’s class I/II recession) or increasing the width of keratinized gingiva for prevention of further progression (as in case of Miller’s class III/IV recession). From the centuries, graft surgeries like free gingival graft, lateral pedicle and Coronally advanced flaps have been successful in the  treatment of gingival recession. As every technique has its own merits and demerits, clinicians have tried to stress upon addition of certain adjuncts or biomaterials to ensure rapid healing and less post-operative discomfort. Platelet concentrates are an excellent biomaterials for increasing width of attached gingiva and enhancing wound healing. They are cost effective, do not require donor tissue for harvesting and contain variety of growth factors for initiating regeneration. In this paper, Platelet-rich fibrin a 2nd generation concentrates has been used as an adjunct to Coronally advanced flap with a purpose of increasing width of keratinized gingiva, obtaining complete root coverage and achieving gingival harmony.

  • References

    1. [1] Newman MG, Klokkevold PR, Takei HH, Carranza FA. Carranza’s clinical periodontology. 10th edition. Missouri: Saunders Elsevier; 2006.

      [2] Raetzke PB. Covering localized areas of root exposure employing the “Envelope Techniqueâ€. J Periodontol. 1985; 56: 397-402.

      [3] Lindhe J, Lang NP, Karring T. Clinical periodontology and implant dentistry.5th edition. Oxford: Blackwell Munksgaard; 2008.

      [4] Miller PD. Root coverage associated with the Free gingival graft: Factors associated with incomplete coverage. J Periodontol.1988; 58: 674-681.

      [5] Sato N. Periodontal surgery: A clinical atlas.2nd edition. Illinois: Quintessence Publishing Co. Inc; 2000.

      [6] Paulo M, Melnick P, KemiyB. The use of free gingival grafts for aesthetic purposes. Periodontal 2000; 2001: 72-96.

      [7] HuangHL, Neiva EF, Soehren ES, Giannobile VW, Wang H.The effect of Platelet-Rich Plasma on the Coronally advanced flap root coverage procedure: A pilot human trial.J Peri¬odontol. 2005; 76: 1768-77.

      [8] Zucchelli G, Cesari C, Amore C, Montebugnoli L, De Sanctis M. Laterally Moved, Coronally Advanced Flap: A Modified surgical approach for isolated recession-type defects.J Periodontol. 2004; 75:1734-41.

      [9] Bernimoulin JP, Luscher B, Muhlemann HR. Coronally repositioned periodontal flap. Clinical evaluation after one year. J Clin Periodontol.1975; 2: 1-13.

      [10] Kanakamedala A, Geetha A, Umasudhakar, Ramakrishnan T, Vijayalakshmi R, PameelaE. Platelet-rich-fibrin: A novel root coverage approach.J Indian SocPeriodontol. 2009; 13: 50-4.

      [11] Castellanos AT, de la Rosa MR, de la Garza M, Caffesse RG. Enamel matrix derivative and coronal flaps to cover marginal tissue recessions. J Periodontol. 2006; 77: 7–14.

      [12] Uraz A, Sezgin Y, Yalim M, Taner IL, CetinerD. Comparative evaluation of platelet-rich fibrin membrane and connective tissue graft in the treatment of multiple adjacent recession defects: A clinical study. J Dent Sci. 2013; 10: 1-10.

      [13] Zhao QM, Ding YJ, Si T. Platelet-rich fibrin in plastic surgery. OA Evidence -Based Medicine. 2013; 1: 1-6.

      [14] Dohan MD, Choukroun J, Diss A, Dohan LS,Anthony J, Dohan J, Mouhyi J, Gogly B.Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part I: Technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2006; 101:37-44.

      [15] KumarAP, KumarC, NagasriM, PadmaR, ShilpaA, Sreedhar A. A split mouth randomized controlled study to evaluate the adjunctive effect of platelet-rich fibrin to coronally advanced flap in Miller's class-I and II recession defects. J Indian SocPeriodontol. 2013; 17: 631-36.

      [16] ThamaraiselvanM,Elavarasu S,Thangakumaran T, Sharanabasappa G, Arthie TJ Indian SocPeriodontol. 2015; 19(1): 66–71.

      [17] Maroo S, Grover HS, Luthra S. Button-assisted Coronally advanced flap: An innovative Ortho-perio amalgamation. J IndOrthod Soc. 2014; 48(2):129-133.

      [18] Guyton AC, Hall JE.Textbook of Medical physiology.11th edition. India; Elseviers Saunders: Philadelphia; 2006.

      [19] EppleyBl, Pietrzak WS, Blanton M. Platelet-Rich Plasma: A review of biology and applications in plastic surgery. Plastic reconstructive surgery.2006; 118 (6):147e- 59e.

      [20] Khiste S, Tari R. Platelet-Rich Fibrin as a biofuel for tissue regeneration. ISRN Biomaterial. 2013; 1-6.

      [21] Kaur P, Puneet, Dahiya V. Platelet-Rich Plasma: A novel Bioengineering concept.Trends BiomaterArtif Organs. 2011; 25: 86-90.

      [22] Harmon K, Hanson R, Bowen R, Greenberg S, Magaziner E, Vandenbosch J, Harshfield D, Shiple B, Audley D. Guidelines for the Use of Platelet Rich Plasma. The International Cellular Medical Society.2011;1-19.

      [23] Wu CL, Lee SS, Tsai CH, Lu KH, Zhao JH, Chang YC. Platelet-rich fibrin increases cell attachment, proliferation and collagen-related protein expression of human osteoblasts. Aust Dent J.2012; 57: 207-212.

      [24] Tsai CH, Shen SY, Zhao JH, Chang YC. Platelet-rich fibrin modulates cell proliferation of human periodontally related cells in vitro. J Dent Sci. 2009; 4: 130-35.

      [25] Jankovic S, Aleksic Z, Milinkovic I, Dimitrizevic B. The Coronally advanced flap in combination with Platelet-rich fibrin (PRF) and Enamel matrix derivative in the treatment of gingival recession: A Comparative study. Eur J Esthet Dent. 2010; 5: 260-73.

      [26] Zucchelli G, Amore C, Sforza NM, Montebugnoli L, De Sanctis M. Bilaminar techniques for the treatment of recession-type defects. A comparative clinical study. J ClinPeriodontol. 2003: 30: 862–870.

      [27] Joshi B,Gupta R.Semilunar flap- Atraumatic suture -less technique for managing gingival recession ; Case series. IJCR. 2016; 8 (11):41300-41303.

      [28] Fatima Z, Bey A, Mian F, Zia A. Management of gingival recession using Coronally advanced flap combined with Bracket application: A CaseReport. J Adv Med Dent Scie. 2014;2 (2):171-75.

      [29] JankovicS, Klokkevold P, Dimitrizevic B, Kenney BE, Camargo P. Use of Platelet–rich fibrin membrane following treatment of gingival recession: A randomized clinical trial. IntJ Periodontics Restorative Dent.2012; 32: 41-50.

      [30] Aroca S, Keglevich T, Barbieri B, Gera I, Etienne D.Clinical evaluation of a modified Coronally advanced flap alone or in combination with a Platelet-rich fibrin membrane for the treatment of adjacent multiple gingival recessions: A 6-month Study. J Periodontol. 2009; 80: 244-52.

      [31] Allen EP, Miller PDjr.Coronal positioning of existing gingiva: Short term results in the treatment of shallow marginal tissue recession. J Periodontol. 1989; 60: 316-19.

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    Joshi, B. (2017). Platelet-rich fibrin-a cost-effective, donor less and indigenous therapy for obtaining root coverage-a case report. International Journal of Dental Research, 5(1), 46-51.