Additional benefits of titanium platelet-rich fibrin (T-PRF) with a coronally advanced flap (CAF) for recession coverage: A case series

Abstract

BACKGROUND: Platelet concentrates (PCs) are a boon in the field of dentistry. Various generations of PCs have been tried and utilized in different treatment methods, such as intrabony defect therapy, root coverage procedures, oral surgical procedures, and palatal wound healing. Titanium-prepared platelet-rich fibrin (T-PRF) is a third-generation PC that is prepared in medical-grade titanium tubes and achieves good healing in the field of periodontics. OBJECTIVES: Not many studies have been performed utilizing T-PRF in the treatment of gingival recession (GR). The present case series study aimed to evaluate the efficacy of T-PRF in the treatment of Cairo's Type 1 GR defects. MATERIAL AND METHODS: A total of 20 patients with 34 Cairo's Type 1 GR defects were recruited. The surgical sites were treated using the trapezoidal coronally advanced flap (CAF) technique and T-PRF as a biomaterial underneath the flap. The plaque index (PI) and the gingival index (GI), recession depth (RD) and recession width (RW), as well as the width of keratinized tissue (WKT), were measured at baseline and 6 months postoperatively. The obtained values were subjected to statistical analysis. The values were presented as mean (M) and standard deviation (SD), the paired t test was performed to measure all the parameters, and a p-value <0.05 was considered to be statistically significant. RESULTS: The changes observed 6 months after the use of T-PRF were non-significant for PI (p = 0.053) and significant for GI (p = 0.016) as compared to the baseline. Significant reductions (p < 0.001) were noted for RD and RW, as well as a significant increase in WKT and a mean root coverage (MRC) of 91%. CONCLUSIONS: Titanium-prepared platelet-rich fibrin can be used as a biomaterial for the treatment of GR defects, as it eliminates the possible silica contamination, as in the case of leukocyte-platelet-rich fibrin (L-PRF), and the need for a second surgical site, as with subepithelial connective tissue graft (SCTG). Moreover, the use of T-PRF results in a thicker membrane formation, and titanium tubes can be reused after proper sterilization.