Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Subepithelial connective tissue graft with and without the use of plasma rich in growth factors for treating root exposure

  • Lafzi, Ardeshir (Department of Periodontics, Shahid Beheshti University of Medical Sciences Faculty of Dentistry) ;
  • Faramarzi, Masoumeh (Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences Faculty of Dentistry) ;
  • Shirmohammadi, Adileh (Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences Faculty of Dentistry) ;
  • Behrozian, Ahmad (Department of Orthodontics, Tabriz University of Medical Sciences Faculty of Dentistry) ;
  • Kashefimehr, Atabak (Department of Periodontics, Tabriz University of Medical Sciences Faculty of Dentistry) ;
  • Khashabi, Ehsan (Department of Periodontics, Urmia University of Medical Sciences Faculty of Dentistry)
  • Received : 2012.08.09
  • Accepted : 2012.10.04
  • Published : 2012.12.31
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Abstract

Purpose: The aim of this study was to evaluate the clinical efficiency of the subepithelial connective tissue graft (SCTG) with and without plasma rich in growth factor (PRGF) in the treatment of gingival recessions. Methods: Twenty bilateral buccal gingival Miller's Class I and II recessions were selected. Ten of the recessions were treated with SCTG and PRGF (test group). The rest ten of the recessions were treated with SCTG (control group). The clinical parameters including recession depth (RD), percentage of root coverage (RC), mucogingival junction (MGJ) position, clinical attachment level (CAL), and probing depth (PD) were measured at the baseline, and 1 and 3 months later. The data were analyzed using the Wilcoxon signed rank and Mann-Whitney U tests. Results: After 3 months, both groups showed a significant improvement in all of the mentioned criteria except PD. Although the amount of improvement was better in the SCTG+PRGF group than the SCTG only group, this difference was not statistically significant. The mean RC was $70.85{\pm}12.57$ in the test group and $75.83{\pm}24.68$ in the control group. Conclusions: Both SCTG+PRGF and SCTG only result in favorable clinical outcomes, but the added benefit of PRGF is not evident.

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References

  1. Keceli HG, Sengun D, Berberoglu A, Karabulut E. Use of platelet gel with connective tissue grafts for root coverage: a randomized-controlled trial. J Clin Periodontol 2008;35: 255-62.
  2. Kassab MM, Cohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc 2003;134:220-5.
  3. Lindhe J, karring T, Lang NP. Clinical periodontology and implant dentistry. 4rd ed. Oxford: Blackwell; 2003.
  4. Rees JS, Addy M. A cross-sectional study of dentine hypersensitivity. J Clin Periodontol 2002;29:997-1003.
  5. Oliver RC, Brown LJ, Loe H. Periodontal diseases in the United States population. J Periodontol 1998;69:269-78.
  6. Grupe HE, Warren RF. Repair of gingival defects by a sliding flap operation. J Periodontol 1956;27:92-5.
  7. Harvey PM. Management of advanced periodontitis. I. Preliminary report of a method of surgical reconstruction. N Z Dent J 1965;61:180-7.
  8. Sullivan HC, Atkins JH. Free autogenous gingival grafts. 3. Utilization of grafts in the treatment of gingival recession. Periodontics 1968;6:152-60.
  9. Miller PD Jr. Root coverage using a free soft tissue autograft following citric acid application. Part 1: Technique. Int J Periodontics Restorative Dent 1982;2:65-70.
  10. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985;56:715-20.
  11. Wennström JL, Zucchelli G. Increased gingival dimensions. A significant factor for successful outcome of root coverage procedures? A 2-year prospective clinical study. J Clin Periodontol 1996;23:770-7.
  12. Paolantonio M. Treatment of gingival recessions by combined periodontal regenerative technique, guided tissue regeneration, and subpedicle connective tissue graft. A comparative clinical study. J Periodontol 2002;73:53-62.
  13. Tozum TF, Keceli HG, Guncu GN, Hatipoglu H, Sengun D. Treatment of gingival recession: comparison of two techniques of subepithelial connective tissue graft. J Periodontol 2005;76:1842-8.
  14. Lekovic V, Camargo PM, Weinlaender M, Vasilic N, Kenney EB. Comparison of platelet-rich plasma, bovine porous bone mineral, and guided tissue regeneration versus platelet-rich plasma and bovine porous bone mineral in the treatment of intrabony defects: a reentry study. J Periodontol 2002;73:198-205.
  15. Maloney JP, Silliman CC, Ambruso DR, Wang J, Tuder RM, Voelkel NF. In vitro release of vascular endothelial growth factor during platelet aggregation. Am J Physiol 1998;275(3 Pt 2):H1054-61.
  16. Anitua E, Andia I. PRGF (platelet rich in growth factors). Dent Dialog 2004;3:31-9.
  17. Wartiovaara U, Salven P, Mikkola H, Lassila R, Kaukonen J, Joukov V, et al. Peripheral blood platelets express VEGF-C and VEGF which are released during platelet activation. Thromb Haemost 1998;80:171-5.
  18. Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:638-46.
  19. Anitua E. Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants 1999;14:529-35.
  20. Kassolis JD, Rosen PS, Reynolds MA. Alveolar ridge and sinus augmentation utilizing platelet-rich plasma in combination with freeze-dried bone allograft: case series. J Periodontol 2000;71:1654-61.
  21. Zechner W, Tangl S, Tepper G, Furst G, Bernhart T, Haas R, et al. Influence of platelet-rich plasma on osseous healing of dental implants: a histologic and histomorphometric study in minipigs. Int J Oral Maxillofac Implants 2003; 18:15-22.
  22. Huang LH, Neiva RE, Soehren SE, Giannobile WV, Wang HL. The effect of platelet-rich plasma on the coronally advanced flap root coverage procedure: a pilot human trial. J Periodontol 2005;76:1768-77.
  23. Lafzi A, Chitsazi MT, Farahani RM, Faramarzi M. Comparative clinical study of coronally advanced flap with and without use of plasma rich in growth factors in the treatment of gingival recession. Am J Dent 2011;24:143-7.
  24. Miller PD Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent 1985;5:8-13.
  25. Tarnow DP. Semilunar coronally repositioned flap. J Clin Periodontol 1986;13:182-5.
  26. Loe H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol 1967;38:Suppl:610-6.
  27. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964;22:121-35.
  28. Anitua E, Andia I. Preparation technique for PRGF. A new approach for bone regeneration. Vitoria-Gasteiz: Puesta Al Dia Publicaciones; 2001.
  29. Jankovic SM, Zoran AM, Vojislav LM, Bozidar DS, Kenney BE. The use of platelet-rich plasma in combination with connective tissue grafts following treatment of gingival recessions. Periodontal Pract Today 2007;4:63-71.
  30. Ando K, Ito K, Murai S. Improvement of multiple facial gingival recession by non-surgical and supportive periodontal therapy: a case report. J Periodontol 1999;70:909-13.
  31. Pini Prato G, Pagliaro U, Baldi C, Nieri M, Saletta D, Cairo F, et al. Coronally advanced flap procedure for root coverage. Flap with tension versus flap without tension: a randomized controlled clinical study. J Periodontol 2000; 71:188-201.
  32. Zucchelli G, Clauser C, De Sanctis M, Calandriello M. Mucogingival versus guided tissue regeneration procedures in the treatment of deep recession type defects. J Periodontol 1998;69:138-45.
  33. Caffesse RG, De LaRosa M, Garza M, Munne-Travers A, Mondragon JC, Weltman R. Citric acid demineralization and subepithelial connective tissue grafts. J Periodontol 2000;71:568-72.
  34. Cheung WS, Griffin TJ. A comparative study of root coverage with connective tissue and platelet concentrate grafts: 8-month results. J Periodontol 2004;75:1678-87.
  35. Karring T, Cumming BR, Oliver RC, Loe H. The origin of granulation tissue and its impact on postoperative results of mucogingival surgery. J Periodontol 1975;46:577-85.
  36. Lundberg M, Wennstrom JL. Development of gingiva following surgical exposure of a facially positioned unerupted incisor. J Periodontol 1988;59:652-5.
  37. Del Fabbro M, Bortolin M, Taschieri S, Weinstein R. Is platelet concentrate advantageous for the surgical treatment of periodontal diseases? A systematic review and meta-analysis. J Periodontol 2011;82:1100-11.
  38. Griffin TJ, Cheung WS. Guided tissue regeneration-based root coverage with a platelet concentrate graft: a 3-year follow-up case series. J Periodontol 2009;80:1192-9.

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