International Journal of Clinical Case Reports 2016, Vol.6, No.21, 1-5
1
Research Report Open Access
Coronally Advanced Flap with Platelet Rich Fibrin, a Novel Approach for Root
Coverage: A Case Report
Ujjwala Makne
, Sandeep Patel, Motilal Jangid,Varsha Barelikar, Sandhya Rathod
Department of Periodontology, Saraswati Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
Corresponding author email
International Journal of Clinical Case Reports
2016, Vol.6, No.21 doi
Received: 03 May, 2016
Accepted: 19 Aug., 2016
Published: 23 Aug., 2016
This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article
:
Makne U., Patel S., Jangid M., Barelikar V., and Rathod S., 2016, Coronally Advanced Flap with Platelet Rich Fibrin, a Novel Approach for Root Coverage: A
Case Report, International Journal of Clinical Case Reports, 6(21): 1-5 (doi
Abstract
Gingival recession remains a widespread finding in the general patient population. Predictable esthetic root coverage has
always remained the dream of any dentist. The desire for improved aesthetics and the consequent need for cosmetic dentistry have
increased tremendously in recent times making aesthetic procedures an integral part of periodontal treatment. A recent innovation in
dentistry is the preparation and use of platelet-rich fibrin (PRF) for coverage of recession defects. This report presents a case with the
use of PRF membrane prepared by a novel technique for root coverage.
Keywords
Platelet-rich fibrin; Recession coverage; Autogenous membrane
Introduction
Gingival recession is defined as location of gingival margin apical to cemento-enamel junction (Glossary of
Periodontology, 4th edi.). It may be a common cause of concern for the patient for a number of reasons including
aesthetic considerations, root hypersensitivity and/or, root caries (Paolantonio, 2002). The risk factors which have
been postulated to play a role in the aetiology of gingival recession
include tooth mal-position, path of eruption,
tooth shape, profile and position in the arch, alveolar bone dehiscence, muscle attachment and frenal pull,
periodontal disease and treatment, iatrogenic restorative or operative treatment procedures, improper oral hygiene
methods, apart from numerous other self-inflicted injuries (Wennström, 1996). The most important factor
increasing the risk of gingival recession is a thin gingival biotype (Muller et al., 1998). Gingival recession may
occur on one or all surfaces of a tooth and thus, may affect a localized area or have a more generalized distribution
within a dentition although many conditions or behavioral habits are also associated with an increased risk for
gingival recession. Numerous periodontal plastic surgical procedures have been proposed in the treatment of
gingival recession defects with varying predictability and success rates. One of the most widely employed
procedures to cover denuded roots is the Coronally Advanced Flap (CAF) procedures with the treatment outcomes
varying between 9-95% (Wennström et al., Muco-gingival Therapy: Periodontal Plastic Surgery, 5th edi.).
However, data also reveals unstable long term results using CAF alone. Another limitation of this technique is the
limited gain in the apico-coronal dimension of the keratinized tissues, which is an important parameter in
preventing the recurrence of such treated gingival recession defects. Therefore, it appears that CAF alone is a less
than optimal technique to achieve efficient root coverage despite its advantage of being associated with low
morbidity. The predictability of this technique and procedure can however be increased by combining CAF with
other regenerative techniques such as a connective tissue grafts, enamel-matrix derivatives, synthetic allografts,
and autologous platelet concentrates including platelet-rich fibrin (PRF). Platelet- rich fibrin is a second
generation platelet concentrate and is defined as an autologous leukocyte and platelet-rich fibrin biomaterial, first
developed by Choukroun et al. (Dohan et al., 2006). It has been used extensively in combination with bone graft
materials for periodontal regeneration, ridge augmentation, and sinus lift procedures for implant placement and for
coverage of recession defects in the form of a membrane. This membrane consists of a fibrin-based, 3-D
polymerized matrix, in a specific structure with the incorporation of platelets, leukocytes, growth factors and
