JMIR Publications

ABSTRACT

Background:

Background:

Periodontal surgery has traditionally relied on connective tissue grafts (CTG) obtained from the tuberosity site to correct gingival recession abnormalities. However, there are challenges to be addressed, including insufficient graft quantity and patient susceptibility. Consequently, titanium-prepared platelet-rich fibrin, or T-PRF, has emerged as a competitive alternative. By combining T-PRF with the Modified Vestibular Incision Supra Periosteal Tunnel Access (M-VISTA) approach, a more conservative way is provided, which may improve the course of treatment.

Objective:

Objective:

The objective of this study is to compare the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) and connective tissue grafts (CTG) from the tuberosity area in managing gingival recession defects using the Modified Vestibular Incision Supra Periosteal Tunnel Access (M-VISTA) technique. The study aims to evaluate improvements in clinical outcomes, including Pocket Probing Depth (PPD), Clinical Attachment Level (CAL), Gingival Marginal Level (GML), Recession Depth (RD), and Width of Keratinized Gingiva (WKG), as well as plaque and bleeding indices.

Methods:

Materials and

Methods:

The proposed methodology entails conducting a randomized clinical trial (CTRI/2024/07/071619) over two years with 24 participants, each presenting with multiple gingival recessions (Gingival Recession > 2 mm, Miller’s Class I or II) on the buccal or labial aspects of teeth in the maxilla or mandible. Participants will be randomly allocated into two groups: the test group and the control group. The M-VISTA technique will be utilized for root coverage using T-PRF in the test group and tuberosity CTG in the control group as regenerative materials. Their effectiveness will be compared by evaluating Pocket Probing Depth (PPD), Clinical Attachment Level (CAL), Relative Gingival Marginal Level (RGML), Recession Depth (RD), and Width of Keratinized Gingiva (WKG). Additionally, the Plaque Index (PI) will be calculated by dividing the total PI score of all teeth by the number of teeth examined, and the Papillary Bleeding Index (PBI) will be assessed using a periodontal probe with scores evaluated on a scale of 0–4 based on bleeding potential. Data will be analyzed using Student’s paired and unpaired t-tests to compare results from baseline to 3 and 6 months for each group.

Results:

Results:

The M-VISTA technique, in combination with T-PRF (test group), is anticipated to yield superior outcomes for root coverage, including improvements in probing pocket depth (PPD), clinical attachment level (CAL), relative gingival marginal level (RGML), root depth (RD), relative attachment level (RAL), and an increase in the thickness of attached gingiva.

Conclusions:

Conclusion: Combined effect of using T-PRF in the M-VISTA procedure is expected to improve the periodontal parameters including, the soft tissue outcomes and the plaque and bleeding index.