The Clinical Result of Coronally Advanced Flap with Concentrated Growth Factor Compared to Coronally Advanced Flap with Connective Graft Tissue for Gingival Thickness Enhancement in Pre-Orthodontics Patients: A 3-Month Randomized Controlled Trial
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Abstract
The purpose of this study was to compare the clinical result of gingival thickness using coronally advanced flap with connective tissue graft (CAF+CTG) and coronally advanced flap with concentrated growth factor (CAF+CGF). Eight pre-orthodontics patients (6 females, 2 males) with a thin gingival biotype and at the least one site of gingival recession at the lower anterior teeth were recruited in this randomized controlled clinical trial (split-mouth). The control group was CAF+CTG, and the test group was CAF+CGF. Outcomes were assessed by measuring gingival thickness (GT), gingival margin (GM), keratinized tissue width (KTW), relative attachment level (RAL) and visual analog scale (VAS). At the 3-month post-operative period, there was a statistically significant difference in the mean GT gain between the test and control groups (p<0.05). The mean GT gain was 0.640 mm and 0.293 mm in the control group and the test group, respectively. However, the mean GT gain at L2 (3 mm below GM) on lateral incisors and L2, L3 (3, 4 mm below GM) on canines were not significantly different between groups. RAL was significantly decreased in the control group compared to the test group (p<0.05). No statistically significant difference was demonstrated between the two groups in terms of GM and KTW. The mean VAS score in the control group was significantly higher than the test group at day 3 postoperative (p<0.05). In conclusion, CAF+CTG is superior to CAF+CGF for increasing GT and decreasing RAL. CAF+CGF can be an alternative treatment due to decreased postoperative complications.
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บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการลงตีพิมพ์ในวิทยาสารทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่นถือเป็นลิขสิทธิ์เฉพาะของคณะทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่น หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด ๆ จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษร จากคณะทันตแพทยศาสตร์ มหาวิทยาลัยขอนแก่นก่อนเท่านั้น
References
Seibert J, Lindhe J. Esthetics and periodontal therapy. In: Lindhe J, ed. Textbook of Clinical Periodontology. 2nd ed. Copenhangen:Denmark:Munksgaard;1989:477-514.
Olsson M, Lindhe J. Periodontal characteristics in individuals with varying form of the upper central incisors. J Clin Periodontol 1991;18(1):78-82.
Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Periodontol 2018;89(Suppl 1):S204-13.
Buser D, von Arx T. Surgical procedures in partially edentulous patients with ITI implants. Clin Oral Implants Res 2000;11(Suppl 1):83-100.
Dannan A. An update on periodontic-orthodontic inter-relationships. J Indian Soc Periodontol 2010;14(1):66-71.
Engelking G, Zachrisson BU. Effects of incisor repositioning on monkey periodontium after expansion through the cortical plate. Am J Orthod 1982;82(1): 23-32.
Wennström JL. Mucogingival considerations in ortho dontic treatment. Semin Orthod 1996;2(1):46-54.
Kim DM, Neiva R. Periodontal soft tissue non-root coverage procedures: a systematic review from the AAP Regeneration Workshop. J Periodontol 2015;86(Suppl 2):S56-72.
Chambrone L, Faggion CM Jr, Pannuti CM, Chambrone LA. Evidence-based periodontal plastic surgery: an assessment of quality of systematic reviews in the treatment of recession-type defects. J Clin Periodontol 2010;37(12):1110-8.
Miller PD. Miller classification of marginal tissue recession revisited after 35 years. Compend Contin Educ Dent 2018;39(8):514-20.
Gupta S, Banthia R, Singh P, Banthia P, Raje S, Aggarwal N. Clinical evaluation and comparison of the efficacy of coronally advanced flap alone and in combination with platelet rich fibrin membrane in the treatment of Miller Class I and II gingival recessions. Contemp Clin Dent 2015;6(2):153-60.
Kuka S, Ipci SD, Cakar G, Yılmaz S. Clinical evaluation of coronally advanced flap with or without platelet-rich fibrin for the treatment of multiple gingival recessions. Clin Oral Investig 2018;22(3):1551-8.
Bozkurt Dogan ş, Öngöz Dede F, Balli U, Atalay EN, Durmuşlar MC. Concentrated growth factor in the treatment of adjacent multiple gingival recessions:a split-mouth randomized clinical trial. J Clin Periodontol 2015;42(9):868-75.
Akcan SK, Ünsal B. Gingival recession treatment with concentrated growth factor membrane: a comparative clinical trial. J Appl Oral Sci. 2020;28:e20190236.
Rodella LF, Favero G, Boninsegna R, Buffoli B, Labanca M, Scari G, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech 2011;74(8):772-7.
Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol 2011;38(7):661-6.
Campbell W, Lewis S. Visual analogue measurement of pain. Ulster Med J 1990;59(2):149–54.
Li R, Liu Y, Xu T, Zhao H, Hou J, Wu Y, et al. The additional effect of autologous platelet concentrates to coronally advanced flap in the treatment of gingival recessions:A systematic review and meta-analysis. Biomed Res Int 2019:2587245.
Moraschini V, Barboza Edos SP. Use of platelet-rich fibrin membrane in the treatment of gingival recession: a systematic review and meta-analysis. J Periodontol 2016;87(3):281-90.
Zucchelli G, Mounssif I, Mazzotti C, Montebugnoli L, Sangiorgi M, Mele M, et al. Does the dimension of the graft influence patient morbidity and root coverage outcomes? A randomized controlled clinical trial. J Clin Periodontol 2014;41(7):708-16.
Karring T, Lang NP, Löe H. The role of gingival connective tissue in determining epithelial differen-tiation. J Periodontal Res 1975;10(1):1-11.
Guiha R, el Khodeiry S, Mota L, Caffesse R. Histological evaluation of healing and revascularization of the subepithelial connective tissue graft. J Periodontol 2001; 72(4):470-8.
Eren G, Kantarcı A, Sculean A, Atilla G. Vascularization after treatment of gingival recession defects with platelet-rich fibrin or connective tissue graft. Clin Oral Investig 2016;20(8):2045-53.
Wara-aswapati N, Pitiphat W, Chandrapho N, Rattanayatikul C, Karimbux N. Thickness of palatal masticatory mucosa associated with age. J Periodontol 2001;72(10):1407-12.