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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Waraporn Suwannarong
Subin Puasiri
Thitikarn Chanwiboon
Rujirada Rotjinda
Pailin Tribuppachatsakul


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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Suwannarong W, Puasiri S, Chanwiboon T, Rotjinda R, Tribuppachatsakul P. 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. Khon Kaen Dent J [Internet]. 2021 Mar. 28 [cited 2023 Jan. 29];24(1):1-14. Available from:
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