Additional benefits of titanium platelet-rich fibrin (T-PRF) with a coronally advanced flap (CAF) for recession coverage: A case series.

BACKGROUND: Platelet concentrates (PCs) are a boon in the field of dentistry. Various generations of PCs have been tried and utilized in different treatment methods, such as intrabony defect therapy, root coverage procedures, oral surgical procedures, and palatal wound healing. Titanium-prepared platelet-rich fibrin (T-PRF) is a third-generation PC that is prepared in medical-grade titanium tubes and achieves good healing in the field of periodontics. OBJECTIVES: Not many studies have been performed utilizing T-PRF in the treatment of gingival recession (GR). The present case series study aimed to evaluate the efficacy of T-PRF in the treatment of Cairo's Type 1 GR defects. MATERIAL AND METHODS: A total of 20 patients with 34 Cairo's Type 1 GR defects were recruited. The surgical sites were treated using the trapezoidal coronally advanced flap (CAF) technique and T-PRF as a biomaterial underneath the flap. The plaque index (PI) and the gingival index (GI), recession depth (RD) and recession width (RW), as well as the width of keratinized tissue (WKT), were measured at baseline and 6 months postoperatively. The obtained values were subjected to statistical analysis. The values were presented as mean (M) and standard deviation (SD), the paired t test was performed to measure all the parameters, and a p-value <0.05 was considered to be statistically significant. RESULTS: The changes observed 6 months after the use of T-PRF were non-significant for PI (p = 0.053) and significant for GI (p = 0.016) as compared to the baseline. Significant reductions (p < 0.001) were noted for RD and RW, as well as a significant increase in WKT and a mean root coverage (MRC) of 91%. CONCLUSIONS: Titanium-prepared platelet-rich fibrin can be used as a biomaterial for the treatment of GR defects, as it eliminates the possible silica contamination, as in the case of leukocyte-platelet-rich fibrin (L-PRF), and the need for a second surgical site, as with subepithelial connective tissue graft (SCTG). Moreover, the use of T-PRF results in a thicker membrane formation, and titanium tubes can be reused after proper sterilization.

Novel method of determining the periodontal regenerative capacity of T­PRF and L­PRF: An immunohistochemical study.

BACKGROUND: Platelet-rich fibrin (PRF) plays an important role in the regeneration of the lost periodontal tissues. Immunohistochemistry (IHC) is the most sensitive staining technique for the identification and localization of specific cells. There are few studies in the available literature which use IHC to compare PRF prepared from titanium and silica glass tubes. OBJECTIVES: The aim of the study was to use IHC to evaluate and compare cells present in the PRF membrane prepared from titanium and silica glass tubes. MATERIAL AND METHODS: Blood was drawn from 10 healthy volunteers and PRF was prepared from titanium and silica glass tubes. Immunohistochemical staining for the localization, distribution and pattern of cells present in PRF with the CD 3, CD 15, CD 20, CD 34, CD 61, and CD 163 antibodies was carried out. A statistical analysis including the χ2 test, independent t-test and unpaired t-test was performed to determine significant differences. RESULTS: There were significantly more T cells, B­lymphocytes and platelets, with a strongly positive staining in terms of the cell distribution and the labeling index in the T-PRF group in comparison with the L-PRF group. However, in terms of localization, a stronger positive staining was obtained with platelets in the T-PRF group and stem cells in the L-PRF group. In terms of the cell pattern, a significantly stronger positive staining was obtained by neutrophils in the L-PRF group and B­lymphocytes in the T­PRF group. CONCLUSIONS: Titanium PRF has the edge over PRF prepared from silica glass tubes, and emerged as a better alternative for use in the field of periodontal regeneration.