Efficacy of free gingival graft in the treatment of Miller Class I and Class II localized gingival recessions: A systematic review.

BACKGROUND: Currently, the leading theme in mucogingival surgery is the correction of gingival recession defects. Free gingival graft (FGG) has been successfully in use in this category of reconstructive therapeutic modality. OBJECTIVES: The aim of this systematic review was to evaluate the literature with respect to efficacy of FGG in the management of Miller Class I and II localized gingival recessions. DATA SOURCES: Search strategies were performed via electronic database which included Pubmed-Medline, Google scholar and manual search using University library resources. Two reviewers assessed the eligibility of the studies. STUDY ELIGIBILITY CRITERIA: Controlled clinical trials, randomized clinical trials and longitudinal studies evaluating recession areas treated by FGG with minimum of 6 months follow up were included. In-vitro and animal studies, studies mainly done on Miller Class III and IV gingival recession defect, studies on multiple gingival recessions and case series and case reports were excluded from the search. RESULTS: The electronic and manual search identified a total of 557 articles. A final screen consisted of 39 articles out of which 17 articles were selected for full-text assessment. Finally, 7 articles were selected for detailed evaluation for this systematic review. FGG has shown significant results in all the studies except for one study. CONCLUSION: FGG produces substantial results, however, highly depends on the case selection and operator's skill and experience. FGG gives an impression of being the best alternative option in zones where gingival recession presents with inadequate width of attached gingiva and depth of vestibular fornix.

A randomized clinical trial of autologous platelet-rich plasma in the treatment of mandibular degree II furcation defects.

AIM: A combined technique using a platelet-rich plasma (PRP)/bovine porous bone mineral/guided tissue regeneration membrane was found to be an effective modality for the treatment of mandibular grade II furcation defects. To elucidate the role played by each component, the present randomized, double-blind study is designed to evaluate the effectiveness of autologous PRP alone in the treatment of mandibular degree II furcation defects compared with open flap debridement (OFD). MATERIAL AND METHODS: Using a split-mouth design, 40 mandibular degree II furcation defects were treated either with autologous PRP or OFD. Plaque index, sulcus bleeding index, vertical probing depth, relative vertical and horizontal clinical attachment level and gingival marginal level were recorded at baseline and 6 months post-operatively. Vertical and horizontal defect depths were also recorded using spiral computed tomography. RESULTS: A statistically significant difference was observed in all the clinical and radiographic parameters at the sites treated with PRP as compared with those with OFD. However, all the furcation defects retained their degree II status. CONCLUSION: Despite a significant improvement, lack of complete closure of furcation defects implies a limited role of autologous PRP as a regenerative material in the treatment of furcation defects, necessitating further long-term studies.

Clinical effectiveness of autologous platelet-rich plasma and Peptide-enhanced bone graft in the treatment of intrabony defects.

BACKGROUND: The goal of periodontal therapy has always been the regeneration of lost attachment apparatus. The use of platelet-rich plasma (PRP) plus anorganic bovine-derived matrix and peptide 15 (ABM/P-15) for periodontal regenerative therapy offers a potentially useful modality for treating periodontal osseous defects. However, it is unknown whether a combination of these materials enhances the outcome of periodontal regenerative therapy. Therefore, this study was carried out to compare the effectiveness of the two regenerative techniques (autologous PRP plus ABM/P-15 versus autologous PRP) in treating intrabony defects in humans by analyzing the clinical and radiologic parameters. METHODS: Using a split-mouth design, 28 intrabony defects were treated with autologous PRP (control) or a combination of autologous PRP and ABM/P-15 (test). Clinical parameters such as plaque index, sulcus bleeding index, probing depth, attachment level, and gingival marginal level were recorded at baseline and 9 months postoperatively. Hard tissue measurements such as defect fill, defect resolution, and change in alveolar crest height were also recorded using spiral computed tomography (CT). RESULTS: A statistically significant difference was observed in all clinical parameters in the test group compared to the control group. Furthermore, spiral CT images revealed significantly greater bone fill in the test group. CONCLUSIONS: A combination of PRP plus ABM/P-15 was more effective than PRP alone in the treatment of intrabony defects. Further studies using a larger sample size are necessary to confirm the results of the present study.