Platelet-Rich Plasma (PRP) and Injectable Platelet-Rich Fibrin (i-PRF) in the Non-Surgical Treatment of Periodontitis-A Systematic Review.

The gold standard in the non-surgical treatment of periodontitis is scaling and root planing (SRP). In recent years, the use of autogenous platelet concentrates has spread over many specialties in dentistry and, thus, has also been gaining popularity in periodontal treatment. Its two main fractions are platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), which, since 2014, can also be used via injection as injectable platelet-rich fibrin (i-PRF). The authors conducted a comprehensive systematic review in accordance with the PRISMA 2020 guidelines. It involved searching PubMed, Embase, Scopus, and Google Scholar databases using the phrases ("Root Planing" OR "Subgingival Curettage" OR "Periodontal Debridement") AND ("Platelet-Rich Plasma"). Based on the authors' inclusion and exclusion criteria, 12 results were included in the review, out of 1170 total results. The objective of this review was to ascertain the impact of utilizing PRP and i-PRF in SRP. The results revealed that both the incorporation of PRP and i-PRF were found to be significantly associated with are duction in gingival pocket depth and again in clinical attachment level; however, i-PRF demonstrated superiority in improving clinical parameters. Furthermore, i-PRF demonstrated notable bactericidal efficacy against Porphyromonas gingivalis. On the other hand, PRP proved inferior to an Nd:YAG laser in clinical parameter improvement; however, it demonstrated significant efficiency as well. This literature review led the authors to the conclusion that autologous platelet concentrates might be competent agents for improving the therapeutic outcomes of SRP.

A Preliminary Clinical Comparison of the Use of Fascia Lata Allograft and Autogenous Connective Tissue Graft in Multiple Gingival Recession Coverage Based on the Tunnel Technique.

BACKGROUND: The most effective method for treating gingival recessions (GR) is with an autogenous connective tissue graft (CTG) via flap surgery. Often, however, the amount of CTG that can be grafted is insufficient to cover all of a patient's gingival recessions at one time. OBJECTIVES: The objective of this study was to provide a 6-month comparative assessment of the results of covering multiple Miller Class I and II gingival recessions with a Fascia Lata Allograft (FL) and a CTG harvested from palatal mucosa. MATERIAL AND METHODS: The study comprised a total of 30 people who underwent multiple gingival recession (GR) procedures using a modified, coronally advanced tunnel technique (MCAT). The patients were divided into two groups of 15 according to the type of materials used for gingival augmentation purposes: FL for the test group and CTG for the control group. A clinical assessment was made at baseline, as well as 3 and 6 months following surgery. The following factors were assessed: recession depth, recession width, probing depth, clinical attachment level, height of keratinized tissue (HKT), distance between the cemento-enamel junction and the muco-gingival junction (CEJ-MGJ), API, SBI. The following values were calculated: average root coverage (ARC), complete root coverage (CRC). RESULTS: No statistically significant differences were observed between the groups in terms of clinical parameters assessed after 6 months, apart from CRC, which was 94.87 ± 0.14 mm in the control group and 94.24 ± 0.20 mm in the study group (p = 0.034). The average HKT in the control group after 6 months amounted to 2.86 ± 1.60 mm, and in the test group to 3.09 ± 0.95 mm, which translates into an increase in comparison to the baseline values of 0.73 mm (p < 0.001) and 0.48 mm (p = 0.017), respectively. CONCLUSION: FL Allografts may serve as an alternative to autogenous CTG in multiple gingival recession coverage procedures based on the tunnel technique.

Multiple gingival recession coverage with an allogeneic biostatic fascia lata graft using the tunnel technique--A histological assessment.

BACKGROUND: Autogenous connective tissue graft (CTG) that can be safely harvested from the palatal mucosa is limited. Often a multi-stage surgical procedure is needed to cover multiple gingival recessions (MGR). To address this problem, efforts are being made to explore substitutes suitable in size to ensure surgical treatment in a single visit.The objective of the present study was the histological evaluation of tissue in the recipient site after augmentation with a hydrated biostatic Fascia Lata Allograft (FLA) in conjunction with MGR coverage at different healing stages. MATERIAL AND METHODS: Twelve patients needing bilateral multiple gingival recession coverage participated in this study. On the test side, the tunnel technique with FLA was used, while CTG, harvested from the palatal mucosa, was used to cover MGR on the control side. Histological assessment was performed 3, 6, 9 and 12 months after augmentation. RESULTS: FLA was well tolerated by the host tissue. During all investigation periods histological images of all patients in the test side revealed a slow process of incorporation of the material grafted in the host connective tissue, showing a colonization of the graft with host fibroblasts and formation of new blood vessels. After 12 months, the graft had fully remodeled into connective tissue of the host gingiva. CONCLUSION: Apart from the limitations of the present study, we conclude that the FLA may serve as a substitute for autogenous CTG harvested from the palatal mucosa and can be applied as a technique for covering MGR in a single visit.