Clinical and Histologic Evaluation of Platelet-Rich Fibrin Accelerated Epithelization of Gingival Wound

Mansi Bansal, Ashish Kumar, Komal Puri, Manish Khatri, Geeti Gupta, Hitesh Vij, Mansi Bansal, Ashish Kumar, Komal Puri, Manish Khatri, Geeti Gupta, Hitesh Vij

Abstract

The foremost indication for gingival depigmentation is patient demand for improved aesthetics. In most cases after the removal of pigmented layer, the area is covered with periodontal packs. These dressings have no curative properties. They only minimise the likelihood of surface trauma during mastication. However, platelet-rich fibrin (PRF) accelerates wound healing by effective neovascularisation and promoting fast cicatricial tissue remodelling. In the present split mouth study, PRF membrane was applied in the first quadrant and non-eugenol dressing (Coe-Pack) in the second quadrant after depigmentation. Clinical evaluation of epithelization with toluidine blue revealed that PRF treated sites stained substantially less indicating better wound healing as compared to Coe-Pack sites, which appeared more erythematous after 5 days. The histologic evaluation also revealed greater inflammatory cell infiltrate on Coe-Pack sites as compared to PRF. Thus, PRF membrane as a periodontal dressing is a successful approach to protect the raw wound area of the depigmented site to reduce healing time and patient discomfort.

Keywords: Depigmentation; platelet-rich fibrin; wound healing.

Figures

Figure 1
Figure 1
(a) Dummett moderate gingival pigmentation at presentation in maxillary arch, (b) partial thickness flap on the facial surface of the gingiva of the maxillary arch, (c) the right half of the area (1st quadrant) was covered with platelet rich fibrin membrane and sutured with 5-0 suture and the left half (2nd quadrant) was covered with non-eugenol periodontal dressing (Coe-Pack), (d) toluidine blue test on 3rd day, (e) toluidine blue test on 5th day
Figure 2
Figure 2
(a) Dummett moderate gingival pigmentation at presentation in maxillary arch, (b) partial thickness flap on the facial surface of the gingiva of the maxillary arch, (c) the right half of the area (1st quadrant) was covered with platelet rich fibrin membrane and sutured with 5-0 suture and the left half (2nd quadrant) was covered with non-eugenol periodontal dressing (Coe-Pack), (d) toluidine blue test on 3rd day, (e) toluidine blue test on 5th day
Figure 3
Figure 3
(a) Dummett moderate gingival pigmentation at presentation in maxillary arch, (b) partial thickness flap on the facial surface of the gingiva of the maxillary arch, (c) the right half of the area (1st quadrant) was covered with platelet rich fibrin membrane and sutured with 5-0 suture and the left half (2nd quadrant) was covered with non-eugenol periodontal dressing (Coe-Pack), (d) toluidine blue test on 3rd day, (e) toluidine blue test on 5th day
Figure 4
Figure 4
(a) Dummett moderate gingival pigmentation at presentation in maxillary arch, (b) partial thickness flap on the facial surface of the gingiva of the maxillary arch, (c) the right half of the area (1st quadrant) was covered with platelet rich fibrin membrane and sutured with 5-0 suture and the left half (2nd quadrant) was covered with non-eugenol periodontal dressing (Coe-Pack), (d) toluidine blue test on 3rd day, (e) toluidine blue test on 5th day
Figure 5
Figure 5
(a) Dummett moderate gingival pigmentation at presentation in mandibular arch, (b) partial thickness flap on the facial surface of the gingiva of the mandibular gingiva, (c) the right half of the area (4th quadrant) was covered with platelet rich fibrin membrane and sutured with 5-0 suture and the left half (3rd quadrant) was covered with non-eugenol periodontal dressing (Coe-Pack), (d) toluidine blue test on 3rd day, (e) toluidine blue test on 5th day
Graph 1
Graph 1
Graph showing higher values of HI in platelet rich fibrin group as compared to Coe-Pack group
Figure 6
Figure 6
(a) Histologic evaluation of platelet rich fibrin treated sites with negligible inflammatory cell infiltrate in the connective tissue, (b) histologic evaluation of Coe-Pack treated sites showing chronic inflammatory cell infiltrate in the connective tissue

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