Efficacy of Platelet-rich Fibrin in Interdental Papilla Reconstruction as Compared to Connective Tissue Using Microsurgical Approach

Dhanavendra Singh, Rajesh Jhingran, Vivek Kumar Bains, Rohit Madan, Ruchi Srivastava, Dhanavendra Singh, Rajesh Jhingran, Vivek Kumar Bains, Rohit Madan, Ruchi Srivastava

Abstract

Aim: This study aims to evaluate autologous platelet-rich fibrin (PRF) and autogenous connective tissue graft (CTG) in interdental papilla (IDP) reconstruction with buccal and palatal split-thickness flap (STF) using microsurgical technique.

Materials and methods: Forty Class I or Class II open gingival or cervical embrasure in maxillary anterior region in 14 patients were surgical treated for the reconstruction of IDP. For experimental Group I (STF with PRF, n = 20), surgical site was flushed with PRF fluid. PRF was then placed under the buccal flap and in the IDP region and squeezed. For experimental Group II (STF with CTG, n = 20) after the preparation of recipient site, CTG procured from palate was trimmed to the desired size and shape and placed at the site. Clinical parameters and patient satisfaction response recorded were plaque index, gingival index, probing pocket depth, clinical attachment level, height of IPD, and papilla index score (PIS).

Results: STF surgery in combination with PRF or CTG, are an effective procedure to increase IDP-height with mean values of 3.10 mm (87.3%) and 3.45 mm (95.8%) for Group I (STF + PRF) and Group II (STF + CTG), respectively. In terms of complete fill (CF) achieved at 3 months, in the present study, the result showed that 90% CF was obtained in Group I (STF + PRF) and 95% in Group II (STF + CTG). The patient response and acceptance for surgical treatment modality in terms of patient postsurgical discomfort score and patient esthetic score was higher for Group II (STF + CTG) than Group I (STF + PRF).

Conclusion: Based on single-centered 3 months' follow-up, it may be concluded that STF surgery in combination with PRF or CTG is an effective procedure to increase IDP-height; however, a long-term multicentric randomized clinical trial may be necessary to evaluate the clinical outcome for autologous PRF in comparison to CTG with STF.

Keywords: Connective tissue graft; interdental papilla; platelet-rich fibrin.

Conflict of interest statement

There are no conflicts of interest.

Copyright: © 2020 Contemporary Clinical Dentistry.

Figures

Figure 1
Figure 1
Platelet-rich fibrin procured
Figure 2
Figure 2
(a) Procurement of connective tissue graft from palate. (b) Connective tissue graft obtained
Figure 3
Figure 3
Flow chart showing study design
Figure 4
Figure 4
(a) Intrasulcular incision. (b) Horizontal incision at the level of cementoenamel junction. (c) Palatal incision. (d) Elevation of flap
Figure 5
Figure 5
Placement of platelet-rich fibrin membrane at the recipient site with split-thickness flap
Figure 6
Figure 6
Placement of connective tissue graft at the recipient site
Figure 7
Figure 7
(a) Group I (split-thickness flap with platelet-rich fibrin) preoperative (baseline). (b) Group I (split-thickness flap with platelet-rich fibrin) 3 months' follow-up
Figure 8
Figure 8
(a) Group II (split-thickness flap with connective tissue graft) baseline. (b) Group II (split-thickness flap with connective tissue graft) 3 months' follow-up

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