Management of marginal tissue recession using platelet-rich fibrin: A case report.

Background: Marginal tissue recession leads to exposure of root surfaces of teeth resulting in root sensitivity, caries, or an unsightly appearance. Its management is carried out both by eliminating contributing factors as well as using surgical techniques. Platelet-rich fibrin (PRF) is a seond-generation platelet concentrate first described by Choukroun et al. in 2001. This case report is of a Millers Class II recession in 41 regions managed using PRF with a double pedicle flap.

Method: A 25-year-old patient presented with gingival recession height of 5 mm, measured from the cemento-enamel junction (CEJ) to gingival margin. The recession width was 3 mm at the CEJ and PD of 1 mm with respect to 41 region. There was no keratinized tissue apical to recession. However, adequate keratinized tissue was clinically present on either side of the recession defect wrt 41 region. A partial thickness double pedicle flap was raised wrt 41 region. PRF was prepared by centrifuging whole blood at 2,700 RPM for 12 min. The membrane was folded to create bulk and secured over the recession defect.

Results: The patient was reviewed at regular intervals of 01, 06, months and 01 year postoperatively. Significant coverage of denuded root was achieved with good color match and relief from sensitivity. Results were stable one year postoperatively.

Conclusion: Cases that present with a deep and wide recession are challenging to address owing to the extensive loss of keratinized tissue. In such cases, double pedicle flap can be carried out to augment gingiva by utilizing keratinized tissue adjacent to the defect site. Platelet concentrates like PRF contain platelet-derived growth factors that exhibit chemotactic and mitogenic properties that promote and modulate cellular functions involved in tissue healing, regeneration, and cell proliferation. PRF is an autologous biomaterial which may be used in root coverage procedures. Long-term studies with a larger sample size are required to establish PRF as a predictable method of gingival recession coverage.