Clinical Evaluation of a Modified Coronally Advanced Flap Alone or in Combination With a Platelet‐Rich Fibrin Membrane for the Treatment of Adjacent Multiple Gingival Recessions: A 6‐Month Study

Background: The aim of this study was to determine whether the addition of an autologous platelet‐rich fibrin clot (PRF) to a modified coronally advanced flap (MCAF) (test group) would improve the clinical outcome compared to an MCAF alone (control group) for the treatment of multiple gingival recessions. Methods: Twenty subjects, presenting three adjacent Miller Class I or II multiple gingival recessions of similar extent on both sides of the mouth, were enrolled in the study. The mean recession value at baseline was 2.9 ± 1.1 mm for test sites and 2.5 ± 0.9 mm for control sites. Each patient was treated on both sides by an MCAF technique; the combination treatment (with a PRF membrane) was applied on the test side. Probing depth (PD), recession width, clinical attachment level (CAL), keratinized gingival width, and gingival/mucosal thickness (GTH) were measured at baseline and at 6 months post‐surgery. Gingival recession was measured at baseline and at 1, 3, and 6 months post‐surgery. Results: Mean root coverage after 1, 3, and 6 months was 81.0% ± 16.6%, 76.1% ± 17.7%, and 80.7% ± 14.7%, respectively, at the test sites and 86.7% ± 16.6%, 88.2% ± 16.9%, and 91.5% ± 11.4%, respectively, at the control sites. Differences between the two groups were statistically significant at 3 and 6 months. At 6 months, complete root coverage was obtained at 74.6% of the sites treated with the control procedure but at only 52.2% of the experimental sites. At 6 months, the increase in GTH was statistically significant when comparing the test sites (from 1.1 ± 0.3 mm at baseline to 1.4 ± 0.5 mm at 6 months) to the control sites (from 1.1 ± 0.3 mm at baseline to 1.1 ± 0.3 mm at 6 months). In the case of PD, there was no significant difference between the two groups at 6 months, but a significant CAL gain in favor of the control group was observed at that time. Conclusions: MCAF is a predictable treatment for multiple adjacent Miller Class I or II recession‐type defects. The addition of a PRF membrane positioned under the MCAF provided inferior root coverage but an additional gain in GTH at 6 months compared to conventional therapy.