Evaluating the use of Erythropoietin Gel with Modified Apically Repositioned Flap in Augmentation of Keratinized Tissue: A Case Report

Background:The keratinized tissue aids in the protection and maintenance of periodontal health and contributes to stabilization of the gingival margin against frictional forces and against gingival recession.Modified Apically Repositioned Flap (MARF) is a technique used for increasing KTW by using a partial thickness flap.The exposed periosteal bed left after the surgery is an open wound that may cause patients to experience postoperative pain, bleeding and discomfort during the healing process.EPO is one of the various biological materials that was introduced to accelerate wound healing and to control post-operative pain and discomfort.This study was carried out to investigate the effect of topical application of erythropoietin when combined with MARF technique.Method: A 35 years old female patient diagnosed with miller class I recession and deficient keratinized tissue apical to the recession, had MARF technique performed to increase KTW combined with application of chitosan based erythropoietin gel.Visual analogue scale was used to assess patient's postoperative pain and discomfort at day 1, day 5 and day 7 after the surgery.Healing index score was used at day 7 and day 14 to assess wound healing.The KTW was measured at baseline and 1 month after the surgery.Results: Chitosan based erythropoietin gel controlled postoperative pain and improved wound healing at the surgical site.The KTW increased 2mm after the surgery. Conclusion:The use of chitosan-based erythropoietin gel adjunct to modified apically repositioned flap (MARF) improved wound healing and decreased patient's postoperative pain and discomfort during healing.