Comparação entre o uso da Fibrina Rica em Plaquetas Advanced (A-PRF) e enxerto de tecido conjuntivo no tratamento de recessões gengivais tipo 1 de Cairo associado a técnica de reposicionamento coronário

Abstract

Gingival recession is defined as the apical migration of the marginal gingiva with exposure o the root surface, which can lead to aesthetic problems, dentinal hyperesthesia, cervical cavities and non-carious cervical lesions. The Subepithelial Connective Tissue Graft (ETCS) associated with the Coronary Positioned Flap (RPC) is considered the gold standard in the treatment of gingival recessions, however the use of Platelet Rich Fibrin - PRF has been showing good results in gingival plastic surgery. The aim of the present study was to evaluate the efficacy of Advanced Platelet Rich Fibrin (A-PRF) used in combination with RPC and to compare with the ETCS use also associated with RPC in Cairo type 1 gingival recessions. Forty recessions were selected, 20 of which belong to the RPC + A-PRF group (test group) and 20 to the RPC + ETCS group. Height of gingival recession, height and thickness of the inserted gingiva, probing depth, level of clinical insertion and tooth sensitivity were evaluated at the beginning and 6 months after the surgery. There was a gain in gingival height of 1.45 ± 0.96mm in the RPC + ETCS group and 1.04 ± 0.95mm in the RPC + A-PRF group, with a coverage of 54.3% in the test group and 73% in the control group. The total coverage (100%) of the recessions was found at 7 sites (35%) in the group with A-PRF and 10 sites (50%) with the ETCS. In both groups there was a significant improvement in tooth sensitivity (p <0.05), and in relation to the other clinical parameters evaluated, there was no statistically significant difference, however, discrete higher rates of gum gain inserted both in height and thickness were found in the control group. After 180 days both techniques showed results of significant improvement in the evaluated periodontal parameters, concluding that both can be used for treatments for Class I type recessions in Cairo.