title: Patient-centered evaluation of microsurgical management of gingival recession using coronally advanced flap with platelet-rich fibrin or amnion membrane: A comparative analysis.
abstract: OBJECTIVE
  To evaluate the efficacy of coronally advanced flap (CAF) procedure under microsurgical approach for the management of Miller's Class I and II gingival recession defects with the use of either platelet-rich fibrin (PRF) or amnion membrane (AM) in comparison to CAF alone.
  
  
  METHODS
  A total of 45 sites with Miller's Class I or II gingival recession defect were randomly distributed for: Experimental Group I (CAF with PRF) sites (n = 15) which were treated with the microsurgical approach using CAF along with PRF; experimental Group II (CAF with AM) sites (n = 15) were treated with the microsurgical approach using CAF along with AM; control Group III (CAF alone) sites (n = 15) were treated with the microsurgical approach using CAF alone. Vertical gingival recession (VGR), horizontal gingival recession (HGR), gingival thickness (GT) (using transgingival probing [TGP] and ultrasonography [USG]) and patients' response and acceptance were documented at baseline, 3 months and 6 months after surgical interventions.
  
  
  RESULTS
  CAF alone and in combination with PRF or AM, were effective techniques for root coverage with average VGR values of 1.47 ± 0.92 mm (56%), 0.67 ± 1.23 mm (36%) and 0.60 ± 1.06 mm (33%) in Group I (CAF with PRF), Group II (CAF with AM), and Group III (CAF alone), respectively. Complete coverage (100%) was obtained in 33.3% sites of Group I (CAF with PRF), 26.6% sites of Group II (CAF with AM) and 13.3% in Group III (CAF alone). Patients' response and acceptance for surgical treatment modality in terms of patient esthetic score and decrease in hypersensitivity score was highest for Group I (CAF with PRF), whereas patient comfort score was highest for Group II (CAF with AM). At 6 months follow-up, significant increase in GT measurements (using TGP and USG) in Group I (CAF with PRF), whereas, nonsignificant increase for Group II (CAF with AM) and no change or decrease for Group III (CAF alone) as compared to baseline was observed.
  
  
  CONCLUSIONS
  The present study observed enhancement in root coverage when PRF or AM are used in conjunction with CAF as compared to CAF alone. These results are based on 6-month follow-up. Therefore, the long-term evaluation may be necessary to appreciate the clinical effect of autologous PRF and AM.
authors.affiliation: Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India.
authors.forename: Sumit Kumar
authors.initials: SK
authors.lastname: Agarwal
authors.affiliation: Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Jhingran
authors.affiliation: Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India.
authors.forename: Vivek Kumar
authors.initials: VK
authors.lastname: Bains
authors.affiliation: Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India.
authors.forename: Ruchi
authors.initials: R
authors.lastname: Srivastava
authors.affiliation: Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Madan
authors.affiliation: Department of Periodontology, Saraswati Dental College, Lucknow, Uttar Pradesh, India.
authors.forename: Iram
authors.initials: I
authors.lastname: Rizvi
keywords: Amnion; gingival recession; gingival thickness; ultrasonography; wound healing