Dişeti çekilmelerinin tedavisinde titanyum trombositten zengin fibrin (T-PRF) ve bağ dokusu greftinin etkinliklerinin karşılaştırılması / Comparison of the efficacy of the titanium plateletrich fibrin (T-PRF) and connecti̇ve tissue graft in thetreatment of gingival recessions
Esthetics, dental hypersensitivity and the prevention of caries and non-carious cervical lesions are considered the main reasons of gingival recession treatment. Subepithelial connective tissue graft (SCTG) is considered the gold standard, although many surgical methods are available for the treatment of gingival recessions. Titanium platelet rich fibrin (T-PRF); it is a platelet concentrate developed in titanium tubes based on the hypothesis that the glass content may be affected by silica during activation of the platelet-rich fibrin (L-PRF) obtained in the glass-covered tubes. The use of titanium causes the fibrin network to become tighter, prolong the resorption time, and a more controlled and prolonged release of growth factors De-epithelized connective tissue graft (DCTG) is obtained by taking the epithelium on the graft extraorally after it is taken with the epithelium. DCTG is a better-performing connective tissue graft thanks to the protection of the more rigid and stable lamina propria located close to the epithelium than SCTG.To date, there is no clinical study that the more stable and organized T-PRF than PRF and the de-epithelial connective tissue graft (DCTG), which is more stable than subepithelial connective tissue graft (SCTG), which is the gold standard in root-surface closure, can be used for predicting the efficacy and predictability of the use of tunnel technique. The aim of this randomized clinical trial was to compare the clinical results of different autogenous graft materials (T-PRF & DBDG) in the treatment of Miller Class I / II gingival recessions. The treatment of 27 patients with Miller Class I / II gingival recession in 80 teeth was completed. Gingival recessions were randomly treated with T-PRF (40 teeth) or DCTG (40 teeth) modified tunnel technique. Clinical measurements were recorded at baseline, 3 months and 6 months after the operation. VAS (Visual Analog Scale), healing index was evaluated and material thickness was recorded. The first gingival recession depth was 3.02 ± 1.15 mm in the T-PRF group and 2.81 ± 0.86 mm in the DCTG group. After 6 months, the mean root closure rate was 78.33% in the T-PRF group and 85.28 in the DBDG group, while the complete root surface mean was 62.5% in the T-PRF group and 70% in the DCTG group. There was no statistically significant difference between the groups for both values. At the end of the treatment, both graft materials were increased the keratinised tissue width and gingival thickness statistically significantly in both groups. Within the limits of this study, it was shown that autogenous T-PRF membrane provide reliable and effective results in the treatment of Miller I / II gingival recession defects. T-PRF can be used as an important alternative to DCTG.