TREATMENT OF MULTIPLE GINGIVAL RECESSIONS IN ANTERIOR MAXILLARY TEETH USING PLATELET-RICH FIBRIN AND AUTOLOGOUS GINGIVAL FIBROBLASTS: A CASE SERIES

PURPOSE. To evaluate the clinical outcome of biografts containing autologous fibroblast cell culture (AFCC) injected into platelet-rich fibrin (PRF) membrane and placed under coronally advanced flap (CAF) for the treatment of multiple gingival recessions in the anterior area of the upper jaw.
MATERIAL AND METHODS. Ten patients with 43 gingival recessions, Miller class I, II and III, located in the anterior maxillary teeth were studied. Patients’ AFCCs were isolated from biopsied palatal mucosa and cultured for cell-suspension preparation. The PRF membrane was made of whole blood taken before surgery. During the mucogingival surgery, the AFCC was introduced into the PRF membrane, which was placed under the CAF. Root coverage, clinical attachment level (CAL), probing depth (PD), gingival recession depth (GRD), keratinized tissue height (KTH), full-mouth plaque score (FMPS), and full-mouth bleeding score (FMBS), were recorded prior to treatment and at 3, 6 and 12 months after surgery.
RESULTS. All patients completed the study. The mean root coverage was 83%. After 12 months, mean GRD was significantly reduced from 1.63 ± 0.28 mm to 0.26 ± 0.12 mm (P = 0.0002). Mean KTH significantly increased from 2.8 ± 0.37 mm to 3.63 ± 0.27 mm (P = 0.0003). PD showed no significant changes at any timepoint (1.52 ± 0.07 mm at baseline and 1.43 ± 0.06 mm 12 months after surgery). After 12 months, complete root coverage was 100% at Miller class I and II teeth, and 54% at Miller class III teeth.
CONCLUSIONS. Application of PRF membrane containing AFCC represents a promising new therapeutic concept, based on living cells, in the treatment of gingival recession. However, well-designed randomised controlled trials are needed to evaluate its effectiveness in comparison with conventional procedures.