Treatment of gingival recession type 1 using coronally advanced flap with leucocytes-platelet rich fibrin: a randomized controlled trial

Clinical Snapshot

Key Findings

• P Value: p > 0.05 for primary outcome

• Effect Size: 7.7 percentage point difference in root coverage (not statistically significant)

• Primary Outcome: Percentage root coverage: 89.30% ± 20.33% (CAF+L-PRF) vs 81.60% ± 27.93% (CAF alone)

• Nnt Or Sensitivity: Complete root coverage achieved in 73.81% vs 57.14% of sites respectively

• Confidence Interval: Not reported

Clinical Application

CAF is standard periodontal practice. L-PRF requires centrifuge and additional chair time but is technically feasible Both procedures covered under private dental insurance. CAF is standard periodontal treatment. L-PRF not specifically listed on PBS but materials are available Adult patients with Miller Class I gingival recession requiring root coverage procedures

Abstract

OBJECTIVE: This study aimed to evaluate the clinical outcomes of gingival recession Type 1 (RT1) treatment using a coronally advanced flap (CAF) alone and in combination with L-PRF at 6 months. MATERIALS AND METHODS: A total of 70 RT1 from 19 patients were included. Participants were randomly assigned to the test group (TG, CAF + L-PRF, n = 42) and the control group (CG) (CAF alone, n = 28). Clinical parameters were assessed at baseline and at 6 months: the primary outcomes were percentage of root coverage (%RC) and complete root coverage (CRC); and the secondary outcomes included mean root coverage (MRC), changes in gingival thickness (GT) and volumetric tissue gain, recession area reduction, analgesic consumption, healing quality (the Inflammatory Proliferative Remodeling [IPR] score), and patient-reported outcome measures (PROMs). Statistical analyses were performed to determine differences between groups; a random-intercept mixed-effects model was used for all site-level outcomes. RESULTS: At six months, %RC was 89.30% ± 20.33% (TG) and 81.60% ± 27.93% (CG) (p > 0.05). For the TG and CG, respectively, %CRC was 73.81% and 57.14%; the mean GT gain was 0.16 ± 0.10 mm and 0.11 ± 0.10 mm (p = 0.08); the mean volume gain was 1.13 ± 1.25 mm3 and 0.86 ± 0.84 mm3 (p = 0.32); the mean number of pills taken was 1.67 ± 0.98 and 2.25 ± 1.02 (p = 0.04); the esthetic satisfaction was 95% ± 5% and 90% ± 7% (p = 0.31); willingness to undergo the procedure again: 93% ± 4% and 88% ± 6% (p = 0.22); sensitivity reduction: 85% ± 6% and 80% ± 8% (p = 0.19). There was no statistically significant difference in healing quality and PROMs. CONCLUSION: Both CAF alone and CAF combined with L-PRF yielded comparable clinical and volumetric outcomes in RT1 treatments. No statistically significant advantages were observed with the adjunctive use of L-PRF. CLINICAL RELEVANCE: Because CAF alone achieves high predictability for RT1 defects, the routine adjunctive use of L-PRF provides limited additional clinical benefits.

References

1. 1.Dos Santos, N. B., Fernandes, G. V. O., Marques, T., Sousa, M. C., Correia, A., Vázquez, M. P. B., & Blanco-Carrión, J. (2026). Treatment of gingival recession type 1 using coronally advanced flap with leucocytes-platelet rich fibrin: a randomized controlled trial. Clinical Oral Investigations. https://doi.org/10.1590/1678-7757-2017-0278