Root coverage with platelet-rich fibrin or connective tissue graft: a split-mouth randomized trial

This study aimed to compare the use of connective tissue grafts (CTG) and platelet-rich fibrin (PRF) associated with the tunnel technique (TT) for the treatment of multiple gingival recessions (GR). Fourteen patients with multiple bilateral GR [type 1 recession (RT 1)] in the maxillary incisors, canines, and/or premolars were included. The TT was performed on both sides (split-mouth model); CTG (36 GR) was used on one side, and on the other, PRF (36 GR) was used. Clinical parameters, including recession depth (RD), probing depth, clinical attachment level (CAL), and keratinized gingiva thickness/width (GT/KTW), were obtained at baseline and after 1, 3, 6, and 16 months. Lower RD (0.81 +/- 0.68 vs. 1.23 +/- 0.71 mm) and CAL (2.54 +/- 0.63 vs. 2.73 +/- 0.82 mm) were observed for CTG compared to PRF after 16 months. Higher GT was obtained for CTG compared to PRF after 3 (1.81 +/- 0.56 vs 1.43 +/- 0.47 mm) and 6 months (1.67 +/- 0.61 vs. 1.38 +/- 0.55 mm, p < 0.05). The recession coverage (RC) was higher for CTG (55.42% +/- 37.14) in comparison to PRF (29.53% +/- 34.08) after 16 months (p < 0.05). Similarly, CTG presented a more complete coverage of the recession (15; 41.66%) than PRF (9; 24.32%). There were no significant differences between the groups in terms of surgery time, postoperative pain, or healing patterns. Greater esthetic satisfaction was obtained with CTG. It was concluded that CTG combined with TT showed clinical and esthetic results superior to those of PRF in multiple GR treatments.