CC BY-NC-ND 4.0 · Eur J Dent 2019; 13(04): 607-612
DOI: 10.1055/s-0039-3399453
Original Article
Dental Investigation Society

Comparison of Connective Tissue Graft and Platelet Rich Fibrin as Matrices in A Novel Papillary Augmentation Access: A Randomized Controlled Clinical Trial

T. Abirami
1   SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
,
Sangeetha Subramanian
1   SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
,
P. S.G. Prakash
1   SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
,
D. J. Victor
1   SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
,
A. M. Devapriya
1   SRM Dental College and Hospital, Ramapuram, Chennai, Tamil Nadu, India
› Author Affiliations
Further Information

Publication History

Publication Date:
31 December 2019 (online)

Abstract

Objective The present study was a randomized controlled clinical trial with the aim of evaluating the increase in papillary height and reduction in black triangle height obtained by the novel papillary augmentation access with either connective tissue graft (CTG) or platelet-rich fibrin (PRF) as matrix from baseline to 6 months.

Materials and Methods A total number of 20 sites with Nordland and Tarnow’s Class I, I-II and II interdental papillary loss were recruited into the study. The sites were randomly allocated with 10 sites per group into either: Group A (control group) or Group B (test group) which utilizes the same technique with CTG or PRF as matrix, respectively. The clinical parameters such as PPD (probing pocket depth) and CAL (clinical attachment level) at the surgical site, plaque score (FMPS), bleeding scores (FMBS), interdental papillary height (PH) and black triangle height (BTH), along with visual analog score by dentist (VAS-D) and by patient (VAS-P) were evaluated at baseline and at 6 months.

Results In both CTG and PRF groups, all the primary and secondary outcome variables such as PH, BTH, VAS-D and VAS-P showed statistically significant improvement from baseline to 6 months (p ≤0.05) within the group. On comparison at 6 months, there were no differences in the papillary height between the groups. However, the BTH has significantly reduced in the CTG group than the PRF group. Similarly, the VAS-D significantly improved in the CTG group than the PRF group (p = 0.010) at 6 months.

Conclusion The study demonstrates that the proposed papillary augmentation access with CTG and PRF was successful in managing the unaesthetic interdental papillary loss, with CTG showing better results in terms of reduction of black triangle than PRF.

 
  • References

  • 1 Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol 1992; 63 (12) 995-996
  • 2 Al-Zarea BK, Sghaireen MG, Alomari WM. Bheran H, Taher I. Black triangles causes and management: a review of literature. Br J Appl Sci Technol 2015; 6 (01) 1-7
  • 3 Beagle JR. Surgical reconstruction of the interdental papilla: case report. Int J Periodontics Restorative Dent 1992; 12 (02) 145-151
  • 4 Han TJ, Takei HH. Progress in gingival papilla reconstruction. Periodontol 2000 1996; 11: 65-68
  • 5 Azzi R, Etienne D, Carranza F. Surgical reconstruction of the interdental papilla. Int J Periodontics Restorative Dent 1998; 18 (05) 466-473
  • 6 Azzi R, Takei HH, Etienne D, Carranza FA. Root coverage and papilla reconstruction using autogenous osseous and connective tissue grafts. Int J Periodontics Restorative Dent 2001; 21 (02) 141-147
  • 7 Carnio J. Surgical reconstruction of interdental papilla using an interposed subepithelial connective tissue graft: a case report. Int J Periodontics Restorative Dent 2004; 24 (01) 31-37
  • 8 Nemcovsky CE. Interproximal papilla augmentation procedure: a novel surgical approach and clinical evaluation of 10 consecutive procedures. Int J Periodontics Restorative Dent 2001; 21 (06) 553-559
  • 9 Lambodharan R, Balaji VR. Interdental papilla regeneration around implants: A novel window technique (2 years follow-up). J Pharm Bioallied Sci 2015; 7 Suppl 2 S815-S818
  • 10 Choukroun J, Diss A, Simonpieri A. et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101 (03) 299-303
  • 11 Muthukumar S, Rangarao S. Surgical augmentation of interdental papilla - A case series. Contemp Clin Dent 2015; 6 Suppl 1 S294-S298
  • 12 Arunachalam LT, Merugu S, Sudhakar U. A novel surgical procedure for papilla reconstruction using platelet rich fibrin. Contemp Clin Dent 2012; 3 (04) 467-470
  • 13 Mathur A, Bains VK, Gupta V, Jhingran R, Singh GP. Evaluation of intrabony defects treated with platelet-rich fibrin or autogenous bone graft: A comparative analysis. Eur J Dent 2015; 9 (01) 100-108
  • 14 Rattanasuwan K, Rassameemasmaung S, Kiattavorncharoen S, Sirikulsathean A, Thorsuwan J, Wongsankakorn W. Platelet-rich plasma stimulated proliferation, migration, and attachment of cultured periodontal ligament cells. Eur J Dent 2018; 12 (04) 469-474
  • 15 Shruthi S, Gujjari SK, Mallya KP. Comparison of two surgical techniques for the reconstruction of interdental papilla. J Interdiscip Dentistry. 2015; 5 (01) 17-22
  • 16 Chaulkar PP, Mali RS, Mali AM, Lele PA, Patil PA. A comparative evaluation of papillary reconstruction by modified Beagle’s technique with the Beagle’s surgical technique: A clinical and radiographic study. J Indian Soc Periodontol 2017; 21 (03) 218-223
  • 17 O’Leary TJ, Drake RB, Crump PP, Allen MF. The incidence of recession in young males: a further study. J Periodontol 1971; 42 (05) 264-267
  • 18 Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J 1975; 25 (04) 229-235
  • 19 Toffler M, Toscano N, Holtzclaw D, Corso MD, Ehrenfest DD. Introducing Choukroun’s platelet rich fibrin (PRF) to the reconstructive surgery milieu. J Implant Adv Clin Dent. 2009; 1 (06) 21-30
  • 20 Cortellini P, Prato GP, Tonetti MS. The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures. J Periodontol 1995; 66 (04) 261-266
  • 21 Becker W, Gabitov I, Stepanov M, Kois J, Smidt A, Becker BE. Minimally invasive treatment for papillae deficiencies in the esthetic zone: a pilot study. Clin Implant Dent Relat Res 2010; 12 (01) 1-8
  • 22 Agarwal SK, Jhingran R, Bains VK, Srivastava R, Madan R, Rizvi I. Patient-centered evaluation of microsurgical management of gingival recession using coronally advanced flap with platelet-rich fibrin or amnion membrane: A comparative analysis. Eur J Dent 2016; 10 (01) 121-133
  • 23 Sharma A, Aggarwal N, Rastogi S, Choudhury R, Tripathi S. Effectiveness of platelet-rich fibrin in the management of pain and delayed wound healing associated with established alveolar osteitis (dry socket). Eur J Dent 2017; 11 (04) 508-513
  • 24 Samani MK, Saberi BV, Ali Tabatabaei SM, Moghadam MG. The clinical evaluation of platelet-rich plasma on free gingival graft’s donor site wound healing. Eur J Dent 2017; 11 (04) 447-454
  • 25 Tavassoli-Hojjati S, Sattari M, Ghasemi T. Ahmadi R, Mashayekhi A. Effect of platelet-rich plasma concentrations on the proliferation of periodontal cells: An in vitro study. Eur J Dent 2016; 10 (04) 469-474
  • 26 Kaushik A, Pk P, Jhamb K. et al. Clinical evaluation of papilla reconstruction using subepithelial connective tissue graft. J Clin Diagn Res 2014; 8 (09) ZC77-ZC81
  • 27 Ahila E, Saravana Kumar R, Reddy VK, Pratebha B, Jananni M, Priyadharshini V. Augmentation of interdental papilla with platelet-rich fibrin. Contemp Clin Dent 2018; 9 (02) 213-217
  • 28 Csiszar A, Wiebe C, Larjava H, Häkkinen L. Distinctive molecular composition of human gingival interdental papilla. J Periodontol 2007; 78 (02) 304-314
  • 29 Plato Palathingal JM. Treatment of black triangle by using a sub-epithelial connective tissue graft. J Clin Diagn Res 2011; 5 (08) 1688-1691
  • 30 Sharma A, Singal V. Connective tissue: A gold standard for reconstruction of black triangle. J Curr Res Sci Med. 2017; 3 (02) 111-114
  • 31 Culhaoglu R, Taner L, Guler B. Evaluation of the effect of dose-dependent platelet-rich fibrin membrane on treatment of gingival recession: a randomized, controlled clinical trial. J Appl Oral Sci 2018; 26: e20170278