Management of Deep Gingival Recessions by Modified Coronally Advanced Tunnel Technique with Titanium Platelet Rich Fibrin Membrane or Connective Tissue Graft: 36 Months Follow-up Clinical Study

Objectives: The goal of the study is to evaluate the results of Titanium-Platelet rich fibrin (T-PRF) membrane and Connective Tissue Graft (CTG) with modified coronally advanced tunnel technique (MCATT) in treatment of deep gingival recession defects. Methods: Twenty-one systemically healthy patients displaying 62 Miller Class I/II gingival recession defects ≥ 3.0 mm in depth were treated with MCATT with CTG or T-PRF membrane were included in this retrospective study. The periodontal parameters were assessed at baseline, 6 and 36 months after surgery. The percentages of the mean root coverage (MRC) and complete root coverage (CRC) were calculated. Results: The baseline probing depth values were reduced at 36 months according to baseline for both groups (p<0.05). The keratinized tissue (KT) was increased at 6 months according to baseline for both groups (from 1.69±0.74mm to 3.61±0.67 mm for T-PRF; and 3.40±1.60 mm to 4.52±2.33 for CTG). The 36th month measurement of KT showed an increase in the T-PRF group compared to 6 months, while the CTG group showed a significant decrease (3.86±0.76 mm and 2.76±1.45 mm, respectively). The CRC ratios were 80% and 56% at 6 and 36 months, respectively for CTG group. However, this ratio remained same (64.86%) for T-PRF group. There was statistically significant difference between CRC ratio of two groups at 36 months (p<0.05). Conclusion: T-PRF membrane with MCATT procedure is as predictable as a CTG with MCATT for management of deep gingival recessions. However, future prospective studies about this topic with a split-mouth design are needed.