Platelet Rich Fibrin and Subepithelial Connective Tissue Graft for Soft Tissue Augmentation Around Implant

Abstract

Soft tissue augmentation of thin gingival soft tissue biotype is highly required especially around dental implant in the esthetic zone, that thin biotype undergoes recession quickly after abutment connection, resulting in compromised esthetic results. Many types of regenerative materials have been used in soft tissue augmentation; SCTG is considered the gold standard of soft tissue regeneration. Among the recently used regenerative material is PRF that offers enhanced blood clot stability resulting in increased release of growth factors stimulating wound healing and tissue regeneration. This study included 10 patients with 16 surgical sites suffering from missing upper tooth\teeth in the upper esthetic zone with thin soft tissue biotype. They are randomly selected and assigned to either group 1 in which PRF used for soft tissue augmentation around implant or group 2 in which SCTG used for soft tissue augmentation around implant. Clinical assessment was done preoperatively and after three, six and nine months after surgery. These clinical parameters were width of keratinized gingiva, clinical gingival thickness, plaque index, bleeding index, and the radiographic parameter gingival thickness was done preoperatively and after nine months by CBCT. Results of the present investigation showed that there was a significant increase in the width of keratinized gingiva as well as gingival thickness after nine months post-surgically in group II (SCTG). Moreover, SCTG demonstrated more improvement than PRF in the width and thickness of the gingiva. Regarding plaque and bleeding indices both treatment modalities showed significant decrease at the end of the study, however, with no significant difference between them. In CBCT pre-operatively, there was no statistically significant difference between the two groups. Post-operatively, SCTG showed statistically significantly higher mean gingival thickness than PRF.