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

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.