Efficacy of Platelet-Rich Fibrin as Regenerative Periodontal Tissue in Chronic Periodontitis: A Case Report

Background: One of the pertinent challenges the periodontists face today is the regeneration of periodontal tissue because of its complex structure. Periodontal tissue damage is characterized by bone and soft tissue loss. At present, one of the recommended materials for regeneration is PRF or platelet-rich fibrin. It is a regeneration material containing growth factors, prepared from the patient’s own blood, that can be used as a membrane. Objective: To see the efficacy of healing periodontal tissue using the addition of PRF. Method: A 31-year-old woman presented to the Department of Periodontology of Hasanuddin University Dental and Oral Hospital with the chief complaint of elongated teeth that often bled. Intraoral examination showed pocket depths of 6 mm and 5 mm in teeth 32 and 42, respectively. Radiographs showed radiolucent features in lower anterior teeth with horizontal bone loss. Chronic periodontitis of 32 and 42. Therapeutic intervention included initial therapy by scaling and root planning, followed by flap operation and regenerative therapy with PRF, membrane and bone graft. Results: One week post regenerative therapy with PRF, the clinical appearance seemed better and there was no complaint from the patient. Conclusion: The addition of PRF to periodontal surgery as a regenerative therapy can accelerate healing in the treatment of chronic periodontitis. Keywords: flap operation, platelet rich-fibrin, tissue regeneratio

Periodontal--Restorative Approach for Treating Non-Carious Cervical Lesions With Multiple Gingival Recessions: A Case Report

Background: Non-carious cervical lesions (NCCLs) are commonly associated with multiple gingival recessions. These cases cause aesthetic issues, dentin hypersensitivity and increased plaque accumulation. Therefore, they require multidisciplinary treatments. Zucchelli proposed the combined periodontal–restorative approach using envelope coronally advanced flap (CAF) in managing multiple gingival recessions with NCCLs. Objective: This case report highlights the effectiveness of Zucchelli’s modified envelope CAF in combination with a restorative approach for the treatment of multiple Miller class- III gingival recessions with type-3 NCCLs. Case Report: Zucchelli’s approach was used to determine maximum root coverage (MRC). Restorative treatments in covering the NCCLs were limited to 1 mm apical to the calculated MRC. Modified envelope CAF was performed with full and partial thickness flap. After root exposure, root planning was done and restorative finishing was performed to acquire the ideal restorative finish line without marginal overhanging. Root surfaces were conditioned for 2 min. Adjacent interdental papillae were deepithelialized, and the flap was repositioned and secured using sling sutures to establish a tight seal, allowing the clot between the root concavity and the flap to mature. Periodontal dressing was applied. Results: After 12 days, healing was uneventful with good aesthetic and functional results. Complete root coverage according to MRC predictions was obtained, and periodontal health was normal. Conclusion: Zucchelli’s modified envelope CAF with restorative approach shows good outcomes in treating multiple gingival recessions with NCCLs, given the correct determination of MRC. Keywords: gingival recession, periodontal plastic surgery, root coverag