Treatment of single gingival recessions using iPRF-biofunctionalized collagen matrix: A randomized clinical trial

The biofunctionalization of collagen matrices (CMs) with injectable platelet-rich fibrin (i-PRF) has been proposed to enhance their bioactivity and clinical efficacy in the treatment of gingival recessions (GRs). This study evaluated the use of a volume-stable collagen matrix (VCMX) biofunctionalized with i-PRF as an adjunct to the coronally advanced flap (CAF) for single GRs.

Seventy-five patients with single RT1 GR were randomly assigned to CAF, CAF+VCMX, or CAF+VCMX+iPRF. Clinical, esthetic, and patient-centered outcomes were assessed at baseline and at 6 months.

All groups resulted in significant recession reduction (CAF: 1.93  ±  0.86 mm; CAF+VCMX: 1.64  ±  0.68 mm; CAF+VCMX+iPRF: 1.70  ±  0.84 mm), with no statistically significant differences among groups (p  =  0.36). Groups treated with VCMX showed greater gingival thickness (GT) gain (CAF: 0.18  ±  0.25 mm; CAF+VCMX: 0.39  ±  0.26 mm; CAF+VCMX+iPRF: 0.45  ±  0.29 mm), favoring CAF+VCMX+iPRF (p  <  0.001). No significant keratinized tissue width (KTW) gain was observed (p  >  0.05). Adjusted models identified baseline KTW and KTW gain as positive predictors of complete root coverage (CRC), and KTW gain as the main predictor for RecRed and %RC.

All approaches were effective in reducing GR and improving clinical parameters. The iPRF addition to the VCMX may not improve root coverage outcomes (NCT05916742).

Gingival recession, or receding gums, occurs when the gum moves away from the tooth, exposing the root of the tooth. This can cause sensitivity and esthetic concerns and increase the tooth's susceptibility to problems. A common surgical treatment is the coronally advanced flap (CAF), which repositions the gum to cover the exposed root. In some cases, dentists add a collagen matrix to help thicken the gum and to improve the outcome. A newer option enhances this matrix with a patient's own blood product called injectable platelet-rich fibrin (i-PRF), which may improve healing. This study included 75 patients with a single recession defect. They were randomly assigned to one of three treatments: CAF alone, CAF with a collagen matrix, or CAF with a collagen matrix enhanced with i-PRF. After 6 months, all treatments led to similar improvements in root coverage, sensitivity, and esthetics. However, patients who received the collagen matrix, especially when combined with i-PRF, developed thicker gum tissue. Thicker and wider gum tissue is associated with better long-term outcomes. All procedures were well tolerated and caused minimal discomfort. Overall, adding a collagen matrix, particularly when enhanced with i-PRF, may support thicker gums and help to maintain long-term results.