| Objective:Coronally advanced flap(CAF)combined with subepithelial connective tissue graft(SCTG)is the gold standard for root surface coverage.Meanwhile,a number of studies at home and abroad have shown that CAF plus platelet-rich fibrin(PRF)can also treat gingival recession effectively.However,PRF is easy to absorb and has a short space maintenance time,it has a poor effect on the increase of keratinized gingival of teeth with different degrees of gingival recession,and the results reported in the literature are inconsistent.In this paper,the effect of coronally advanced flap(CAF)combined with platelet-rich fibrin(PRF)surgery was discussed through Metaanalysis,and the effect was compared with that of coronally advanced flap(CAF)combined with subepithelial connective tissue graft(SCTG),so as to provide more options for different clinical patients.Methods:Computer search was conducted on Pub Med,Science Direct,Cochrane Library,Embase,and CNKI database,and literature was searched on all randomized controlled trial(RCT)for the treatment of Miller I/II gingival recession and comparing Coronally advanced flap(CAF)plus platelet-rich fibrin(PRF)with Coronally advanced flap(CAF)plus subepithelial connective tissue grafts(SCTG)from July 2019.The two researchers screened the included literature,extracted relevant data,and evaluated the included literature independently.Rev Man5.3software was used for Meta-analysis and evaluation.For the Meta analysis results,fixed-effect model was used if the heterogeneity was less than 50%.If the heterogeneity of the included study is large,the reasons leading to the heterogeneity should be analyzed,and then the decision on whether to combine independent studies should be made.Results:A total of 7 studies were included,including 124 patients and 290 gingival sites,which were divided into experimental group(PRF)and control group(CTG).The indicators analyzed were gingival recession depth(GRD),gingival recession width(GRW),keratinized tissue width(KTW),keratinized tissue thickness(KTT),keratinized gingival width(KTW),keratinized gingival thickness(KTT),clinical attachment level(CAL),probing depth(PD),and visual analogue score(VAS).The follow-up time was at least 6 months.There are Six literatures Measuring and recording the final postoperative keratinized tissue width between PRF group and CTG group,and the Meta-analysis results showed significant differences statistically[MD=-0.54;95%CI:-0.83,-0.04;P<0.05].The final postoperative keratinized tissue thickness(KTT)analysis was statistically significant after the removal of heterogeneity[MD=-0.23;95%CI:-0.39,0.07;P<0.05].Postoperative VAS of 142 sites were recorded in four literatures,and the differences were statistically significant after the removal of the two literatures with high heterogeneity [MD=-0.26;95%CI:-0.48,-0.04;P <0.05].However,compared with the CAF+SCTG group,the statistical data of gingival recession depth(GRD),gingival recession width(GRW),clinical attachment level(CAL),probing depth(PD)in the CAF+PRF group showed no statistical significance(P > 0.05).Conclusion:Platelet-rich fibrin(PRF)is a second-generation biological material obtained by centrifugation from one’s blood.The treatment of gingival recession by CAF and PRF was compared with the traditional incremental periodontal soft tissue surgery by CAF combined with SCTG.PRF has a shorter operation time and can reduce postoperative pain significantly.However,in terms of the width and thickness of keratinized gingival,the effect was not obvious,The clinical indicators such as gingival recession depth(GRD),gingival recession width(GRW),clinical attachment level(CAL),probing depth(PD)were poor.Therefore,clinically sensitive patients with Miller I/II gingival recession can be considered to use CAF combined with PRF membrane for periodontal soft tissue increment.However,due to the small number of studies that can be included,a longer follow-up period of multi-center large sample prospective clinical RCT is needed to further validate the problem. |
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