Case Report DOI: 10.18231/2457-0087.2018.0015 IP International Journal of Periodontology and Implantology, April-June 2018;3(2):71-74 71 Recession coverage with coronally advanced flap along with Prf membrane- A case report Sukhmeet Kaur 1 , Rasveen Kaur 2,* , Preetika Bansal 3 , Chandni Mittal 4 , Supreet Jhind 5 1,2,5 Senior Lecturer, 3 Reader, 4 Junior Lecturer, Dept. of Periodontics, 1,3,4 Dashmesh Institute of Research & Dental Sciences, Faridkot, Punajb, 2,5 Maharishi Markandeshwar College of Dental Sciences & Research, Mullana, Haryana, India *Corresponding Author: Email: dr.rasveenkaur@gmail.com Abstract Gingival recession is a common pesky problem affecting almost all middle and older aged to some degree and in patients with good oral hygiene as well as in periodontally untreated populations with poor oral hygiene. Gingival recession has been associated with dentinal hypersensitivity, root caries and esthetic compromise. Various periodontal plastic surgical procedures are available including coronally advanced flap (CAF), each having advantages and disadvantages. To improve the clinical outcome of such surgical procedures, several regenerative materials have been combined with it. In this case report, we aimed the root coverage in Miller’s class II by means of coronally advanced flap technique along with PRF membrane. A platelet-rich fibrin (PRF) membrane is a readily available and inexpensive biomaterial that is beneficial in periodontal plastic surgery procedures . Keywords: Gingival recession, Root coverage, Coronally advanced flap, Platelet-rich membrane. Introduction Gingival recession is an apical migration of the gingival margin tissue relative to the cemento-enamel junction characterized by the exposure of the root surface. Several factors influence the development of marginal tissue recession including traumatic tooth brushing technique trauma, 1 plaque-induced inflammation, tooth alignment, orthodontics, restorative procedures, high muscle attachment and frenal pull. 2 Isolated gingival recessions have been treated by several techniques. 3 The migration of the marginal tissue in an apical direction may lead to esthetic, dentin hypersensitivity, root caries, and cervical wear recessions. Various methods for performing mucogingival grafts to cover denuded root surfaces are available. But coronally advanced flap (CAF) is a predictable surgical procedure when there is adequate keratinized tissue present apical to the recession defect in the treatment of Miller Class I and II gingival recessions. 4 CAF alone gives an unstable result for long-term period, despite of having many advantages. Such procedure leads to formation of long junctional epithelium, which is risk factor for future recurrence of gingival recession. To improve the results various regenerative procedures have been tried with CAF which enhances root coverage. One of such material is Platelet rich fibrin (PRF) which is a second generation autologous platelet concentrate and does not require any extensive preparation as in needed in the preparation of PRP. The growth factors within platelet concentrates (platelet-rich plasma [PRP] and platelet- rich fibrin [PRF]) up-regulate cellular activity, effective in the enhancement of early wound healing and are promoters of periodontal tissue regeneration. 5 Platelet rich fibrin (PRF) is a 3-D polymerized matrix in which platelet, cytokines, leucocytes, various growth factors including vascular endothelial growth factor (VEGF), insulin-like growth factor, platelet-derived growth factor (PDGF), transforming growth factor (TGF), epidermal growth factor, basic fibroblast growth factor and circulating stem cells are trapped and that can serve as a resorbable membrane. Due to these factors, PRF accelerates wound healing and has a supportive effect on the immune system, cell migration and proliferation. 6,7 Because of various inherent factors present in autologous platelet concentrate which has the capacity for bone regeneration and accelerate soft tissue wound healing, the gingival recession shown in this case report, was treated using autologous PRF membrane combined with CAF. Case Report A 45 year old male patient came in the department of Periodontology at Dasmesh Intitute of Research and Dental Sciences, Faridkot with good general health complaining of sensitivity in upper tooth region. During clinical examination, Miller’s class-II gingival recession noticed in relation to maxillary right canine (Fig 1). Due to the presence of sufficient attached gingiva apical to recession in the buccal area, surgical planning was directed to the coronally positioned flap along with PRF membrane in order to obtain the desirable result.