www.ijcmr.com International Journal of Contemporary Medical Research Volume 3 | Issue 4 | April 2016 | ICV: 50.43 | ISSN (Online): 2393-915X; (Print): 2454-7379 1190 Coronally Advanced Flap Along with Autologous Platelet Rich Fibrin: Boon for Recession Coverage- A Case Report Maya Mhaske 1 , Neha Thakur 2 , Sachin Raut 2 CASE REPORT ABSTRACT Introduction: Gingival recession results due to the apical migration of gingival margin. Correction of such gingival re- cession is necessary to enhance aesthetic as well as function- al demand. Variety of periodontal plastic surgical procedures including coronally advanced lap (CAF) are described, each having advantages and disadvantages. To improve the clini- cal outcome of such surgical procedures, several regenerative materials have been combined with it. Though platelet rich ibrin (PRF) is one of the best regenerative material, it is not frequently used along with the periodontal plastic surgical procedures. In the present case report, PRF is combined with CAF for the treatment of multiple gingival recessions. Case report: 29 years female reported to our department with complain of gingival recession. CAF surgery along with the incorporation of PRF was carried out to treat the gingival re- cession. Conclusion: The addition of PRF to CAF procedure provided complete root coverage. This case report helped to focus treat- ment outcomes and predictability of autologous PRF when used along with CAF for the treatment of recession defects on multiple adjacent teeth. Keywords: Recession, Platelet rich ibrin (PRF), Coronally advanced lap (CAF), Regeneration, Root coverage. INTRODUCTION Gingival recession is the displacement of the soft tissue mar- gin apical to cemento-enamel junction with exposure of root in the oral cavity. 1 It is one of the major aesthetic concern seen in the ield of periodontology. Root hypersensitivity is a common complaint associated with gingival recession, re- sulting because of root exposure and subsequent exposure of dentinal tubules in the oral cavity. It also results in at- tachment loss and root caries. 2 One or more etiologic factors are responsible for gingival recession includes inlammatory periodontal disease; mechanical trauma from tooth brushing; occlusal trauma; high frenal attachment; tooth malposition or root prominence leading to the thinning of bony plate; or- thodontic tooth movement in unusual direction; underlying alveolar dehiscence; thin gingival biotype; and other perio- dontal treatment-related factors. 3 Various periodontal plastic surgical procedures are offered to treat gingival recession. Most commonly used techniques are free graft which includes free gingival graft and subepithe- lial connective tissue graft; and pedicle lap which includes lateral pedicle lap and coronally advanced lap (CAF). With the use of free gingival grafts, gingival tissue color match- ing is always a problem which results in an unsatisfactory aesthetic. Though subepithelial connective tissue graft is satisfactory in terms of aesthetic and recession coverage, it requires a second surgical site. CAF technique have also shown more predictable recession coverage with apparently acceptable aesthetic results. 2 CAF when used alone is un- stable on long-term, in spite of having many advantages. 4 Such procedure does not always result in the regeneration of lost attachment apparatus such as cementum, periodontal ligament, and alveolar bone, which may act as a future risk factor in the recurrence of gingival recession. To avoid such further risk of recurrence, CAF is often combined with var- ious regenerative materials like guided tissue regeneration membranes, enamel matrix proteins derivatives, alloderm, living tissue-engineered human ibroblast derived dermal substitute which helps to regenerate functional attachment apparatus as well as enhances root coverage. 2 Various new regenerative materials have been tried with CAF. One of such material is autologous platelet concen- trates. 2 Platelet rich ibrin (PRF) is an autologous plate- let concentrate system which require simpliied process of preparation, and also does not need addition of any anticoag- ulant during its preparation. 5 The prepared PRF has a three dimensional ibrin network incorporated with platelets, leu- kocytes, different growth factors, and circulating stem cells. Use of PRF is increasing in the periodontal and implant sur- gical procedures because of it’s enhanced capacity for bone regeneration and soft tissue wound healing. 2 Thus by considering various advantages of PRF, the multi- ple gingival recession shown in the present case report, was treated using autologous PRF membrane combined with CAF. CASE REPORT A 29 year old female patient reported to the department of periodontology in CSMSS Dental College, Aurangabad with the chief complaint of unaesthetic appearance and teeth sen- sitivity in maxillary anterior region. Patient noticed the pres- ence of such unaesthetic appearance 1 year back. During clinical examination, Miller’s class-I gingival reces- sion noticed with maxillary right central incisor, left central incisor and lateral incisor i.e. with11, 21 and 22. Gingival re- cession of 2 mm, 3mm and 1.5mm were recorded with teeth 22,11 and 21 respectively (Fig 1). The teeth presented shal- 1 Professor and Guide, HOD, 2 Post Graduate Student, Department of Periodontology, CSMSS Dental College and Hospital, Au- rangabad, India Corresponding author: Dr. Neha Thakur, Annapurna Girls Hos- tel, Near CSMSS Dental College, Kanchanwadi, Paithan Road, Au- rangabad 431002, India How to cite this article: Maya Mhaske, Neha Thakur, Sachin Raut. Coronally advanced lap along with autologous platelet rich ibrin: boon for recession coverage- a case report. International Journal of Contemporary Medical Research 2016;3(4):1190-1193.