
Connective tissue graft (CTG) is widely considered the gold standard due to its predictable and stable long-term results, particularly in cases requiring significant soft tissue augmentation. However, it necessitates a second surgical site, increasing patient discomfort. Platelet-rich fibrin (PRF), a minimally invasive alternative, promotes tissue regeneration through growth factor release, enhancing healing while reducing postoperative morbidity. A comprehensive analysis of scientific literature, including clinical studies and case reports, was conducted to compare the effectiveness of both techniques in achieving root coverage, increasing gingival thickness, and improving esthetic and patient-related outcomes. While CTG consistently demonstrates superior long-term stability, PRF offers promising regenerative potential with less postoperative discomfort. This review evaluates the efficacy, clinical outcomes, and patient satisfaction associated with CTG and PRF in the management of gingival recession. However, limitations such as variability in PRF preparation methods, lack of standardized protocols, and limited long-term clinical data hinder its widespread acceptance. Despite these challenges, PRF remains a viable option for patients seeking a less invasive approach with improved healing. Future research should focus on refining PRF protocols and establishing their long-term efficacy to broaden their application in periodontal therapy.
Citation: Sanehi Punse, Prasad Dhadse, Anand Wankhede, Ruchita Patil, Rutuja Karamore. Regenerative potential of connective tissue grafts vs. platelet-rich fibrin preparations in periodontal therapy: a comparative review[J]. AIMS Bioengineering, 2025, 12(2): 249-264. doi: 10.3934/bioeng.2025012
[1] | Aishwarya Rathod, Priyanka Jaiswal, Deepika Masurkar . Advanced platelet rich fibrin in periodontal regeneration. AIMS Bioengineering, 2023, 10(2): 175-182. doi: 10.3934/bioeng.2023012 |
[2] | Kapil Bhangdiya, Anand Wankhede, Priyanka Paul Madhu, Amit Reche . An overview on platelet concentrates in tissue regeneration in periodontology. AIMS Bioengineering, 2023, 10(1): 53-61. doi: 10.3934/bioeng.2023005 |
[3] | Daniele D’Arrigo, Marta Bottagisio, Silvia Lopa, Matteo Moretti, Arianna B. Lovati . Tissue engineering approaches to develop decellularized tendon matrices functionalized with progenitor cells cultured under undifferentiated and tenogenic conditions. AIMS Bioengineering, 2017, 4(4): 431-445. doi: 10.3934/bioeng.2017.4.431 |
[4] | Tanishka Taori, Anjali Borle, Shefali Maheshwari, Amit Reche . An insight into the biomaterials used in craniofacial tissue engineering inclusive of regenerative dentistry. AIMS Bioengineering, 2023, 10(2): 153-174. doi: 10.3934/bioeng.2023011 |
[5] | Fabrizio Belleggia . Hard and soft tissue augmentation of vertical ridge defects with the “hard top double membrane technique”: introduction of a new technique and a case report. AIMS Bioengineering, 2022, 9(1): 26-43. doi: 10.3934/bioeng.2022003 |
[6] | Daniel Pelaez, John H. Michel, Herman S. Cheung . Growth on elastic silicone substrate elicits a partial myogenic response in periodontal ligament derived stem cells. AIMS Bioengineering, 2016, 3(4): 515-527. doi: 10.3934/bioeng.2016.4.515 |
[7] | Jéssica de Oliveira Rossi, Gabriel Tognon Rossi, Maria Eduarda Côrtes Camargo, Rogerio Leone Buchaim, Daniela Vieira Buchaim . Effects of the association between hydroxyapatite and photobiomodulation on bone regeneration. AIMS Bioengineering, 2023, 10(4): 466-490. doi: 10.3934/bioeng.2023027 |
[8] | Shaoyung Chen, Hsinyi Mao, Pinhua Tu, Naichen Cheng, Jiashing Yu . Fabrication of decellularized adipose tissue/alginate composite microspheres with pASCs encapsulation for tissue engineering. AIMS Bioengineering, 2017, 4(3): 351-365. doi: 10.3934/bioeng.2017.3.351 |
[9] | Carlos M. Carballosa, Jordan M. Greenberg, Herman S. Cheung . Expression and function of nicotinic acetylcholine receptors in stem cells. AIMS Bioengineering, 2016, 3(3): 245-263. doi: 10.3934/bioeng.2016.3.245 |
[10] | Izgen Karakaya, Nuran Ulusoy . Basics of dentin-pulp tissue engineering. AIMS Bioengineering, 2018, 5(3): 162-178. doi: 10.3934/bioeng.2018.3.162 |
Connective tissue graft (CTG) is widely considered the gold standard due to its predictable and stable long-term results, particularly in cases requiring significant soft tissue augmentation. However, it necessitates a second surgical site, increasing patient discomfort. Platelet-rich fibrin (PRF), a minimally invasive alternative, promotes tissue regeneration through growth factor release, enhancing healing while reducing postoperative morbidity. A comprehensive analysis of scientific literature, including clinical studies and case reports, was conducted to compare the effectiveness of both techniques in achieving root coverage, increasing gingival thickness, and improving esthetic and patient-related outcomes. While CTG consistently demonstrates superior long-term stability, PRF offers promising regenerative potential with less postoperative discomfort. This review evaluates the efficacy, clinical outcomes, and patient satisfaction associated with CTG and PRF in the management of gingival recession. However, limitations such as variability in PRF preparation methods, lack of standardized protocols, and limited long-term clinical data hinder its widespread acceptance. Despite these challenges, PRF remains a viable option for patients seeking a less invasive approach with improved healing. Future research should focus on refining PRF protocols and establishing their long-term efficacy to broaden their application in periodontal therapy.
In dentistry, symmetrical teeth arrangement and harmonious soft tissue morphology are prioritized for esthetic reasons. Marginal gingival recession results in esthetic difficulties and dental hypersensitivity because of root exposure. Periodontal plastic surgery attempts to regenerate the periodontal tissues that have been lost due to periodontitis [1]. Intraoral soft-tissue grafting is one of the dependable root-covering methods that has grown in popularity [2]. The choice of treatment depends on variables such as recession depth and post-operative esthetics [3]. Several techniques are employed, including the gold-standard method of using connective tissue grafts (CTGs) followed by envelope approach, lateral sliding flap, free gingival graft and coronally advanced flap, pouch and tunnel, vestibular incision supra-periosteal tunnel access (VISTA), and modified-VISTA [4]. However, conventional surgical techniques like CTGs and free gingival autografts have limitations, such as a second surgical site and lacking growth factors [5]–[7]. Growth factors are essential for faster healing and regeneration in periodontal treatment. Different preparation of platelet-rich fibrin (PRF) provides an alternative to CTG for the root coverage procedure. PRF has the advantage as it is less invasive, abundant with growth factors, and does not need require second surgical sites, but its outcomes are not always consistent [8],[9]. To comprehensively evaluate the outcomes of root coverage procedures, it is essential to include not only clinical success parameters but also esthetic aspects. The root coverage esthetic score (RES) has been introduced as a standardized and quantitative tool to objectively assess esthetic outcomes, including gingival margin level, soft tissue contour, color match, and texture. Incorporating RES into studies that compare CTG and PRF enables a more detailed analysis of their esthetic performance, beyond the traditional measurement of root coverage alone. Two distinct approaches were recently put up to evaluate the esthetic results of root covering operations. In a previous study, a five-point ordinal improvement scale—poor, fair, good, very good, and excellent—was proposed following the panel scoring system. In order to assess the overall esthetic result following root coverage operations, the root coverage esthetic score (RES) system was also established. Five factors are evaluated to determine this score: gingival colour, soft tissue surface, marginal contour, gingival margin level, and MGJ position. Five factors are evaluated to determine this score: gingival colour, soft tissue surface, marginal contour, gingival margin level, and MGJ location. The range of RES values is 0 (i.e., final residual recession that is equal to or greater than the baseline recession) to 10 (i.e., CRC linked to the other four factors being fulfilled). In a study that contrasted the use of an acellular dermal matrix allograft seeded with autologous gingival fibroblasts with a subepithelial connective tissue transplant, RES was also utilized to assess the esthetic outcomes of localized recessions. To the best of our knowledge, the RES's interrater agreement has not been statistically evaluated, despite the fact that its preliminary proposal appears promising [10].
The electronic literature search was done for articles through PubMed, Scopus, and Google Scholar databases. Studies included in the review focused on periodontal regeneration using CTG and/or PRF. Clinical outcomes such as gingival thickness, probing depth reduction, clinical attachment level improvement, and keratinized tissue width were reported. Only studies involving human participants with no systemic health conditions affecting periodontal regeneration were included. Exclusion criteria included nonclinical studies, such as animal studies, in vitro experiments, or noncomparative studies and/or reviews. Studies involving patients with systemic conditions such as uncontrolled diabetes, active smoking, immunosuppressive disorders, or severe periodontal disease requiring unrelated treatments were excluded. Studies with poor oral hygiene compliance or untreated dental infections were excluded, along with editorials, opinion articles, or studies with insufficient data. Data extraction (Figure 1).
CTG can be procured from the edentulous ridges, maxillary tuberosity, and palate, with the palate being the most frequently used donor site due to the large dimensions of graft that could be obtained and also the presence of histological similarity between the palatal mucosa and keratinized attached mucosa of the alveolar ridge [11]. The lateral palate, distal to the canine and mesial to the first molar's palatal ridge, has proven to be the best place to obtain connective tissue grafts. The majority of studies have demonstrated a satisfactory amount of vessels, cells, and fibers, especially found within the lamina propria, as well as an adequate tissue thickness for accomplishing good esthetic outcomes during root coverage methods, despite an observed variability in the histological composition of the tissues collected from this area [1]. The various locations and their structure are as follows:
1. Palatal mucosa: [2]
- Composition: Dense connective tissue rich in collagen fibers, fibroblasts, and a robust blood supply.
- Use: This is the most common donor site for connective tissue grafts. It provides thick, durable tissue ideal for root coverage, increasing keratinized tissue, and stabilizing gingival margins.
- Site characteristics: Tissue is typically harvested from the area between the first premolar and molar due to its optimal thickness and accessibility.
2. Maxillary tuberosity: [2]
- Composition: Soft connective tissue with higher elasticity and moderate collagen content.
- Use: Often used when thicker or more pliable tissue is needed, such as in esthetic zones or when palatal tissue is inadequate.
- Site characteristics: The tissue is softer and may have a better esthetic outcome in some cases, though it may be less stable under tension. An enhanced harvesting location for autografts with greater tissue thickness has been thought to be the tuberosity.
3. Edentulous ridge:
- Composition: Dense fibrous connective tissue with minimal glandular and fatty tissue.
- Use: Selected when additional tissue is needed for grafting, especially in patients with an edentulous site near the area of recession.
- Site characteristics: Offers stable and vascularized tissue for grafting in challenging cases.
4. Lateral pedicle graft (Adjacent tooth site): [3]
- Composition: Gingival tissue with intact vasculature from the adjacent tooth or site.
- Use: Used in single-tooth recession cases to mobilize tissue from a neighboring area without the need for a separate donor site.
- Site characteristics: Maintains blood supply, allowing rapid healing and effective root coverage.
PRF was initially created in France for use in oral and maxillofacial surgery. Since PRF is made as a natural concentrate without any anticoagulants added, it is categorized as a second-generation platelet concentrate [4]. Leukocytes; cytokines; structural glycoproteins; growth factors, including transforming growth factor B1, platelet-derived growth factor, vascular endothelial growth factor; and glycoproteins like thrombospondin-1 are all present in the thick fibrin matrix that is PRF [8]. Using a specialized centrifugation and collection kit, the patient's blood sample is extracted during the surgical operation and undergoes a single centrifugation without blood manipulation. Neither calcium chloride nor bovine thrombin were utilized for fibrin polymerization, nor was an anticoagulant used while blood collection. After centrifugation, three different portions are created: 1) red blood cells, which are concentrated at the bottom of the test tube and can be quickly disposed of; 2) the surface layer, which is a liquid serum of platelet-depleted plasma; and 3) the latter fraction, which is a dense PRF clot that is suitable for use as a membrane in clinical settings [12]. The primary PRF varieties utilized in periodontal procedures (Table 1).
1. Conventional PRF (Leukocyte-PRF [L-PRF]) [6]
- Preparation: Centrifugation of blood without anticoagulants, leading to a clot rich in fibrin, platelets, and leukocytes at 2700–3000 rpm for 12 minutes.
- Uses: Enhancing soft and hard tissue healing, promoting bone regeneration in guided bone regeneration (GBR), and supporting wound healing after flap surgeries.
- Advantages: L-PRF is a solid biomaterial that does not disperse soon after application. Solid-state L-PRF has been demonstrated to dramatically embed platelet and leukocyte growth factors into the fibrin matrix, resulting in an enhanced cytokine life span [13]. It is also easy to prepare, biodegradable, and biocompatible.
- Limitations: Requires rapid processing to prevent clotting.
2. Advanced PRF (A-PRF) [7]
- Preparation: Modified centrifugation (i.e., lower speed and longer time) to optimize cell and growth factor content at 1500 rpm for 14 minutes.
- Uses: Enhanced angiogenesis due to higher leukocyte and growth factor content that is effective in periodontal regeneration and defect healing.
- Advantages: Better release of growth factors over time compared to conventional PRF.
- Limitations: Requires precise centrifugation protocols, and the longer preparation time may not be ideal for immediate use.
3. Injectable PRF (i-PRF) [9]
- Preparation: Very low-speed centrifugation producing a liquid concentrate at 700–800 rpm for 3–4 minutes.
- Uses: Injectable form allows precise application in defect sites, mixed with bone grafts, or used as an injectable matrix for soft tissue healing.
- Advantages: The human liquid fibrinogen in i-PRF gradually transforms into a PRF clot rich in growth factors that release continuously for 10–14 days [14]. Nonclotting form is ideal for minimally invasive procedures.
- Limitations: Short working time before clot formation.
4. Titanium-PRF (T-PRF) [15]
- Preparation: Centrifugation in titanium tubes instead of glass (silica) tubes, which may reduce contamination and enhance biocompatibility at 2700 rpm for 12 minutes.
- Uses: Promoting osteogenesis and soft tissue healing.
- Advantages: Higher mechanical strength and growth factor release. Researchers discovered that co-aggregation brought on by titanium had been comparable to that, and that clots formed in titanium pipes were the same as those formed in glass vials. T-PRF has special advantages like improved biocompatibility since titanium particles, not silica particles, are employed to activate platelets.
- Limitations: Requires specialized equipment (i.e., titanium test tubes).
Sr. no. | Type of PRF | Centrifugation speed | Time | Tube type | Form | Features |
1. | Conventional PRF (L-PRF) | 2700–3000 rpm | 12 minutes | Glass (no anticoagulant) | Solid clot | Quick processing required to avoid early clotting |
2. | A-PRF | 1500 rpm | 14 minutes | Glass (modified protocol) | Solid clot | Lower speed and longer time optimize cell content |
3. | i-PRF | 700–800 rpm | 3–4 minutes | Plastic (no anticoagulant) | Liquid form | Very short spin time yields nonclotting liquid form |
4. | T-PRF | 2700 rpm | 12 minutes | Titanium tubes | Solid clot | Titanium enhances biocompatibility and mechanical strength |
The comparison between CTG and PRF in periodontal surgeries highlights their unique benefits and limitations, particularly in soft tissue augmentation and regenerative procedures. CTG, harvested from the patient's palate, is composed of a connective tissue matrix with fibroblasts and collagen, providing structural support and predictable outcomes for gingival recession treatment and tissue augmentation. Because it may thicken tissue and produce better functional and cosmetic outcomes, it is regarded as the gold standard for root covering [2]. However, CTG requires a second surgical site, leading to increased patient morbidity, prolonged healing time, and postoperative discomfort. In contrast, PRF, derived from autologous blood, contains a fibrin matrix rich in platelets; leukocytes; and growth factors, such as PDGF, TGF-β, and VEGF. These factors promote angiogenesis, wound healing, and tissue regeneration. By doing away with the requirement for a donor site, PRF lowers discomfort following surgery and patient complications [4]. While PRF is effective in enhancing soft tissue healing and regeneration, its predictability for complete root coverage is lower compared to CTG (Table 2).
Aspect | CTG | PRF |
Root coverage success | 90–97% (Consistently high) | 70–80% (Moderate, less predictable) |
Patient morbidity | Higher due to the second surgical site | Lower as no donor site is needed |
Long-term stability | High tissue stability | Moderate; lacks structural support |
Esthetic outcomes | Superior tissue thickness and color match | Improved vascularity but less tissue volume |
Edel [16] and Broome and Taggart [17] introduced early trapdoor techniques, achieving approximately 85–88% root coverage by enhancing wound closure and healing. Langer and Calagna [18] refined the internal bevel flap technique, providing smoother tissue junctions with 90% coverage. Langer and Langer [19] established SCTG as a gold standard, demonstrating 90–100% success. Subsequent innovations, such as Harris' [20] parallel blade technique and Bouchard et al.'s SCTG for class I/II recessions, maintained high coverage rates (92%).
Minimally invasive approaches, like Hürzeler and Weng's [21] single incision and Zucchelli et al.'s [22] extraoral de-epithelialization, further optimized healing, achieving 88–90% coverage. Harris et al. [20] and Cairo et al. [23] reinforced CTG's effectiveness, reporting up to 94% root coverage. More recent studies, including Tadepalli et al. [24], compared tunnel and coronally advanced flap (CAF) techniques with CTG, reporting variable success rates (55–93%). Overall, CTG remains the most effective approach for root coverage, with consistent success in achieving optimal clinical outcomes (Table 3).
Author | Year | Technique | Material | Root Coverage (%) |
Edel [16] | 1974 | Trapdoor technique | Complete wound closure | ~85% |
Broome and Taggart [17] | 1976 | Trapdoor using Brasher-Rees knife | Wider base, faster healing | ~88% |
Langer and Calagna [18] | 1980 | Internal bevel flap and parallel incision | Smoother junction, less shrinkage | ~90% |
Langer and Langer [19] | 1985 | SCTG for root coverage | Sub-epithelial CTG | 90–100% |
Harris [25] | 1992 | Parallel blade and ingraft knife technique | Uniformly thick CTG | ~92% |
Bouchard et al. [26] | 1994 | SCTG for class I and II recession | Sub-epithelial CTG | 92% |
Hürzeler and Weng [21] | 1999 | Single-incision | No vertical incisions | ~88% |
Lorenzana and Allen [27] | 2000 | Single-incision | Larger graft harvest | ~90% |
Del Pizzo et al. [28] | 2002 | Single-incision with periosteum preservation | Enhances healing | ~89% |
Zucchelli et al. [22] | 2003 | Extraoral de-epithelialization | Useful for thin palates | ~90% |
Bosco and Bosco [29] | 2007 | CTG from the thin palate | Minimizes vascular injury | ~92% |
Cairo et al. [23] | 2008 | CTG for Miller class I/II | CTG | >90% |
McLeod et al. [30] | 2009 | Partial palatal de-epithelialization | Uniform, thin CTG | ~91% |
De Carvalho et al. [31] | 2023 | CTG with tunnel technique in gingival recession | CTG | 55% |
Tadepalli et al. [24] | 2024 | CAF + CTG in maxillary gingival recession | CTG | 93% |
Root coverage outcomes using PRF and related biomaterials in combination with CAF or other techniques. Early studies, such as Huang et al. [32] using PRP with CAF, showed moderate success (78.5%). Aroca et al. [33] and Jankovic et al. [34] introduced PRF membranes with CAF, achieving improved root coverage (85–87%).
Subsequent research, including Eren and Atilla [35], Agarwal et al. [36], and Oncu [37], reinforced PRF's efficacy, with coverage rates consistently around 85–89%. Alternative fibrin-based approaches, such as concentrated growth factors (CGF) used by Bozkurt Dogan et al. [38] and Xue et al. [39], reported higher success (~90–92.5%). Studies like Subbareddy et al. [40] applied PRF with the VISTA technique, achieving 91.3% coverage. Recent research by Tazegul et al. [41] demonstrated stable results (87–88%), supporting PRF's role in periodontal regeneration. Overall, PRF and CGF enhance root coverage outcomes, providing a viable alternative to traditional grafting techniques (Table 4).
Author | Year | Technique | Material | Root Coverage (%) |
Aroca et al. [33] | 2009 | CAF + PRF | PRF membrane | 85.2% |
Huang et al. [32] | 2005 | CAF + PRP | Liquid PRP | 78.5% |
Jankovic et al. [34] | 2010 | CAF + PRF | PRF membrane | 87.1% |
Kumar et al. [42] | 2013 | CAF + PCG | Collagen sponge soaked with PCG | 74.3% |
Eren and Atilla. [35] | 2014 | CAF + PRF | PRF membrane | 88.9% |
Agarwal et al. [36] | 2016 | CAF + PRF | PRF membrane | 86.5% |
Bozkurt Dogan et al. [38] | 2015 | CAF + CGF | CGF membrane | 90.3% |
Gupta et al. [43] | 2015 | CAF + PRF | PRF membrane | 83.7% |
Oncu et al. [37] | 2017 | CAF + PRF | PRF membrane | 89.2% |
Jain et al. [44] | 2017 | CAF + PRF | PRF membrane | 84.6% |
Rehan et al. [45] | 2018 | CAF + PRF | PRF membrane | 85.9% |
Dholakia et al. [46] | 2019 | CAF + PRF | PRF membrane | 87.4% |
Subbareddy et al. [40] | 2020 | VISTA + PRF | PRF membrane | 91.3% |
Tazegul et al. [41] | 2022 | CAF + PRF | PRF membrane | 88.1% |
Xue et al. [39] | 2022 | TUN + CGF | CGF membrane | 92.5% |
Root coverage outcomes in CAF and tunnel techniques using either CTG or PRF. Collins et al. [47] and Eren and Atilla [35] demonstrated high root coverage with both CTG (~96–94%) and PRF (~93–92%). Hedge et al. [48] and Jankovic et al. [34] showed similar trends, with slightly lower percentages for PRF compared to CTG.
Joshi et al [49] reported a significant difference, with CTG achieving 93.33% root coverage compared to only 70.64% with PRF. Kumar et al. [42], however, observed better outcomes with PRF (74.4%) over CTG (58.9%), indicating potential variability in treatment response. Studies by Oncu [37], Tunali et al. [50], and Uraz et al. [50] consistently favored CTG over PRF, though differences remained moderate (96% vs. 75%).
Interestingly, Uzun et al. [4] found nearly identical results for CTG (93.22%) and PRF (93.29%) with the tunnel technique, suggesting PRF may be equally effective in certain surgical approaches. Overall, while CTG generally achieves higher root coverage, PRF remains a promising alternative, particularly in cases where autogenous grafting is less favorable (Table 5).
Author | Year | Technique | Material | Root Coverage (%) |
Collins et al. [47] | 2021 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 96.97 / 93.33 |
Eren and Atilla [35] | 2014 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 94.2 / 92.7 |
Hedge et al. [48] | 2021 | VISTA + CTG vs. VISTA + PRF | CTG, PRF membrane | 86.43 / 83.25 |
Jankovic et al. [34] | 2012 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 91.96 / 88.68 |
Joshi et al. [49] | 2020 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 93.33 / 70.64 |
Kumar et al. [42] | 2017 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 58.9 / 74.4 |
Oncu [37] | 2017 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 84 / 77.12 |
Tunali et al. [50] | 2015 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 77.36 / 76.63 |
Uraz et al. [50] | 2015 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 96.46 / 75.26 |
Uzun et al. [4] | 2018 | TUN + CTG vs. TUN + PRF | CTG, PRF membrane | 93.22 / 93.29 |
CTG and PRF have potential applications beyond periodontology due to their regenerative properties. In oral and maxillofacial surgery, CTG is used for alveolar ridge augmentation and soft tissue reconstruction, while PRF enhances wound healing in sinus lifts, bone grafting, and cystic defect repairs. In implantology, CTG improves peri-implant soft tissue thickness, and PRF accelerates osseointegration and bone regeneration [51]. Dermatology and plastic surgery benefit from CTG for soft tissue augmentation and scar revision, whereas PRF is used in esthetic medicine for skin rejuvenation, chronic wound healing, and hair restoration [52]. PRF is also utilized in orthopedics and sports medicine for tendon, ligament, and joint injury healing, as well as in ophthalmology for corneal wound healing and ocular surface reconstruction [53]. These diverse applications highlight the broad regenerative potential of CTG and PRF across medical and dental fields.
CTG and PRF are effective in periodontal surgery, but their roles and outcomes differ. CTG is the gold standard for treating gingival recession, offering 90–97% root coverage, excellent tissue stability, and superior esthetics, making it ideal for severe or complex cases. However, it requires a secondary surgical site, leading to higher morbidity and longer recovery times.
PRF, a minimally invasive autologous biomaterial, accelerates healing and regeneration through its growth factors, achieving 70–80% root coverage. While less predictable than CTG, PRF is effective in enhancing angiogenesis and soft tissue healing, especially for mild-to-moderate cases or when combined with CTG.
On the other hand, PRF is easy to prepare, cost-effective, and associated with faster initial healing. It is more suitable for patients with mild to moderate recession or those who prefer less invasive treatment. While CTG achieves superior volume and thickness, PRF enhances soft tissue texture and vascularity but may not match CTG in volume augmentation. In some cases, combining CTG and PRF can yield synergistic benefits, leveraging the strengths of both approaches to optimize outcomes. Ultimately, the choice between CTG and PRF depends on patient preferences, defect characteristics, and clinical expertise.
[1] |
Jung UW, Um YJ, Choi SH (2008) Histologic observation of soft tissue acquired from maxillary tuberosity area for root coverage. J periodontol 79: 934-940. https://doi.org/10.1902/jop.2008.070445 ![]() |
[2] | Amin PN, Bissada NF, Ricchetti PA, et al. (2018) Tuberosity versus palatal donor sites for soft tissue grafting: a split-mouth clinical study. Quintessence Int 49: 589. https://doi.org/10.3290/j.qi.a40510 |
[3] | Das AC, Panda S, Kumar M, et al. (2020) Treatment of gingival recession by lateral positioned pedicle graft: a case report. Indian J Forensic Med Toxicol 14: 8160-8163. |
[4] |
Uzun BC, Ercan E, Tunalı M (2018) Effectiveness and predictability of titanium-prepared platelet-rich fibrin for the management of multiple gingival recessions. Clin Oral Invest 22: 1345-1354. https://doi.org/10.1007/s00784-017-2211-2 ![]() |
[5] |
Dohan Ehrenfest DM, Rasmusson L, Albrektsson T (2009) Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 27: 158-167. https://doi.org/10.1016/j.tibtech.2008.11.009 ![]() |
[6] |
Anitua E, Andia I, Ardanza B, et al. (2004) Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 91: 4-15. https://doi.org/10.1160/TH03-07-0440 ![]() |
[7] |
Ghanaati S, Booms P, Orlowska A, et al. (2014) Advanced platelet-rich fibrin: a new concept for cell-based tissue engineering by means of inflammatory cells. J Oral Implantol 40: 679-689. https://doi.org/10.1563/aaid-joi-D-14-00138 ![]() |
[8] |
Dohan Ehrenfest DM, De Peppo GM, Doglioli P, et al. (2009) Slow release of growth factors and thrombospondin-1 in Choukroun's platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 27: 63-69. https://doi.org/10.1080/08977190802636713 ![]() |
[9] |
Miron RJ, Fujioka-Kobayashi M, Hernandez M, et al. (2017) Injectable platelet rich fibrin (i-PRF): opportunities in regenerative dentistry?. Clin Oral Invest 21: 2619-2627. https://doi.org/10.1007/s00784-017-2063-9 ![]() |
[10] |
Jhaveri HM, Chavan MS, Tomar GB, et al. (2010) Acellular dermal matrix seeded with autologous gingival fibroblasts for the treatment of gingival recession: A proof-of-concept study. J periodontol 81: 616-625. https://doi.org/10.1902/jop.2009.090530 ![]() |
[11] | Reiser GM, Bruno JF, Mahan PE, et al. (1996) The subepithelial connective tissue graft palatal donor site: anatomic considerations for surgeons. Int J Periodontics Restorative Dent 16: 130-137. |
[12] |
Farid Shehab M, Hamid NMA, Askar NA, et al. (2018) Immediate mandibular reconstruction via patient-specific titanium mesh tray using electron beam melting/CAD/rapid prototyping techniques: One-year follow-up. Robot Comp Surg 14: e1895. https://doi.org/10.1002/rcs.1895 ![]() |
[13] |
Bhangdiya K, Wankhede A, Madhu PP, et al. (2023) An overview on platelet concentrates in tissue regeneration in periodontology. AIMSBOA 10: 53-61. https://doi.org/10.3934/bioeng.2023005 ![]() |
[14] |
Kyyak S, Blatt S, Pabst A, et al. (2020) Combination of an allogenic and a xenogenic bone substitute material with injectable platelet-rich fibrin – a comparative in vitro study. J Biomater Appl 35: 83-96. https://doi.org/10.1177/0885328220914407 ![]() |
[15] |
Tunalı M, Özdemir H, Küçükodacı Z, et al. (2014) A novel platelet concentrate: titanium-prepared platelet-rich fibrin. BioMed Res Int 2014: 1-7. https://doi.org/10.1155/2014/209548 ![]() |
[16] |
Edel A (1974) Clinical evaluation of free connective tissue grafts used to increase the width of keratinised gingiva. J Clin Periodontol 1: 185-196. https://doi.org/10.1111/j.1600-051X.1974.tb01257.x ![]() |
[17] |
Broome WC, Taggart EJ (1976) Free autogenous connective tissue grafting: report of two cases. J Periodontol 47: 580-585. https://doi.org/10.1902/jop.1976.47.10.580 ![]() |
[18] |
Langer B, Calagna L (1980) The subepithelial connective tissue graft. J Prosthet Dent 44: 363-367. https://doi.org/10.1016/0022-3913(80)90090-6 ![]() |
[19] |
Langer B, Langer L (1985) Subepithelial connective tissue graft technique for root coverage. J Periodontol 56: 715-720. https://doi.org/10.1902/jop.1985.56.12.715 ![]() |
[20] |
Harris RJ, Miller LH, Harris CR, et al. (2005) A comparison of three techniques to obtain root coverage on mandibular incisors. J Periodontol 76: 1758-1767. https://doi.org/10.1902/jop.2005.76.10.1758 ![]() |
[21] | Hürzeler MB, Weng D (1999) A single-incision technique to harvest subepithelial connective tissue grafts from the palate. Int J Periodontics Restorative Dent 19: 278. |
[22] |
Zucchelli G, Mele M, Stefanini M, et al. (2010) Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative randomized-controlled clinical trial. J Clin Periodontol 37: 728-738. https://doi.org/10.1111/j.1600-051X.2010.01550.x ![]() |
[23] |
Cairo F, Nieri M, Pagliaro U (2014) Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. a systematic review. J Clin Periodontology 41: S44-S62. https://doi.org/10.1111/jcpe.12182 ![]() |
[24] |
Tadepalli A, Ramachandran L, Parthasarathy H, et al. (2024) Advanced platelet-rich fibrin versus connective tissue graft in maxillary gingival recession management. Clin Adv Periodontics 2024: cap.10317. https://doi.org/10.1002/cap.10317 ![]() |
[25] |
Harris RJ (1992) The connective tissue and partial thickness double pedicle graft: a predictable method of obtaining root coverage. J Periodontol 63: 477-486. https://doi.org/10.1902/jop.1992.63.5.477 ![]() |
[26] |
Bouchard P, Etienne D, Ouhayoun J, et al. (1994) Subepithelial connective tissue grafts in the treatment of gingival recessions. a comparative study of 2 procedures. J Periodontol 65: 929-936. https://doi.org/10.1902/jop.1994.65.10.929 ![]() |
[27] | Lorenzana ER, Allen EP (2000) The single-incision palatal harvest technique: a strategy for esthetics and patient comfort. Int J Periodontics Restorative Dent 20: 297-305. |
[28] |
Del Pizzo M, Modica F, Bethaz N, et al. (2002) The connective tissue graft: a comparative clinical evaluation of wound healing at the palatal donor site: a preliminary study. J Clin Periodontol 29: 848-854. https://doi.org/10.1034/j.1600-051X.2002.290910.x ![]() |
[29] | Bosco AF, Bosco JMD (2007) An alternative technique to the harvesting of a connective tissue graft from a thin palate: enhanced wound healing. Int J Periodontics Restorative Dent 27: 132. |
[30] |
McLeod DE, Reyes E, Branch-Mays G (2009) Treatment of multiple areas of gingival recession using a simple harvesting technique for autogenous connective tissue graft. J periodontol 80: 1680-1687. https://doi.org/10.1902/jop.2009.090187 ![]() |
[31] |
Teodoro De Carvalho VA, Mattedi MAM, Vergara-Buenaventura A, et al. (2023) Influence of graft thickness on tunnel technique procedures for root coverage: a pilot split-mouth randomized controlled trial. Clin Oral Invest 27: 3469-3477. https://doi.org/10.1007/s00784-023-04955-x ![]() |
[32] |
Huang LH, Neiva REF, Soehren SE, et al. (2005) The effect of platelet-rich plasma on the coronally advanced flap root coverage procedure: a pilot human trial. J periodontol 76: 1768-1777. https://doi.org/10.1902/jop.2005.76.10.1768 ![]() |
[33] |
Aroca S, Barbieri A, Clementini M, et al. (2018) Treatment of class III multiple gingival recessions: Prognostic factors for achieving a complete root coverage. J Clin Periodontol 45: 861-868. https://doi.org/10.1111/jcpe.12923 ![]() |
[34] | Jankovic S, Aleksic Z, Milinkovic I, et al. (2010) The coronally advanced flap in combination with platelet-rich fibrin (PRF) and enamel matrix derivative in the treatment of gingival recession: a comparative study. Eur J Esthet Dent 5: 260-273. https://doi.org/10.4103/0972-124X.145790 |
[35] |
Eren G, Atilla G (2014) Platelet-rich fibrin in the treatment of localized gingival recessions: a split-mouth randomized clinical trial. Clin Oral Invest 18: 1941-1948. https://doi.org/10.1007/s00784-013-1170-5 ![]() |
[36] | Agarwal C, Purohit P, Sharma S K, et al. (2014) Modified approach of double papillae laterally positioned flap technique using Alloderm® for root coverage. JCDR 8: ZD25. https://doi.org/10.7860/JCDR/2014/8367.4606 |
[37] |
Periodontology KM, Karatay A (2017) The use of platelet-rich fibrin versus subepithelial connective tissue graft in treatment of multiple gingival recessions: a randomized clinical trial. Int J Periodontics Restorative Dent 37: 265-271. https://doi.org/10.11607/prd.2741 ![]() |
[38] |
Bozkurt Doğan Ş, Öngöz Dede F, Ballı U, et al. (2015) Concentrated growth factor in the treatment of adjacent multiple gingival recessions: a split-mouth randomized clinical trial. J Clin Periodontol 42: 868-875. https://doi.org/10.1111/jcpe.12444 ![]() |
[39] |
Xue F, Zhang R, Zhang Y, et al. (2022) Treatment of multiple gingival recessions with concentrated growth factor membrane and coronally advanced tunnel technique via digital measurements: a randomized controlled clinical trial. J Dent Sci 17: 725-732. https://doi.org/10.1016/j.jds.2021.10.012 ![]() |
[40] | Tazegül K, Doğan ŞB, Ballı U, et al. (2022) Growth factor membranes in treatment of multiple gingival recessions: a randomized clinical trial. Quintessence Int 53: 288-297. https://doi.org/10.3290/j.qi.b2407765 |
[41] |
Kumar A, Bains V, Jhingran R, et al. (2017) Patient-centered microsurgical management of gingival recession using coronally advanced flap with either platelet-rich fibrin or connective tissue graft: a comparative analysis. Contemp Clin Dent 8: 293. https://doi.org/10.4103/ccd.ccd_70_17 ![]() |
[42] |
Gupta S, Banthia R, Singh P, et al. (2015) Clinical evaluation and comparison of the efficacy of coronally advanced flap alone and in combination with platelet rich fibrin membrane in the treatment of Miller Class I and II gingival recessions. Contemp Clin Dent 6: 153. https://doi.org/10.4103/0976-237X.156034 ![]() |
[43] | Jain A, Jaiswal GR, Kumathalli K, et al. (2017) Comparative evaluation of platelet rich fibrin and dehydrated amniotic membrane for the treatment of gingival recession- a clinical study. J Clin Diagn Res 11: ZC24-ZC28. https://doi.org/10.7860/JCDR/2017/29599.10362 |
[44] |
Rehan M, Khatri M, Bansal M, et al. (2018) Comparative evaluation of coronally advanced flap using amniotic membrane and platelet-rich fibrin membrane in gingival recession: An 18-month clinical study. Contemp Clin Dent 9: 188-194. https://doi.org/10.4103/ccd.ccd_799_17 ![]() |
[45] |
Del Pizzo M, Zucchelli G, Modica F, et al. (2005) Coronally advanced flap with or without enamel matrix derivative for root coverage: a 2-year study. J Clin Periodontol 32: 1181-1187. https://doi.org/10.1111/j.1600-051X.2005.00831.x ![]() |
[46] |
Subbareddy BV, Gautami PS, Dwarakanath CD, et al. (2020) Vestibular incision subperiosteal tunnel access technique with platelet-rich fibrin compared to subepithelial connective tissue graft for the treatment of multiple gingival recessions: a randomized controlled clinical trial. Contemp Clin Dent 11: 249-255. https://doi.org/10.4103/ccd.ccd_405_19 ![]() |
[47] |
Collins JR, Cruz A, Concepción E, et al. (2021) Connective tissue graft vs platelet-rich fibrin in the treatment of gingival recessions: a randomized split-mouth case series. J Contemp Dent Pract 22: 327-334. https://doi.org/10.5005/jp-journals-10024-3104 ![]() |
[48] |
Hegde S, Madhurkar JG, Kashyap R, et al. (2021) Comparative evaluation of vestibular incision subperiosteal tunnel access with platelet-rich fibrin and connective tissue graft in the management of multiple gingival recession defects: a randomized clinical study. J Indian Soc Periodontol 25: 228-236. https://doi.org/10.4103/jisp.jisp_291_20 ![]() |
[49] |
Joshi A, Suragimath G, Varma S, et al. (2020) Is platelet rich fibrin a viable alternative to subepithelial connective tissue graft for gingival root coverage?. Indian J Dent Res 31: 67-72. https://doi.org/10.4103/ijdr.IJDR_434_18 ![]() |
[50] |
Tunalı M, Özdemir H, Arabacı T, et al. (2015) Clinical evaluation of autologous platelet-rich fibrin (L-PRF) in the treatment of multiple adjacent gingival recession defects: A 12-month study. Int J Periodontics Restorative Dent 35: 105-114. https://doi.org/10.11607/prd.1826 ![]() |
[51] |
Zuiderveld EG, Van Nimwegen WG, Meijer HJA, et al. (2021) Effect of connective tissue grafting on buccal bone changes based on cone beam computed tomography scans in the esthetic zone of single immediate implants: a 1-year randomized controlled trial. J Periodontol 92: 553-561. https://doi.org/10.1002/JPER.20-0217 ![]() |
[52] | Mohale SA, Thakare PV, Gaurkar SS, et al. (2024) Effectiveness of injectable platelet-rich fibrin therapy in alopecia and facial rejuvenation: a systematic review. Cureus 16: e62198. https://doi.org/10.7759/cureus.62198 |
[53] |
Alves R, Grimalt R (2018) A review of platelet-rich plasma: history, biology, mechanism of action, and classification. Skin Appendage Disord 4: 18-24. https://doi.org/10.1159/000477353 ![]() |
Sr. no. | Type of PRF | Centrifugation speed | Time | Tube type | Form | Features |
1. | Conventional PRF (L-PRF) | 2700–3000 rpm | 12 minutes | Glass (no anticoagulant) | Solid clot | Quick processing required to avoid early clotting |
2. | A-PRF | 1500 rpm | 14 minutes | Glass (modified protocol) | Solid clot | Lower speed and longer time optimize cell content |
3. | i-PRF | 700–800 rpm | 3–4 minutes | Plastic (no anticoagulant) | Liquid form | Very short spin time yields nonclotting liquid form |
4. | T-PRF | 2700 rpm | 12 minutes | Titanium tubes | Solid clot | Titanium enhances biocompatibility and mechanical strength |
Aspect | CTG | PRF |
Root coverage success | 90–97% (Consistently high) | 70–80% (Moderate, less predictable) |
Patient morbidity | Higher due to the second surgical site | Lower as no donor site is needed |
Long-term stability | High tissue stability | Moderate; lacks structural support |
Esthetic outcomes | Superior tissue thickness and color match | Improved vascularity but less tissue volume |
Author | Year | Technique | Material | Root Coverage (%) |
Edel [16] | 1974 | Trapdoor technique | Complete wound closure | ~85% |
Broome and Taggart [17] | 1976 | Trapdoor using Brasher-Rees knife | Wider base, faster healing | ~88% |
Langer and Calagna [18] | 1980 | Internal bevel flap and parallel incision | Smoother junction, less shrinkage | ~90% |
Langer and Langer [19] | 1985 | SCTG for root coverage | Sub-epithelial CTG | 90–100% |
Harris [25] | 1992 | Parallel blade and ingraft knife technique | Uniformly thick CTG | ~92% |
Bouchard et al. [26] | 1994 | SCTG for class I and II recession | Sub-epithelial CTG | 92% |
Hürzeler and Weng [21] | 1999 | Single-incision | No vertical incisions | ~88% |
Lorenzana and Allen [27] | 2000 | Single-incision | Larger graft harvest | ~90% |
Del Pizzo et al. [28] | 2002 | Single-incision with periosteum preservation | Enhances healing | ~89% |
Zucchelli et al. [22] | 2003 | Extraoral de-epithelialization | Useful for thin palates | ~90% |
Bosco and Bosco [29] | 2007 | CTG from the thin palate | Minimizes vascular injury | ~92% |
Cairo et al. [23] | 2008 | CTG for Miller class I/II | CTG | >90% |
McLeod et al. [30] | 2009 | Partial palatal de-epithelialization | Uniform, thin CTG | ~91% |
De Carvalho et al. [31] | 2023 | CTG with tunnel technique in gingival recession | CTG | 55% |
Tadepalli et al. [24] | 2024 | CAF + CTG in maxillary gingival recession | CTG | 93% |
Author | Year | Technique | Material | Root Coverage (%) |
Aroca et al. [33] | 2009 | CAF + PRF | PRF membrane | 85.2% |
Huang et al. [32] | 2005 | CAF + PRP | Liquid PRP | 78.5% |
Jankovic et al. [34] | 2010 | CAF + PRF | PRF membrane | 87.1% |
Kumar et al. [42] | 2013 | CAF + PCG | Collagen sponge soaked with PCG | 74.3% |
Eren and Atilla. [35] | 2014 | CAF + PRF | PRF membrane | 88.9% |
Agarwal et al. [36] | 2016 | CAF + PRF | PRF membrane | 86.5% |
Bozkurt Dogan et al. [38] | 2015 | CAF + CGF | CGF membrane | 90.3% |
Gupta et al. [43] | 2015 | CAF + PRF | PRF membrane | 83.7% |
Oncu et al. [37] | 2017 | CAF + PRF | PRF membrane | 89.2% |
Jain et al. [44] | 2017 | CAF + PRF | PRF membrane | 84.6% |
Rehan et al. [45] | 2018 | CAF + PRF | PRF membrane | 85.9% |
Dholakia et al. [46] | 2019 | CAF + PRF | PRF membrane | 87.4% |
Subbareddy et al. [40] | 2020 | VISTA + PRF | PRF membrane | 91.3% |
Tazegul et al. [41] | 2022 | CAF + PRF | PRF membrane | 88.1% |
Xue et al. [39] | 2022 | TUN + CGF | CGF membrane | 92.5% |
Author | Year | Technique | Material | Root Coverage (%) |
Collins et al. [47] | 2021 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 96.97 / 93.33 |
Eren and Atilla [35] | 2014 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 94.2 / 92.7 |
Hedge et al. [48] | 2021 | VISTA + CTG vs. VISTA + PRF | CTG, PRF membrane | 86.43 / 83.25 |
Jankovic et al. [34] | 2012 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 91.96 / 88.68 |
Joshi et al. [49] | 2020 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 93.33 / 70.64 |
Kumar et al. [42] | 2017 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 58.9 / 74.4 |
Oncu [37] | 2017 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 84 / 77.12 |
Tunali et al. [50] | 2015 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 77.36 / 76.63 |
Uraz et al. [50] | 2015 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 96.46 / 75.26 |
Uzun et al. [4] | 2018 | TUN + CTG vs. TUN + PRF | CTG, PRF membrane | 93.22 / 93.29 |
Sr. no. | Type of PRF | Centrifugation speed | Time | Tube type | Form | Features |
1. | Conventional PRF (L-PRF) | 2700–3000 rpm | 12 minutes | Glass (no anticoagulant) | Solid clot | Quick processing required to avoid early clotting |
2. | A-PRF | 1500 rpm | 14 minutes | Glass (modified protocol) | Solid clot | Lower speed and longer time optimize cell content |
3. | i-PRF | 700–800 rpm | 3–4 minutes | Plastic (no anticoagulant) | Liquid form | Very short spin time yields nonclotting liquid form |
4. | T-PRF | 2700 rpm | 12 minutes | Titanium tubes | Solid clot | Titanium enhances biocompatibility and mechanical strength |
Aspect | CTG | PRF |
Root coverage success | 90–97% (Consistently high) | 70–80% (Moderate, less predictable) |
Patient morbidity | Higher due to the second surgical site | Lower as no donor site is needed |
Long-term stability | High tissue stability | Moderate; lacks structural support |
Esthetic outcomes | Superior tissue thickness and color match | Improved vascularity but less tissue volume |
Author | Year | Technique | Material | Root Coverage (%) |
Edel [16] | 1974 | Trapdoor technique | Complete wound closure | ~85% |
Broome and Taggart [17] | 1976 | Trapdoor using Brasher-Rees knife | Wider base, faster healing | ~88% |
Langer and Calagna [18] | 1980 | Internal bevel flap and parallel incision | Smoother junction, less shrinkage | ~90% |
Langer and Langer [19] | 1985 | SCTG for root coverage | Sub-epithelial CTG | 90–100% |
Harris [25] | 1992 | Parallel blade and ingraft knife technique | Uniformly thick CTG | ~92% |
Bouchard et al. [26] | 1994 | SCTG for class I and II recession | Sub-epithelial CTG | 92% |
Hürzeler and Weng [21] | 1999 | Single-incision | No vertical incisions | ~88% |
Lorenzana and Allen [27] | 2000 | Single-incision | Larger graft harvest | ~90% |
Del Pizzo et al. [28] | 2002 | Single-incision with periosteum preservation | Enhances healing | ~89% |
Zucchelli et al. [22] | 2003 | Extraoral de-epithelialization | Useful for thin palates | ~90% |
Bosco and Bosco [29] | 2007 | CTG from the thin palate | Minimizes vascular injury | ~92% |
Cairo et al. [23] | 2008 | CTG for Miller class I/II | CTG | >90% |
McLeod et al. [30] | 2009 | Partial palatal de-epithelialization | Uniform, thin CTG | ~91% |
De Carvalho et al. [31] | 2023 | CTG with tunnel technique in gingival recession | CTG | 55% |
Tadepalli et al. [24] | 2024 | CAF + CTG in maxillary gingival recession | CTG | 93% |
Author | Year | Technique | Material | Root Coverage (%) |
Aroca et al. [33] | 2009 | CAF + PRF | PRF membrane | 85.2% |
Huang et al. [32] | 2005 | CAF + PRP | Liquid PRP | 78.5% |
Jankovic et al. [34] | 2010 | CAF + PRF | PRF membrane | 87.1% |
Kumar et al. [42] | 2013 | CAF + PCG | Collagen sponge soaked with PCG | 74.3% |
Eren and Atilla. [35] | 2014 | CAF + PRF | PRF membrane | 88.9% |
Agarwal et al. [36] | 2016 | CAF + PRF | PRF membrane | 86.5% |
Bozkurt Dogan et al. [38] | 2015 | CAF + CGF | CGF membrane | 90.3% |
Gupta et al. [43] | 2015 | CAF + PRF | PRF membrane | 83.7% |
Oncu et al. [37] | 2017 | CAF + PRF | PRF membrane | 89.2% |
Jain et al. [44] | 2017 | CAF + PRF | PRF membrane | 84.6% |
Rehan et al. [45] | 2018 | CAF + PRF | PRF membrane | 85.9% |
Dholakia et al. [46] | 2019 | CAF + PRF | PRF membrane | 87.4% |
Subbareddy et al. [40] | 2020 | VISTA + PRF | PRF membrane | 91.3% |
Tazegul et al. [41] | 2022 | CAF + PRF | PRF membrane | 88.1% |
Xue et al. [39] | 2022 | TUN + CGF | CGF membrane | 92.5% |
Author | Year | Technique | Material | Root Coverage (%) |
Collins et al. [47] | 2021 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 96.97 / 93.33 |
Eren and Atilla [35] | 2014 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 94.2 / 92.7 |
Hedge et al. [48] | 2021 | VISTA + CTG vs. VISTA + PRF | CTG, PRF membrane | 86.43 / 83.25 |
Jankovic et al. [34] | 2012 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 91.96 / 88.68 |
Joshi et al. [49] | 2020 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 93.33 / 70.64 |
Kumar et al. [42] | 2017 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 58.9 / 74.4 |
Oncu [37] | 2017 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 84 / 77.12 |
Tunali et al. [50] | 2015 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 77.36 / 76.63 |
Uraz et al. [50] | 2015 | CAF + CTG vs. CAF + PRF | CTG, PRF membrane | 96.46 / 75.26 |
Uzun et al. [4] | 2018 | TUN + CTG vs. TUN + PRF | CTG, PRF membrane | 93.22 / 93.29 |