Comparison of the clinical efficacy of concentrated growth factor and advanced platelet-rich fibrin in the treatment of type I multiple gingival recessions: a controlled randomized clinical trial.

OBJECTIVES: The purpose of this randomized controlled clinical trial was to compare and evaluate the clinical effects of concentrated growth factor (CGF) and advanced platelet-rich fibrin (A-PRF) applied together with coronally advanced flap (CAF) technique using a microsurgical approach in the treatment of type I multiple gingival recessions (GR). MATERIALS AND METHODS: Sixteen patients with multiple recession defects (Cairo type I) were included in this randomized and controlled study. Forty-five gingival recession defects were randomly equally divided into three groups (n = 15): CAF + CGF (test site); CAF + A-PRF (test site), and CAF alone (control site). Clinical attachment level (CAL), vertical gingival recession (VGR), horizontal gingival recession (HGR), gingival thickness (GT), width of keratinized gingiva (KGW), percentages of the mean (MRC), and complete root coverage (CRC), patient esthetic score (PES), and hypersensitivity score (HS) were recorded at baseline and 6 months after surgery. Patient comfort score (PCS) was evaluated at the day of surgery. RESULTS: Significant improvements were determined in CAL, VGR, HGR, KGW, and GT at 6 months when compared to baseline levels in intra-group comparisons for all groups, and also GT was increased in CAF + A-PRF and CAF + CGF compared to CAF alone at 6 months in intergroup comparisons (p < 0.05). At 6 months, MRC was detected 85.66 ± 22.68% in the CAF + CGF, 90.88 ± 20.87% in the CAF + A-PRF, and 75.10 ± 32,37% in the CAF alone, and a significant increase was detected in the CAF + A-PRF group compared to CAF alone (p < 0.05). CRC in CAF + CGF was 66.66%, in CAF + A-PRF 80% and in CAF alone was 53.33% (p > 0.05). PES and HS values showed significant improvement from baseline to 6 months for all groups and also in CAF + CGF and CAF + A-PRF compared to CAF alone at 6 months in intergroup comparisons (p < 0.05). CONCLUSIONS: The present study showed that the use of A-PRF and CGF membranes in GR therapy may have an additional benefit in GT increase and also A-PRF may increase the percentages of MRC. The use of A-PRF and CGF membranes may be beneficial in terms of improving patient-related parameters. CLINICAL RELEVANCE: A-PRF and CGF may be superior to CAF alone in terms of patient-related parameters and GT increase in multiple recession defects. TRIAL REGISTRATION NUMBER: 17578e02-00a9-4a41-8c8d-42a637143531.

Role of Inhibitor SMADs in Stage 3 Grade B periodontitis before and after periodontal treatment.

OBJECTIVE: This study aimed to examine the levels of transforming growth factor-beta (TGF-ß) and inhibitory-Smads (I-Smads) in saliva and gingival crevicular fluid (GCF) in patients with Stage 3 Grade B periodontitis before and after non-surgical periodontal treatment. BACKGROUND: Recently, it has been stated that Smads play an active role in all conditions where TGF-ß is involved, including periodontal inflammation. METHODS: Twenty healthy participants (control) and 20 patients with Stage 3, Grade B periodontitis were recruited. GCF and saliva samples and clinical periodontal recordings were investigated at the baseline and 1 month after treatment. TGF-ß and I-Smads (Smads 6 and 7) were determined by ELISA. RESULTS: Salivary Smad6 and Smad7 levels were significantly lower in the periodontitis group than healthy controls (p < .05), while there was no difference in salivary TGF-ß levels between groups at baseline (p > .05). The total amounts and concentrations of GCF TGF-ß, Smad6, and Smad7 were significantly lower in the periodontitis group than healthy controls at baseline (p < .05), and then decreased in concentration levels with treatment (p < .001). Positive correlations were found between total amounts and concentrations of GCF TGF-ß, Smad6, and Smad7 (p < .05). CONCLUSION: Our findings revealed that Smad6 and Smad7 in GCF and saliva decreased in periodontitis and then increased after periodontal treatment. Our study suggests that I-Smads act in parallel with TGF-ß in periodontal inflammation and may have a role in the development of periodontitis.

Increased levels of interleukin-32 isoforms alpha, beta, gamma, and delta in the gingival crevicular fluid and plasma of the patients with periodontitis.

BACKGROUND AND OBJECTIVE: Interleukin (IL)-32, which has been recently reported to be associated with periodontitis, has been suggested to have pleiotropic effect due to its 9 different isoforms. The aim of this study was to investigate the levels of IL-32α, IL-32ß, IL-32γ, IL-32δ isoforms in gingival crevicular fluid (GCF) and plasma before and after non-surgical periodontal treatment in patients with periodontitis (P). MATERIALS AND METHODS: Twenty-seven P and 27 periodontally healthy controls (C) were recruited in this study. Non-surgical periodontal treatment was performed to periodontitis patients. GCF and plasma sampling and clinical periodontal parameters were evaluated before and 1 month after treatment. Enzyme-linked immunosorbent assay was used to analyze the levels of IL-32α, IL-32ß, IL-32γ, IL-32δ isoforms in GCF and plasma samples. RESULTS: The levels of IL-32α, IL-32ß, IL-32γ, and IL-32δ in plasma and GCF were significantly higher in patients with periodontitis than healthy controls (P < .001). In P group, plasma and GCF IL-32α, IL-32ß, IL-32γ, and IL-32δ levels after non-surgical periodontal treatment were lower when compared to baseline (P < .001). Moreover, there was a positive correlation between GCF and plasma IL-32α, IL-32ß, IL-32γ, and IL-32δ levels in all groups at baseline and after treatment (P < .05). CONCLUSION: The study supported that there was a relationship between elevated levels of IL-32 isoforms and periodontitis. Also, our novel findings suggest that the pro-inflammatory role of IL-32 in the periodontitis may be originated from IL-32α, IL-32ß, IL-32γ, and IL-32δ isoforms.