Leukocyte- and Platelet-Rich Fibrin Versus Connective Tissue Graft for a Coronally Advanced Flap in the Treatment of Miller Class I and II Localized Gingival Recessions: A Randomized Controlled Clinical Trial.

The aim of the present study was to compare leukocyte- and platelet-rich fibrin (L-PRF) membranes with a connective tissue graft (CTG) in combination with a coronally advanced flap (CAF) in the treatment of Miller Class I or II localized gingival recessions. A randomized controlled clinical trial with 17 recessions in each group was initiated; the control group received treatment with CAF+CTG, and the test group received CAF+L-PRF. The following variables were measured before treatment and after 1, 3, and 6 months: gingival recession depth (RD), gingival recession width (RW), gingival thickness (GT), probing depth (PD), clinical attachment level (CAL), and keratinized tissue height (KTH). Also, the root coverage percentage (RC), the pain score, postoperative complications, and the root coverage esthetic score (RES) were recorded after surgery. Both treatments presented significant improvements in the RD, RW, and CAL at 1, 3, and 6 months. CTG achieved a significantly higher RC at 1, 3, and 6 months and a significantly higher RES score at 6 months. L-PRF presented a significantly lower pain score and less postoperative complications. Both strategies were effective for the treatment of localized gingival recessions. The CTG obtained higher RC and esthetic results, and L-PRF had less pain and postsurgical complications.

Molecular signatures of extracellular vesicles in oral fluids of periodontitis patients.

OBJECTIVE: To characterize extracellular vesicles (EVs) in gingival crevicular fluid (GCF) and saliva samples from healthy/gingivitis and periodontitis patients and correlate them with clinical inflammatory periodontal parameters. MATERIAL AND METHOD: An exploratory study, including 86 subjects, was conducted. Clinical and periodontal data were recorded, and oral fluid samples were obtained. EVs were precipitated by ExoQuick-TC™ and characterized by nanoparticle tracking (NanoSight™), Western blot (WB), transmission electron microscopy (TEM), and ELISA analysis. RESULTS: TEM showed nanoparticles morphologically compatible with EVs, and WB analysis revealed bands of specific EV markers (CD9, TSG101, and Alix) in both oral fluids of periodontitis and healthy/gingivitis subjects. The total concentration of EVs in GCF was increased in periodontitis patients compared to healthy/gingivitis subjects (p = .017). However, we did not observe differences in the EV concentration of saliva samples (p = .190). The size of GCF-EVs was 144.2 nm in periodontitis and 160.35 nm in healthy/gingivitis patients (p = .038). The CD63 exosome marker was increased in GCF of periodontitis patients (p = .00001). The total concentration of EVs in GCF was correlated with bleeding on probing (rho = 0.63, p = .002), periodontal probing depth (rho = 0.56, p = .009), and clinical attachment level (rho = 0.48, p = .030). CONCLUSION: Periodontitis patients have an increased concentration of EVs in GCF, and their role in periodontitis should be clarified.