# Efficacy of Injectable Platelet-Rich Fibrin for Interdental Papilla Reconstruction Compared With Connective Tissue Grafts: A Randomized Controlled Clinical Trial

## TL;DR

This study compares injectable platelet-rich fibrin and connective tissue grafts for fixing missing gum tissue between teeth, finding similar effectiveness with less discomfort from the injectable method.

## Contribution

Demonstrates that injectable platelet-rich fibrin is as effective as connective tissue grafts for interdental papilla reconstruction with reduced patient discomfort.

## Key findings

- Both I-PRF and CTG groups showed significant improvement in interdental papilla height and reduction in black triangle height.
- No significant difference was found between the two groups in clinical outcomes.
- I-PRF resulted in lower patient-reported pain scores compared to CTG.

## Abstract

Introduction

The loss of interdental papilla in the anterior region of the mouth results in aesthetic and functional impairment. To overcome the limitations of soft-tissue grafts, autogenous platelet concentrates have been developed and shown promising results for periodontal regeneration. Injectable platelet-rich fibrin (I-PRF) slowly releases growth factors and can enhance neovascularization. The present study compared the clinical efficacy of I-PRF with that of connective tissue grafts (CTGs) in the treatment of interdental papilla deficits.

Materials and methods

Patients with class I or II papilla defect sites (based on the Nordland and Tarnow classification) in the maxillary anterior region were randomly assigned (n = 15) to either the test group, the members of which were treated with I-PRF microneedling (the I-PRF group), or the control group, the members of which were treated with CTGs using the tunneling technique (the CTG group). The full-mouth plaque score, the full-mouth bleeding score, the probing pocket depth, the clinical attachment level, the interdental papilla height (IDPH), and the black triangle height (BTH) were recorded at baseline and at one month and three months after the intervention. The patients provided self-recorded visual analog scale (VAS) scores on the third and seventh postoperative days. Intra- and inter-group comparisons were made using nonparametric tests.

Results

Both groups showed significant increases in IDPH and reductions in BTH from the baseline to three months. The intra-group analysis showed a significant difference in the IDPH and BTH values between the evaluation periods, whereas the inter-group comparison was not significant. The VAS scores for the I-PRF group were less than those for the CTG group.

Conclusions

I-PRF microneedling was comparable to CTGs using the tunneling technique in improving papillary dimensions in patients with interdental papilla deficiency. Microneedle administration of noninvasive I-PRF offers the advantages of patient comfort and less morbidity.