DOI: 10.4103/jisp.jisp_191_25 ISSN: 0972-124X

Comparative evaluation of subepithelial connective tissue graft versus platelet-rich fibrin for interdental papilla reconstruction using microtunneling technique: A randomized controlled clinical study

Jaya Naikode, Neeraj Chandrahas Deshpande, Monali Shah, Tusharika Sharma
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Abstract:

Background:

Loss of the interdental papilla in the maxillary anterior region may cause open gingival embrasures (“black triangles”), resulting in esthetic, phonetic, and functional concerns. Microsurgical tunneling preserves tissue continuity and facilitates access to the papillary region. Although subepithelial connective tissue grafts (CTGs) are an established augmentation material, platelet-rich fibrin (PRF) may offer a less invasive autologous alternative.

Aim:

The aim of this study was to clinically compare CTG and PRF, delivered using an identical microsurgical tunneling technique, for the reconstruction of interdental papillary defects.

Materials and Methods:

This randomized controlled clinical study included 26 papillary defect sites with Class I–III interdental papillary loss in systemically healthy individuals. Sites were randomly allocated to the CTG ( n = 13) or PRF ( n = 13) groups. Vertical defect height, horizontal defect width, and papillary area were assessed at baseline and 3 months. Within- and between-group changes were analyzed using paired and independent t -tests, respectively, and P < 0.05 was considered statistically significant.

Results:

Both the groups showed significant improvement at 3 months ( P < 0.001). CTG reduced vertical defect height from 3.38 ± 1.04 to 1.23 ± 1.09 mm and horizontal width from 2.23 ± 0.83 to 0.69 ± 0.75 mm; papillary area increased from 5.27 ± 0.78 to 6.46 ± 0.78 mm 2 . PRF reduced vertical height from 3.15 ± 0.99 to 1.23 ± 1.01 mm and horizontal width from 2.46 ± 0.78 to 1.08 ± 0.86 mm; area increased from 5.30 ± 0.81 to 6.42 ± 0.76 mm 2 . No significant between-group differences were observed.

Conclusion:

Both CTG and PRF produced significant short-term clinical improvement. PRF may offer a less invasive alternative by avoiding a palatal donor site. Larger, long-term studies are needed to establish treatment stability.

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