Evaluation of Free Buccal Fat Pad Graft with and without Advanced Platelet-Rich Fibrin in the Treatment of Localized Gingival Recession(A Randomized Controlled Clinical Trial)

Recently, new treatment modalities have been proposed to be replaced in cases of ordinary gingival grafting procedures such as the buccal fat pad (BFP) reported as a pedicelled graft for the treatment of severe gingiva recessions in maxillary molars. As periodontal wound healing is a complex biological process consisting of multiple concurrent cellular events leading to repair or regeneration. With the knowledge of the biological features of the platelet concentrates, the initial protocols evolved from the platelet concentrates of the first generation that include platelet-rich plasma (PRP) and plasma rich in growth factors (PGRF) to the second-generation concentrates. So, we hypothesize that the combination of the free buccal fat graft with advanced platelet-rich fibrin will provide a promising solution as compared to the gold standard connective tissue graft in localized gingival recession treatment in terms of both patient and soft tissue-related outcomes. Objectives; To evaluate the effectiveness of free buccal pad fat graft combined with advanced platelet-rich fibrin in comparison with the following :(1) Free buccal pad graft alone. (2) Advanced platelet-rich fibrin. (3) Connective tissue graft.As all the previously mentioned treatment modalities will use coronally advanced flap in localized gingival recession treatment with the primary outcome of this study will be the percentage of root coverage, whereas the secondary outcomes include recession depth, probing depth, clinical attachment level, width of keratinized gingiva, gingival thickness, visual analogue scale to record post-operative pain, hypersensitivity, and patient satisfaction.