Evaluation of Apically Positioned flap with A_PRF Vs. Free Gingival Grafts to Enhance the Keratinized Tissue Around Dental Implants: A Randomized Controlled Clinical Split Mouth Trial

Aim: The essential goal of mucogingival plastic surgery is to obtain an adequate keratinized tissue and an optimal gingival phenotype, The aim of this study was to evaluate the efficacy of Advanced platelet-rich fibrin (A-PRF) with Apically Positioned flap (APF) compared to Free Gingival Grafts (FGG) with APF during dental implants second surgical. Material and Methods: In this study, 30 Periodontal Plastic-Surgery were performed for 15 patients in the posterior area of the upper/lower jaws in a split mouth, Where one of the sides was treated (randomly) by APF with A-PRF //Test group// and the other sides treated with FGG //Control group//. - Clinical parameters were taken and included: Width of keratinized tissue (WKT), Gingival thickness (G.T), healing index (HI), pain index (PI) in different periods of time. Results: At 2 months of healing (T2), the mean (SD) width of the keratinized tissue was 8.54 ± 0.75 and 8.63 ± 1.18 mm for the test group and control group respectively (P > 0.05). at 6 months of healing (T6), the mean (SD) thickness of the keratinized tissue (Phenotype) was 2.87 + 0.51 and 2.86 ± 0.53 mm for the test group and control group respectively (P > 0.05).and results showed a noticeable improvement in the pain amount values and the degree of healing in the test group (P < 0.05). Conclusions: Within the limits of this study, the A-PRF group provided better healing and less pain than the control group and was effective treatment option and could serve as an alternative to FGGs. Clinical significance: Patient-related outcomes are of utmost importance in clinical practice. The use of (A-PRF&APF) provides an inexpensive and reliable alternative to improve postoperative pain and healing in mucogingival plastic surgery