الفهرس 
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Abstract
Gingival recession is one of the most common esthetic problems facing patients. Gingival recession had several classifications throughout dental literature; the most commonly used classification is Miller’s classification which was introduced in 1985. Several modifications were proposed to it as its major drawbacks were the inability to specify and identify the mucogingival junction, keratinized tissue amount and inability to determine the amount of interdental bone loss.
There are a lot of techniques for treatment of gingival recession that include different surgical flaps with or without grafting. The most commonly used treatment for gingival recession is the coronally repositioned flap with or without soft tissue grafting.
The most commonly used graft for recession treatment is the sub epithelial connective tissue graft which is the gold standard as it is able to achieve complete root coverage and increase in the gingival tissue thickness. Recently other grafting options were introduced: Alloderm, guided tissue membranes with and without bone grafting beneath them and Platelet Rich Fibrin (PRF) and its derivatives.
Platelet Rich Fibrin is one of the platelet concentrates that was introduced by Choukron in 2001, it provide the tissues with growth factors and stimulate angiogenesis and wound healing. There are different preparations of PRF which are: leucocyte platelet rich fibrin (L-PRF), advanced platelet Rich Fibrin (a-PRF) and injectable platelet Rich Fibrin (i-PRF), these preparations are rich in growth factors. i-PRF is an injectable form of PRF that contains huge amount of growth factors. It can be mixed with different bone graft forming steak bone
L-PRF is an autologous grafting membrane that contains numerous amounts of growth factors and lymphocytes that stimulated healing. Studies had compared L-PRF and sub-epithelial connective tissue when used in the treatment of gingival recession and found promising results in percentage of root coverage and increased soft tissue thickness.
In this study thirty patients diagnosed with Miller class I & II gingival recession were randomizely allocated in three groups each group included ten patients. In group I patients were treated with i-PRF mixed with xenograft and coronally repositioned flap, in group II patients were treated with L-PRF membrane with coronally repositioned
flap and in group III patients were treated with sub- epithelial connective tissue graft and coronally repositioned flap. The clinical parameters assessed at baseline, 3, 6 and
9 months were: probing depth, clinical attachment level, gingival recession depth, percentage of root coverage, length of attached gingival tissues and the root esthetic score while the soft tissue thickness and the buccal plate of bone thickness were assessed at baseline and 9 months post-surgical.
The results of the study showed that the sub- epithelial connective tissue graft gave the best results in regard to the different clinical parameters, the L-PRF group gave better results than the i-PRF mixed with xenograft group but inferior to the sub-epithelial connective tissue graft group. The i-PRF group mixed with xenograft gave the least clinical results and it was not able to stimulate labial/buccal plate of bone formation