Effect of i-PRF and LLLT on Free Gingival Graft Shrinkage

NCT ID: NCT07303192

Last Updated: 2025-12-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-01

Study Completion Date

2025-08-30

Brief Summary

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This randomized clinical trial aims to evaluate whether injectable platelet-rich fibrin (i-PRF) and low-level laser therapy (LLLT) can reduce graft shrinkage after free gingival graft procedures. Free gingival grafts are commonly used to increase the width of keratinized tissue around teeth, but the graft often shrinks during healing. In this study, patients will receive standard free gingival graft surgery with or without additional i-PRF or laser therapy. The goal is to determine whether these treatments improve healing and help maintain the size of the graft.

Detailed Description

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This randomized controlled clinical trial investigates the effects of injectable platelet-rich fibrin (i-PRF) and low-level laser therapy (LLLT) on the shrinkage of free gingival grafts (FGG) used to treat gingival recession. Free gingival grafting is commonly performed to increase the width of keratinized tissue around teeth, but shrinkage during healing can reduce clinical outcomes.

The study included 48 systemically healthy adult patients with Cairo Class I gingival recession in mandibular anterior teeth. Participants were randomly assigned to one of three groups: control (FGG alone), i-PRF (FGG + platelet-rich fibrin), or LLLT (FGG + low-level laser therapy). Ethical approval was obtained from the Clinical Research Ethics Committee of Inonu University (Protocol No: 2024/84), and all participants provided written informed consent. The study protocol was registered at ClinicalTrials.gov (NCT06744270) and conducted according to CONSORT 2010 guidelines.

All patients received preoperative periodontal treatment, including plaque removal and oral hygiene instructions. Free gingival grafts were harvested from the palatal region and adapted to the recipient site, then stabilized with sutures. In the i-PRF group, autologous platelet-rich fibrin gel was applied to the graft surface. In the LLLT group, laser therapy was applied immediately after surgery and on postoperative days 3, 5, 7, and 14. The control group received no additional treatment beyond standard grafting.

Postoperative care included use of a periodontal dressing, chlorhexidine mouthwash, analgesics as needed, and oral hygiene instructions after suture removal. Clinical evaluations included gingival recession depth, keratinized tissue height, probing depth, clinical attachment level, and graft area measurements at baseline, 1, 3, and 6 months. Edema, erythema, and patient-reported pain were also assessed during follow-up.

The primary outcome of the study was graft shrinkage, calculated as the percentage decrease in graft area over time. Secondary outcomes included clinical parameters and patient-reported postoperative morbidity. All measurements were performed by calibrated, blinded examiners to ensure reliability.

Conditions

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Graft Shrinkage Gingival Recession, Localized

Keywords

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free gingival graft shrinkage low-level laser therapy injectable platelet-rich fibrin

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Control Group

Patients receive free gingival graft only without additional treatment.

Group Type ACTIVE_COMPARATOR

Free Gingival Graft (FGG)

Intervention Type PROCEDURE

Standard free gingival graft procedure performed without additional treatments.

i-PRF group

Patients receive free gingival graft with injectable platelet-rich fibrin applied to the graft surface.

Group Type EXPERIMENTAL

Free Gingival Graft (FGG)

Intervention Type PROCEDURE

Standard free gingival graft procedure performed without additional treatments.

Low-Level Laser Therapy (LLLT)

Intervention Type DEVICE

Low-level laser therapy is applied to the graft site immediately after surgery and on postoperative days 3, 5, 7, and 14 to potentially improve healing and reduce graft shrinkage.

LLLT Group

Patients receive free gingival graft with low-level laser therapy applied immediately after surgery and on postoperative days 3, 5, 7, and 14.

Group Type EXPERIMENTAL

Free Gingival Graft (FGG)

Intervention Type PROCEDURE

Standard free gingival graft procedure performed without additional treatments.

Injectable Platelet-Rich Fibrin (i-PRF)

Intervention Type BIOLOGICAL

Autologous platelet-rich fibrin gel is applied to the graft surface after free gingival graft surgery to potentially reduce graft shrinkage.

Interventions

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Free Gingival Graft (FGG)

Standard free gingival graft procedure performed without additional treatments.

Intervention Type PROCEDURE

Injectable Platelet-Rich Fibrin (i-PRF)

Autologous platelet-rich fibrin gel is applied to the graft surface after free gingival graft surgery to potentially reduce graft shrinkage.

Intervention Type BIOLOGICAL

Low-Level Laser Therapy (LLLT)

Low-level laser therapy is applied to the graft site immediately after surgery and on postoperative days 3, 5, 7, and 14 to potentially improve healing and reduce graft shrinkage.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 years.
* Systemically healthy.
* Cairo Class I gingival recession in vital mandibular anterior incisors.
* No caries or restorations in the relevant teeth.
* Keratinized gingiva height \< 2 mm in the included teeth.
* Plaque Index (PI) \< 1.
* Gingival Index (GI) \< 1.

Exclusion Criteria

* Active periodontal disease or probing depth \> 3 mm.
* Use of medications that could prevent surgery or affect wound healing.
* Pregnancy or breastfeeding.
* History of periodontal surgery in the working area.
* Active smokers.
* Current orthodontic treatment.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kahramanmaras Sutcu Imam University

OTHER

Sponsor Role lead

Responsible Party

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Esra Bozkurt

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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esra bozkurt

Role: PRINCIPAL_INVESTIGATOR

Kahramanmaras Sutcu Imam University

Locations

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Kahramanmaraş Sütçü İmam University

Kahramanmaraş, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Shakiliyeva S, Sahin D, Gunpinar S, Gursel M. Comparison of conventional and modified sling suture techniques in free gingival graft operations-a randomized controlled clinical trial. BMC Oral Health. 2025 Feb 21;25(1):279. doi: 10.1186/s12903-025-05456-x.

Reference Type BACKGROUND
PMID: 39984903 (View on PubMed)

Related Links

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https://www.inonu.edu.tr/klinik.etik

Inonu University Clinical Research Ethics Committee

Other Identifiers

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2024/84

Identifier Type: -

Identifier Source: org_study_id