الفهرس 
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Abstract
Gingival recession is defined as the apical migration of the junctional epithelium with exposure of root surface. It is a common condition that can be localized or generalized, involving single or multiple teeth and its extent and prevalence increase with age.
Patients with gingival recession may complain of esthetic problems due to root exposure. Although gingival recession can occur without any symptoms, it can give rise to pain from exposed dentin, tooth sensitivity, loss of the tooth, poor esthetics, or root decay. It also poses a problem while performing oral hygiene procedures.
The present study was conducted to compare between the clinical effectiveness of leukocyte platelet rich fibrin (L-PRF) and de-epithelized connective tissue graft (DECTG) both with modified tunneling technique in management of Miller class I and II (multiple) gingival recession using root coverage (length and width) and gingival thickness as primary outcomes and patient satisfaction and keratinized tissue width as secondary outcomes.
Thirty patients (57 % males and 43 % females) with mean age of 33.5 (5.6) with ninety recession sites in anterior and premolar area, were recruited from the outpatient clinic of Oral Medicine, Periodontology, and Oral Diagnosis department, Faculty of Dentistry, Ain Shams University. They were randomly assigned to one of the following treatments:
group I (Tunneling technique + L-PRF): consisted of 15 patients who had Miller Class I or II multiple gingival recession and were treated by leukocyte and platelet rich fibrin with modified tunneling technique and was considered the (The study group).
group II (Tunneling technique +DECTG): consisted of 15 patients who had Miller Class I or II multiple gingival recession and were treated by de-epithelized connective tissue graft with modified tunneling technique and was considered the (The positive control group).
Clinical parameters were recorded which included probing depth (PD) plaque index (PI), gingival index (GI), recession depth (RD), recession width (RW), width of keratinized tissue width (KTW), clinical attachment loss (CAL) and gingival thickness (GT). The measurements were taken prior to surgeries at baseline and six months postoperatively. Patient satisfaction was also assessed.
The results of the present study showed that there was no statistically significant difference in mean (RD, RW, CAL, PD) between the two groups at baseline. After 6 months, both treatment modalities showed significant improvement in all the previous parameters with no significant difference except (KTW and GT) which were better in positive control group.
Statistical analysis showed significant differences between the studied groups regarding patient satisfaction questionnaire scores as the L-PRF group experienced statistically significant less pain when compared to DECTG during treatment, one day and 1st week after treatment, and patients in this group, unlike the other group were willing to repeat the treatment if needed. On the other hand, no statistically significant differences were observed between groups regarding cosmetic outcomes.