Efficacy of concentrated growth factor combined with coronally advanced flap in the treatment of gingival recession: a systematic review and meta-analysis.

Objective: This study aims to evaluate the efficacy of combining the coronally advanced flap (CAF) technique with concentrated growth factor (CGF) in the treatment of gingival recession (GR), and to compare this approach with other alternative treatments.

Methods: This systematic review and meta-analysis included randomized controlled trials (RCTs) comparing CAF combined with CGF to other treatments for root coverage procedures. Included studies evaluated systemically healthy adults (> 18 years) with Miller Class I/II or Cairo RT1 gingival recessions. Primary outcomes were complete root coverage (CRC) and mean root coverage (MRC); secondary outcomes included changes in keratinized tissue width (KTW), gingival thickness (GT), clinical attachment level (CAL), recession width (RW), recession depth (RD), and probing depth (PD). A comprehensive search was conducted across multiple databases, including PubMed, Scopus, Cochrane Library, Web of Science, and Embase, up to November 9, 2024. The study protocol was prospectively registered in PROSPERO (CRD42024556815). Statistical analyses were performed using Review Manager 5.4.1.

Results: Eight studies were included in the meta-analysis. Compared to CAF alone, the combination of CAF and CGF significantly improved CRC (OR = 1.79, P = 0.04), MRC (MD = 10.38%, P = 0.04), KTW (MD = 0.40 mm, P = 0.02), GT (MD = 0.26 mm, P < 0.00001), and CAL (MD = 0.36 mm, P = 0.03). CAF combined with connective tissue graft (CTG) showed superior efficacy for CRC compared to CAF + CGF (OR = 0.25, P = 0.009). However, no significant differences were found between CAF + CTG and CAF + CGF for MRC, CAL, KTW, RD, RW, or PD. Additionally, no significant differences were observed when comparing CAF + CGF with CAF + PRF across all clinical parameters (all P > 0.05).

Conclusions: The findings of this meta-analysis indicate that CAF/CGF improves clinical outcomes in treating GR compared to CAF alone, and CGF may be a viable alternative to CTG when CTG is not applicable. Further studies are needed to validate the efficacy of CAF/CGF in the treatment of GR. Conclusions: In cases where CTG is not applicable, CGF may serve as a viable alternative for the treatment of Miller class I and II GR.