Evaluation of Root Coverage in Gingival Recessions Treated With Collagen Matrix and Platelet-Rich Fibrin: A Systematic Review

Gingival recession is a common mucogingival defect that results in root exposure, dentinal hypersensitivity, and aesthetic compromise. Various surgical techniques and biomaterials have been employed to achieve predictable root coverage, among which collagen matrices (CM) and platelet-rich fibrin (PRF) have gained clinical prominence. This systematic review aimed to evaluate and compare the efficacy of CM and PRF in achieving root coverage and improving soft-tissue parameters in gingival recession defects. Electronic searches were conducted across PubMed, Web of Science, Scopus, Sciencedirect, EBSCOHost, and Google Scholar databases up to September 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Only randomized controlled trials comparing CM and PRF were included. Six studies involving 210 sites were analyzed qualitatively. Both PRF and CM demonstrated significant improvements in root coverage, gingival thickness, and keratinized tissue width; however, three studies showed superior outcomes with PRF or PRF combined with CM compared to CM alone. Techniques such as the vestibular incision, subperiosteal tunnel access, and pinhole surgical technique, when combined with PRF, provided better soft-tissue outcomes and patient comfort. The overall quality of evidence, evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, was moderate due to methodological heterogeneity and lack of blinding in outcome assessment. Within the limitations of this review, PRF, either alone or in combination with CM, appears to offer enhanced regenerative outcomes and greater predictability in root coverage procedures compared to CM alone.