Management of Miller’s Class I and II Gingival Recession with FGF-2 Impregnated versus Plain Bioresorbable Collagen Membrane: A Randomised Controlled Trial

Introduction: Gingival Recession (GR) is a prevalent clinical condition that compromises both aesthetics and function. The concept of Guided Tissue Regeneration (GTR) aims to regenerate periodontal tissue using an occlusive barrier membrane. Recent advances in the utilisation of different barrier membranes suggest that growth factors such as Fibroblast Growth Factor-2 (FGF-2) may further enhance regenerative outcomes. Aim: To compare the efficacy of Coronally Advanced Flap (CAF) with FGF-2 impregnated bioresorbable collagen membrane versus CAF with plain bioresorbable collagen membrane in treating Miller’s class I and II GR. Materials and Methods: This randomised controlled trial was conducted in the Department of Periodontics and Oral Implantology at Santosh Dental College, Ghaziabad, Uttar Pradesh, India, from October 2022 to November 2024. Individuals aged 18-40 years old, predominantly females, participated in the study. Out of 30 patients screened, a total of 24 sites in 24 patients were included and were randomly assigned to Group A (CAF with collagen membrane) and Group B (CAF with FGF-2 impregnated membrane). Clinical parametersRecession Depth (RD), Width of Keratinised Gingiva (WKG), Clinical Attachment Level (CAL), Probing Pocket Depth (PPD), gingival biotype, Plaque Index (PI), Gingival Index (GI) - were measured at baseline, three months, and six months. Data were analysed using Statistical Package for Social Sciences (SPSS) version 26.0 with a significance level set at p-value≤0.05. The Shapiro-Wilk test and the Wilcoxon signed-rank test were used for analysis. Results: A total of 24 patients, predominantly females, were included with a mean age of 29±6.35 years. Both groups showed clinical improvements; which were significantly greater in group B by six months. A reduction in RD was observed in both groups at three months, but group B showed a significantly greater reduction by six months (p-value=0.026*). For WKG, group B demonstrated a significantly greater gain than group A at six months (p-value=0.002*). Group B demonstrated a significantly lower mean CAL than group A at six months (p-value=0.043). The PPD values remained comparable across all intervals. By six months, gingival biotype values yielded a significant intergroup difference (p-value=0.042). The PI decreased significantly in both groups, with the test group showing consistently lower PI scores (p-value=0.002). Differences in GI were not statistically significant between groups at baseline, three months and six months. Conclusion: The study results support that both CAF with collagen membrane and CAF with FGF-2 impregnated collagen membrane effectively addressed the recession defects. However, the use of collagen membrane along with FGF-2 can be a promising adjunct in periodontal regenerative procedures.