Management of Anterior Dehiscence Defects Using Guided Bone/Tissue Regeneration with Connective Tissue Graft and Platelet-Rich Fibrin: A Case Series

Abstract

Alveolar dehiscence and gingival recession are periodontal defects that impair aesthetics and function, especially when present in the anterior region. Conventional surgical techniques, such as coronally advanced flaps and connective tissue grafts, may enhance soft tissue coverage but fail to correct the bone defects. To rectify this, regenerative strategies that include guided bone and tissue regeneration (GBR/GTR) and autologous platelet concentrates like platelet-rich fibrin (PRF) have shown potential with promising results. However, reports combining GBR/GTR and PRF treatment of anterior alveolar dehiscence defects remain limited. This case series demonstrating the combined use of guided bone/tissue regeneration, connective tissue grafting, and both injectable and membrane forms of platelet-rich fibrin for the management of anterior alveolar dehiscence defects. This report discusses two cases of anterior alveolar dehiscence with gingival recession that were treated with a combined regenerative protocol. In Case 1, a 28-year-old female with a peri-implant dehiscence defect was treated with “sticky bone”, which was made by mixing her own bone with injectable PRF, a connective tissue graft (CTG), and an advanced PRF membrane. In Case 2, a similar presentation maxillary central incisor of a 25-year-old female was treated with allogeneic bone graft, injectable PRF, CTG, and a PRF membrane. Both cases adhered to minimally invasive surgical protocols, complemented by postoperative injectable PRF applications. After six months, both patients showed a big improvement in gingival thickness, bone regeneration, soft tissue stability, and aesthetic results. There were no reported problems, and the patients were satisfied with the results. The combined application of guided regeneration, connective tissue grafting (CTG), and platelet-rich fibrin (PRF) presents a minimally invasive and biologically orientated technique that improves outcomes for both hard and soft tissues. Additional long-term studies are necessary to validate its predictability and clinical stability.