Efficacy of injectable platelet-rich fibrin and microneedling for thin gingival phenotype: a systematic review and meta-analysis.
7 affiliations
- 1Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India.
- 2Department of Periodontology and Oral Implantology, Adhiparasakhti Dental College and Hospital, Melmaruvathur, Tamil Nadu, India.
- 3Department of Periodontology and Oral Implantology, School of Dental Sciences Karad, Krishna Vishwa Vidyapeeth, Karad, Maharashtra, India.
- 4Eleanor Duncan Aboriginal Services, Tuggerah, NSW, Australia.
- 5Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India. [email protected].
- 6Oral Health, School of Health Sciences, College of Medicine, Health and Wellbeing, University of Newcastle, Ourimbah, NSW, Australia. [email protected].
- 7College of Medicine and Dentistry, James Cook University, Smithfield, QLD, Australia. [email protected].
Abstract
Background
Thin gingival phenotypes, characterized by a reduced gingival thickness (GT), are particularly susceptible to recession and inflammation. Injectable platelet-rich fibrin (i-PRF) and microneedling (MN) are emerging minimally invasive approaches for enhancing gingival thickness and improving periodontal health. To evaluate the efficacy of i-PRF and MN combination compared to i-PRF or MN monotherapy in the treatment of thin gingival phenotype.Methods
A comprehensive literature search was conducted across five databases with no language restrictions. Studies were selected based on predefined selection criteria that assessed primary outcomes (Gingival Thickness - GT, Width of Keratinised Tissue - KTW). Four split-mouth, prospective randomized trials involving 116 participants were included. Data from these studies were extracted individually by two reviewers, with a risk of bias assessment performed using the Cochrane RoB 2 tool. A meta-analysis was executed using RevMan Version 5.1.Results
Of the 164 studies initially identified, four studies were eligible for inclusion and three for the meta-analysis. The combined use of i-PRF and MN showed a significant increase in GT, particularly within the first three months, compared to i-PRF alone. However, no significant differences were found for KTW across groups. The results for secondary outcomes, including clinical attachment level (CAL), probing depth (PD), and plaque index (PI) showed significant improvements, with i-PRF + MN leading to enhanced patient comfort and aesthetic satisfaction. The certainty evidence was estimated as low.Conclusion
i-PRF combined with MN may provide an adjunctive benefit for increasing GT in thin periodontal phenotypes, particularly within the first three months. These results should be interpreted with considerable caution given the small number of studies included and the high risk of bias. While a modest improvement in GT was observed with the combination approach, the impact on KTW remains inconclusive.
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BibTeX
@article{nedungadi2026efficacy,
title = {{Efficacy of injectable platelet-rich fibrin and microneedling for thin gingival phenotype: a systematic review and meta-analysis.}},
author = {Aaron Nedungadi and Sharath Shetty and Anita Kulloli and Santosh Martande and Magesh Kumar and Saumya Singh and Poornima Ramamurthy and Dileep Sharma},
journal = {BMC oral health},
year = {2026},
month = jul,
doi = {10.1186/s12903-026-09334-y},
url = {https://europepmc.org/article/MED/42894167},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Efficacy of injectable platelet-rich fibrin and microneedling for thin gingival phenotype: a systematic review and meta-analysis.
AU - Aaron Nedungadi
AU - Sharath Shetty
AU - Anita Kulloli
AU - Santosh Martande
AU - Magesh Kumar
AU - Saumya Singh
AU - Poornima Ramamurthy
AU - Dileep Sharma
PY - 2026
DA - 2026/07/01
JO - BMC oral health
DO - 10.1186/s12903-026-09334-y
UR - https://europepmc.org/article/MED/42894167
AB - Background Thin gingival phenotypes, characterized by a reduced gingival thickness (GT), are particularly susceptible to recession and inflammation. Injectable platelet-rich fibrin (i-PRF) and microneedling (MN) are emerging minimally invasive approaches for enhancing gingival thickness and improving periodontal health. To evaluate the efficacy of i-PRF and MN combination compared to i-PRF or MN monotherapy in the treatment of thin gingival phenotype.Methods A comprehensive literature search was conducted across five databases with no language restrictions. Studies were selected based on predefined selection criteria that assessed primary outcomes (Gingival Thickness - GT, Width of Keratinised Tissue - KTW). Four split-mouth, prospective randomized trials involving 116 participants were included. Data from these studies were extracted individually by two reviewers, with a risk of bias assessment performed using the Cochrane RoB 2 tool. A meta-analysis was executed using RevMan Version 5.1.Results Of the 164 studies initially identified, four studies were eligible for inclusion and three for the meta-analysis. The combined use of i-PRF and MN showed a significant increase in GT, particularly within the first three months, compared to i-PRF alone. However, no significant differences were found for KTW across groups. The results for secondary outcomes, including clinical attachment level (CAL), probing depth (PD), and plaque index (PI) showed significant improvements, with i-PRF + MN leading to enhanced patient comfort and aesthetic satisfaction. The certainty evidence was estimated as low.Conclusion i-PRF combined with MN may provide an adjunctive benefit for increasing GT in thin periodontal phenotypes, particularly within the first three months. These results should be interpreted with considerable caution given the small number of studies included and the high risk of bias. While a modest improvement in GT was observed with the combination approach, the impact on KTW remains inconclusive.
SN - 1472-6831
ER -