SUMMARY

Gingival phenotype is an important aspect of periodontium which maintains the health of the tissue as well as plays a decisive role in prediction of periodontal treatment outcomes. Thin gingival phenotype poses certain risks of poor periodontal treatment outcome in cases of implant, coronally advanced flap and other root coverage procedures and implants. In this study a non-surgical treatment modalities are being employed in an attempt to increase the thickness of thin gingival phenotype.

In this study the aim was to evaluation of clinical, photographic parameters and patient reported outcomes in microneedling with and without i-PRF in thin gingival phenotype. Thirty Systemically healthy subjects with thin gingival phenotype was included in this study. The lower anterior teeth were randomly divided into two halves by flip coin method, in which the one side is treated with Microneedling (MN) + i-PRF (Group 1) and another was treated by Microneedling alone (Group 2). The procedure was repeated for 4 times in an interval of 10 days. Measurement of Gingival Thickness (GT), Width of Keratinized Tissue (WKT), Oral Hygiene Index (OHI), Gingival Index (GI) and Patient reported outcome measurement (PROM) which included Pain, swelling, discomfort and redness was assessed.

Follow up of all the patients was done till 6 months. From the baseline to 6 months, both the groups showed statistical significant improvement in the gingival thickness (P < 0.001). No significant improvement in WKG in both the groups. The intergroup comparison showed highly statistical significant increment in GT. Photographic analysis by RGB and L* a* b* showed highly statistical significant changes from baseline to 6 months. In group 1 there was significant variation in PROM from baseline to 7 days. PROM in group 2 showed statistical significant changes in Visual analogue scale and redness. Overall better comfort was observed in group 2 in PROM.

Thus, this study concludes that microneedling along with i- PRF provides significant improvement in thickness of gingiva. This study is first study of its kind to conduct photographic analysis and patient reported outcomes to measure in non-surgical periodontal therapy. The photographic analysis showed changes from baseline to 6 months suggestive of changes in gingiva. Patient reported outcomes measurement enable us to analyse the patient’s perception regarding treatment which showed overall better comfort in microneedling group.  Hence, this non-surgical treatment modality can be used improve the gingival phenotype of the patients with minimal discomfort and without need of surgery in cases of thin gingival phenotype.