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<p><b>Aim</b> Gingival phenotype is critical for periodontal health and aesthetics, with a thin phenotype predisposing to recession. While effective, traditional surgical augmentation techniques involve significant morbidity, highlighting the need for minimally invasive alternatives. The aim of this study was to assess the efficacy of microneedling, alone or combined with other therapies, for gingival phenotype modification.</p><p><b>Methods</b> Seven randomised controlled trials (2020–2024) were included after a comprehensive database search. Studies featured split-mouth or parallel designs with participants having a thin periodontal phenotype. Interventions compared microneedling alone or with injectable platelet-rich fibrin against conventional techniques. Gingival thickness was the primary outcome.</p><p><b>Results</b> All included studies reported significant increases in gingival thickness (0.22–0.28 mm), especially when microneedling was combined with injectable platelet-rich fibrin. When used with a coronally advanced flap, microneedling produced comparable results to acellular dermal matrix for gingival thickness, with superior keratinised tissue width gains. Patient-reported outcomes consistently favoured microneedling.</p><p><b>Discussion</b> These findings suggest that microneedling stimulates collagen production through controlled micro-injuries, providing a graft-less alternative to traditional approaches. While effects on keratinised tissue width were variable, the consistent improvement in gingival thickness across studies supports clinical applicability.</p><p><b>Conclusion</b> Microneedling offers a minimally invasive alternative for gingival augmentation without donor site morbidity. Standardised protocols and longer-term studies are needed to establish its definitive role in periodontal practice.</p>

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The applications of microneedling in the change of gingival phenotype: a systematic review of randomised clinical trials

  • 期刊论文

  • 发表日期：

    2026年3月6日

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  • Luiz Eduardo Rodrigues Juliasse,
  • Carlos Fernando Mourão,
  • Gabriela Ellen da Silva Gomes,
  • Bruno Cesar de Vasconcelos Gurgel

摘要

Aim Gingival phenotype is critical for periodontal health and aesthetics, with a thin phenotype predisposing to recession. While effective, traditional surgical augmentation techniques involve significant morbidity, highlighting the need for minimally invasive alternatives. The aim of this study was to assess the efficacy of microneedling, alone or combined with other therapies, for gingival phenotype modification.

Methods Seven randomised controlled trials (2020–2024) were included after a comprehensive database search. Studies featured split-mouth or parallel designs with participants having a thin periodontal phenotype. Interventions compared microneedling alone or with injectable platelet-rich fibrin against conventional techniques. Gingival thickness was the primary outcome.

Results All included studies reported significant increases in gingival thickness (0.22–0.28 mm), especially when microneedling was combined with injectable platelet-rich fibrin. When used with a coronally advanced flap, microneedling produced comparable results to acellular dermal matrix for gingival thickness, with superior keratinised tissue width gains. Patient-reported outcomes consistently favoured microneedling.

Discussion These findings suggest that microneedling stimulates collagen production through controlled micro-injuries, providing a graft-less alternative to traditional approaches. While effects on keratinised tissue width were variable, the consistent improvement in gingival thickness across studies supports clinical applicability.

Conclusion Microneedling offers a minimally invasive alternative for gingival augmentation without donor site morbidity. Standardised protocols and longer-term studies are needed to establish its definitive role in periodontal practice.