Using the injectable-platelet-rich-fibrin (I-PRF)for enhancing the gingival phenotype

A thin gingival biotype is important predisposing factor for gingival recessions. There is still no way to improve the gingival thickness predictably. Platelet rich fibrin (PRF) was developed as a second generation autologous platelet concentrate without the use of anticoagulants or other additives. A liquid injectable-platelet-rich fibrin (I-PRF) was developed by modifying spin centrifugation forces and centrifugation time and utilizing non-glass centrifugation tubes. Wound healing which starts on holes as a result of a lot of microneedling to the tissue ends up with new collagen formation. The holes exist after microneedling increase penetration and efficacy of the applied substances. This randomized controlled clinical trial attempts to evaluate the effect to gingival thickness using I-PRF alone and with microneedle (MN) in individuals with thin gingival thickness. In this split mouth study, 33 systemically healthy patients with thin gingival biotype were randomly treated with MN+I-PRF, and I-PRF. I-PRF was injected on the one side and MN+I-PRF was performed on the other side of the same patient. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival thickness (GT), and keratinized tissue width (KTW) were assessed before the treatment and every month for six months after the final injections. After evaluation of the GT between the groups, statistically significant difference was found in the MN+I-PRF group at the sixth month after the final injection. In the intra-group comparisons, a statistically significant increase in GT was observed within both I-PRF [GT increased from 0.43mm±0.14 to 0.62mm±0.11 (p<0.001)] and MN+I-PRF [GT increased from 0,4mm±0,14 to 0,66mm±0,12 (p<0.001)] groups at the sixth month after the final injection. In the intra-group comparisons, a statistically significant increase in KTW was observed within MN+I-PRF group [KTW increased from 2.94mm±1.21 to 2.99mm±0,22 (p<0.001)] at the sixth month after the final injection. In individuals with thin gingival phenotype, I-PRF alone and with MN increased gingival thickness. I-PRF with MN may play a role in increasing the keratinized gingival width.