Non-Cochrane · intervention · PM42894167
Efficacy of injectable platelet-rich fibrin and microneedling for thin gingival phenotype: a systematic review and meta-analysis.
Nedungadi Aaron, Shetty Sharath, Kulloli Anita, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-09334-y
Findings
22 findings
| Population | ||||
|---|---|---|---|---|
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Keratinized tissue width 6 months | MD 0.04 [-0.30, 0.37] Low Downgraded: risk of bias, inconsistency 2 studies · 65 participants |
| Adults (>=18 years) with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling (i-PRF + MN) | Injectable platelet-rich fibrin (i-PRF) alone | Keratinized tissue width (KTW, mm) 3 months · University dental hospitals in Turkiye and India | MD 0.04 [-0.29, 0.37] Low Downgraded: risk of bias, inconsistency 2 studies · 65 participants |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Recession depth | no estimate extracted GRADE not reported 1 study |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Plaque index | no estimate extracted GRADE not reported 1 study |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Bleeding on probing | no estimate extracted GRADE not reported 1 study |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Gingival thickness 1 month | MD 0.02 [-0.03, 0.06] Low Downgraded: risk of bias 2 studies · 69 participants |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Clinical attachment level | no estimate extracted GRADE not reported 1 study |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Probing depth | no estimate extracted GRADE not reported 1 study |
| Adults (>=18 years) with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling (i-PRF + MN) | Injectable platelet-rich fibrin (i-PRF) alone | Gingival thickness (GT, mm) 3 months · University dental hospitals in Turkiye and India | MD 0.05 [0.01, 0.09] Low Downgraded: risk of bias, inconsistency 3 studies · 101 participants |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Gingival thickness 1, 3 and 6 months pooled | MD 0.05 [0.02, 0.08] GRADE not reported 3 studies |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Keratinized tissue width 3 and 6 months pooled | MD 0.04 [-0.20, 0.27] GRADE not reported 2 studies |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Injectable platelet-rich fibrin | Gingival thickness 6 months | MD 0.10 [-0.03, 0.24] Low Downgraded: risk of bias, inconsistency 2 studies · 65 participants |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Microneedling | Plaque index | no estimate extracted GRADE not reported 1 study |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Microneedling | Gingival thickness | no estimate extracted GRADE not reported 1 study |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Microneedling | Gingival index | no estimate extracted GRADE not reported 1 study |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Microneedling | Keratinized tissue width | no estimate extracted GRADE not reported 1 study |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Baseline before i-PRF plus microneedling | Gingival thickness Baseline to 6 months | MD 0.26 [0.20, 0.31] Low Downgraded: risk of bias, inconsistency 2 studies · 65 participants |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin plus microneedling | Baseline before i-PRF plus microneedling | Keratinized tissue width Baseline to 6 months | MD 0.43 [-0.24, 1.10] Low Downgraded: risk of bias, inconsistency 2 studies · 65 participants |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin | Baseline before i-PRF | Gingival thickness Baseline to 6 months | MD 0.17 [0.12, 0.22] Low Downgraded: risk of bias, inconsistency 2 studies · 65 participants |
| Adults with thin gingival phenotype | Injectable platelet-rich fibrin | Baseline before i-PRF | Keratinized tissue width Baseline to 6 months | MD 0.39 [-0.29, 1.07] Low Downgraded: risk of bias, inconsistency 2 studies · 65 participants |
| Adults with thin gingival phenotype | i-PRF plus microneedling or i-PRF | Baseline before treatment | Keratinized tissue width Baseline to 6 months | MD 0.43 [0.05, 0.81] GRADE not reported 2 studies · 65 participants |
| Adults with thin gingival phenotype | i-PRF plus microneedling or i-PRF | Baseline before treatment | Gingival thickness Baseline to 6 months | MD 0.21 [0.17, 0.25] GRADE not reported 2 studies · 65 participants |
Included primary studies 4
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Adhikary 2023 Gingival Augmentation in the Thin Phenotype Using Injectable Platelet-Rich Fibrin and Microneedling. PMID:37456469 | 2023 | this review only | Gingival thickness; Keratinized tissue width | not extracted yet |
| Chetana 2024 Evaluation of microneedling with and without injectable-platelet rich fibrin for gingival augmentation in thin gingival phenotype-A… PMID:38188907 | 2024 | this review only | not stated | not extracted yet |
| Ozsagir 2020 Injectable platelet-rich fibrin and microneedling for gingival augmentation in thin periodontal phenotype: A randomized controlled… PMID:31912532 | 2020 | this review only | Gingival thickness; Keratinized tissue width | not extracted yet |
| Soundarajan 2023 Injectable Platelet-Rich Fibrin and Microneedling—A Non-Surgical Approach for Gingival Augmentation: A Randomized Controlled Clinical Trial DOI:10.1177/23202068231157997 | 2023 | this review only | Gingival thickness | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients aged 18 years or older with thin gingival phenotype | 116 adults with thin gingival phenotype (GT <= 0.8 mm mandibular anterior in 3 studies; < 1.5 mm canine/premolar in 1) (n=4) |
| Intervention | Injectable platelet-rich fibrin combined with microneedling (i-PRF + MN) | i-PRF + MN (n=4) |
| Comparison | i-PRF alone or microneedling alone | i-PRF alone (n=3); MN alone (n=1, Chetana 2024, not meta-analysed) |
| Outcomes | Primary: gingival thickness (GT), keratinized tissue width (KTW); secondary: plaque index, probing depth, recession depth, bleeding on probing, clinical attachment level | GT between groups at 1 (n=2), 3 (n=3) and 6 months (n=2); KTW between groups at 3 and 6 months (n=2); GT and KTW change from baseline to 6 months within each arm (n=2); secondary outcomes PI, PD, RD, BOP, CAL, GI and patient-reported comfort and aesthetics narrative only |
| Study designs | Parallel-group and split-mouth RCTs | Split-mouth prospective RCTs (n=4); 3 in meta-analysis |
| Timing | Not specified | 1, 3 and 6 months (follow-up up to 6 months; Soundarajan 3 months) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |