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Background Several procedures have been used to enhance thin gingival phenotype and the majority of these procedures have been surgical. A new minimally invasive approach that involved multiple injections of platelet-rich fibrin (i-PRF) to enhance the thin gingival phenotype has been proposed. As the hyaluronic acid (HA) and the i-PRF share similar properties in terms of promoting periodontal regeneration, the present trial aimed to evaluate the effectiveness of multiple injections of the i-PRF in patients with thin gingival phenotypes in comparison with those of the HA in increasing the gingival thickness (GT) and the keratinized tissue width (KTW). Materials and methods Eighty-four sites from 14 systematically healthy patients who had thin gingival phenotypes (GT ≤1 mm) were included in this split-mouth randomized controlled trial. For each patient, each side of the anterior mandible was randomly allocated to one of the two materials (HA or i-PRF). In the HA group, the selected sites of the gingiva were injected with cross-linked HA using a 30-gauge microneedle. In the i-PRF group, the i-PRF was injected in the same manner. This procedure was repeated in both groups three times with intervals of 7 days. The GT, KTW, and periodontal indices: gingival index (GI), bleeding on probing (BOP), and probing depth (PD) were measured at baseline, 1 month, and 3 months following the initial injection. Results The GT increased significantly in both groups at the three assessment times (p<0.001). The KTW also showed a statistically significant increase in the intragroup comparisons in both groups (p<0.05). No statistically significant difference was observed between the two groups at the three assessment times for the GT and the KTW (p>0.05). The GI significantly decreased after 1 month and 3 months compared to the baseline values in both groups (p<0.05). The intergroup comparisons for the GI revealed no statistically significant differences at the three assessment times (p>0.05). As for the BOP and the PD, no statistically significant differences were found between the three assessment times (p>0.05) and between the two groups at each assessment time (p>0.05). Conclusion Multiple injections of the i-PRF and the HA in the thin gingival phenotype resulted in an increased GT and increased KTW, with no statistically significant differences between the two methods. Both minimally invasive techniques were more effective in improving the GT rather than the KTW.

Background: Gingival biotype is one of the most important factors that impede success in dental treatments; it affects the outcomes of periodontal surgery, and restorative treatments. Researchers classified gingival biotypes into thin biotype and thick biotype. It is crucial to identify tissue biotype before treatment. Aim of Study: To determine the prevalence of gingival biotypes in a Syrian population, in addition, to study the distribution of gingival biotypes according to gender and tooth shape. Material and Methods: This cross sectional study included 500 volunteers (300 males and 200 females) from the patients who had visited the department of periodontology-dental faculty at Damascus University. Gingival thickness was assessed to determine the gingival biotype for the maxillary central incisors using the direct measurement technique (Trans-gingival probing). Shapes of the maxillary incisors were recorded. A written informed consent was taken from each patient. Statistical analysis was done using test k2 p < 0.05. Results: The mean age was 26.8 ± 4.4 years. Thick gingival biotype was detected in 58.4% of the sample and most of patients are men while the prevalence of thin gingival biotype was 41.6% of the sample. It was also observed that patients with thin gingival biotype had triangular tooth shape in 99.5% (p < 0.05). Conclusion: Thick gingival biotype was observed to be more prevalent in a Syrian population than thin biotype. Most Syrian males had thick gingival biotype with square tooth shape while females had thinner biotype and triangular tooth shape.

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