Evaluation of the efficacy of microneedling alone and in combination with injectable hyaluronic acid in augmentation of peri‑implant soft tissues: A randomized controlled trial

Abstract

Objectives: The objective of this study was to evaluate the efficacy of injectable hyaluronic acid (HA) combined with microneedling (MN) in augmenting peri-implant soft tissue. Materials and Methods: Sixty-five patients were enrolled and divided into two groups. Group 1 received MN alone, while Group 2 received HA following MN on the peri-implant mucosa. Various parameters – including the plaque index (PI), gingival index (GI), peri-implant probing depth, clinical attachment levels, Sulcus Bleeding Index, mucosal thickness (MT), keratinized tissue width (KTW), interproximal width (IPW), and papillary recession height (PRH) – were evaluated at baseline, 3 months, and 6 months postoperatively. Patient-reported outcome measures were assessed to gauge treatment effectiveness and patient satisfaction. Results: Group 2 patients exhibited reduced PI, GI, SBI, PIPD, and CAL compared to Group 1. Both groups showed a significant increase in MT and KTW after 6 months; MT increased to 1.03 ± 0.11 mm in Group 1 and 2.48 ± 0.45 mm in Group 2, while KTW increased to 2.44 ± 0.84 mm in Group 1 and 4.34 ± 1.02 mm in Group 2. In addition, the mean PRH was 1.67 ± 0.32 mm in Group 1 and 0.88 ± 0.25 mm in Group 2, with a mean IPW of 2.19 ± 0.52 mm in Group 1 and 0.90 ± 0.16 mm in Group 2. Conclusion: HA combined with MN leads to increased MT and KTW, reduced inflammation, and improved papillary fill. Thus, HA with MN may serve as an effective short-term implant maintenance modality, assisting clinicians in achieving peri-implant soft tissue regeneration.