Microneedling in Periodontal Plastic Surgery

Microneedling is an emerging minimally invasive technique that is gaining attention in periodontal plastic surgery for soft tissue regeneration and gingival phenotype modification. Conventional periodontal plastic surgical procedures such as free gingival grafts and connective tissue grafts are effective but often associated with donor site morbidity, postoperative discomfort, and prolonged healing. Microneedling, also known as percutaneous collagen induction therapy, creates controlled microinjuries in the gingival tissues using fine needles, thereby stimulating wound healing, collagen synthesis, angiogenesis, and tissue remodelling. This review discusses the concept, mechanism of action, devices, clinical applications, advantages, limitations, and future prospects of microneedling in periodontology. Current evidence suggests that microneedling can enhance gingival thickness, improve periodontal phenotype, support root coverage procedures, aid gingival depigmentation, facilitate local drug delivery, and promote periodontal tissue regeneration. The technique also shows potential as a minimally invasive diagnostic aid through oral biofluid collection. Advantages include reduced patient morbidity, absence of donor site surgery, faster healing, and improved patient acceptance. However, limited long-term evidence and lack of standardized protocols remain challenges. Further well-designed randomized clinical trials are required to establish its effectiveness and clinical guidelines in periodontal therapy.