Gingival Thickness Augmentation Using Microneedling and Hyaluronic Acid: A Case Report with Preliminary Results

Gingival phenotype plays a critical role in soft tissue stability, esthetics, and susceptibility to recession. While phenotype modification has traditionally relied on surgical approaches, there is growing interest in minimally invasive, non-surgical alternatives. This split-mouth clinical study evaluated gingival thickness modification using hyaluronic acid alone and hyaluronic acid combined with microneedling. In each patient, one site received hyaluronic acid application, while the contralateral site was treated with microneedling followed by hyaluronic acid, allowing direct intra-individual comparison. Both approaches resulted in increased gingival thickness; however, the combination of microneedling and hyaluronic acid demonstrated a more pronounced and consistent soft tissue thickening. These findings suggest that microneedling may enhance the biological effectiveness of hyaluronic acid by improving tissue responsiveness and penetration.