Abstract
Loss of the interdental papilla represents a frequent aesthetic and functional challenge in dentistry. Traditional surgical procedures can partially restore papillary form but are limited by technical sensitivity, donor-site morbidity, and unpredictable long-term results. Consequently, interest has shifted toward minimally invasive, biologically driven strategies for papilla reconstruction. Among non-surgical options, the injection of hyaluronic acid (HA) and the injectable form of platelet-rich fibrin (iPRF) have shown considerable promise. Combining microneedling (MN) enhances trans-mucosal delivery of the biologic agent and can boost regenerative outcomes. Despite promising results, direct comparisons between HA and MN + iPRF remain scarce. Therefore, the present study aims to compare the clinical outcomes of MN + iPRF versus HA gel injection in the reconstruction of Class I interdental papilla loss. This pilot study was conducted as a split-mouth, double-blind, randomized trial to compare the efficacy of MN + iPRF vs. HA injections in reconstructing interdental papillae. A total of seven adult patients (N = 7) were enrolled, contributing 20 interdental papillary sites based on individual clinical presentation. Each site was randomly assigned to one of two treatment groups: Group MN + iPRF (n = 10 sites), and Group HA (n = 10 sites). Clinical parameters measured at baseline, 6 weeks, and 12 weeks included papillary height and papillary width at three levels (base, middle, and tip), and Papillary thickness. Both techniques showed comparable improvements in papillae height and contour over the study period. Intergroup analysis showed no statistically significant difference in all parameters at any time point. This pilot study, with its small sample size, suggests comparable short-term outcomes, but larger studies are needed to determine definitive efficacy. The absence of statistical significance should therefore be interpreted cautiously and does not indicate equivalence between the two treatment approaches.