Human gingival fibroblasts culture in an autologous scaffold and assessing its effect on augmentation of attached gingiva in a pilot clinical trial

An important goal of periodontal plastic surgery is the creation of attached gingiva around the teeth. In this study, the aims were to culture gingival fibroblasts in a biodegradable scaffold and measure the width of attached gingiva after the clinical procedure.
This study was carried out on 4 patients (8 sites), with inadequate attached gingiva next to at least two teeth in contralateral quadrants of the same jaw. A biopsy of attached gingiva (epithelial connective tissue) was taken using a surgical blade. Following culture of gingival fibroblasts, 250 × 103 cells in 250 µl nutritional medium were mixed with platelet-rich in growth factor (PRGF). Periosteal fenestration technique was done on one side (control) and tissue-engineered mucosal graft (test) was carried out on the contralateral side in each patient. The width of keratinized tissue, probing depth (PD) and width of attached gingiva were recorded at baseline and 3 months after the operation.
An increased width of keratinized and attached tissue on all operated sites after 3 months was observed. These results showed the increased mean of the width of keratinized and attached gingiva to be 4.17 mm and 4.14 mm in test and 1.10 mm and 1.10 mm in control sites, respectively. The difference of keratinized and attached gingiva width between test and control sites was significant (P = 0.030, and P = 0.010 respectively).
According to the results of this study, PRGF can be used as a scaffold to transfer gingival fibroblasts to recipient sites with significant clinical results.