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

Moien Aramoon, Saeed Rajabalian, Mohammad Mohammadi, Neda Khodarahmi, Maryam Farzadmoghadam


BACKGROUND AND AIM: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.


Tissue Engineering; Gingiva; Blood Platelet; Scaffold

Full Text:



Newman MG, Takei H, Klokkevold PR, Carranza FA. Carranza's clinical periodontology-e-book: Expert consult: Online. 12th ed. Philadelphia, PA: Elsevier Health Sciences; 2014. p. 628.

Ochsenbein C. Newer concepts of mucogingival surgery. J Periodontol 1960; 31(3): 175-85.

Staffileno H, Wentz F, Orban B. Histologic study of healing of split thickness flap surgery in dogs. J Periodontol 1962; 33(1): 56-69.

Corn H. Periosteal separation-its clinical significance. J Periodontol 1962; 33(2): 140-53.

Robinson RE, Agnew RG. Periosteal fenestration at the mucogingival line. J Periodontol 1963; 34(6): 503-12.

Friedman N. Mucogingival surgery: The apically repositioned flap. J Periodontol 1962; 33(4): 328-40.

Edel A. Clinical evaluation of free connective tissue grafts used to increase the width of keratinised gingiva. J Clin Periodontol 1974; 1(4): 185-96.

Bjorn H. Free transplantation of gingiva properia. Swed Dent J 1963; 22: 684-9.

Silverstein L, Callan D. An acellular dermal matrix allograft and a palatal graft for tissue augmentation. Periodontal Insights 1996; 6: 3-6.

Pack AR, Gaudie WM, Jennings AM. Bony exostosis as a sequela to free gingival grafting: two case reports. J Periodontol 1991; 62(4): 269-71.

Brasher WJ, Rees TD, Boyce WA. Complications of free grafts of masticatory mucosa. J Periodontol 1975; 46(3): 133-8.

Knight MA, Evans G. Tissue engineering: Progress and challenges. Plast Reconstr Surg 2004; 114(2): 26e-37e.

Raghoebar GM, Tomson AM, Scholma J, Blaauw EH, Witjes MJ, Vissink A. Use of cultured mucosal grafts to cover defects caused by vestibuloplasty: an in vivo study. J Oral Maxillofac Surg 1995; 53(8): 872-8.

Ueda M, Hata KI, Sumi Y, Mizuno H, Niimi A. Peri-implant soft tissue management through use of cultured mucosal epithelium. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 86(4): 393-400.

Prato GP, Rotundo R, Magnani C, Soranzo C, Muzzi L, Cairo F. An autologous cell hyaluronic acid graft technique for gingival augmentation: A case series. J Periodontol 2003; 74(2): 262-7.

Pini Prato GP, Rotundo R, Magnani C, Soranzo C. Tissue engineering technology for gingival augmentation procedures: A case report. Int J Periodontics Restorative Dent 2000; 20(6): 552-9.

Lauer G, Schimming R. Tissue-engineered mucosa graft for reconstruction of the intraoral lining after freeing of the tongue: A clinical and immunohistologic study. J Oral Maxillofac Surg 2001; 59(2): 169-75.

Okuda K, Momose M, Murata M, Saito Y, lnoie M, Shinohara C, et al. Treatment of chronic desquamative gingivitis using tissue-engineered human cultured gingival epithelial sheets: A case report. Int J Periodontics Restorative Dent 2004; 24(2): 119-25.

McGuire MK, Nunn ME. Evaluation of the safety and efficacy of periodontal applications of a living tissue-engineered human fibroblast-derived dermal substitute. I. Comparison to the gingival autograft: A randomized controlled pilot study. J Periodontol 2005; 76(6): 867-80.

Mohammadi M, Shokrgozar MA, Mofid R. Culture of human gingival fibroblasts on a biodegradable scaffold and evaluation of its effect on attached gingiva: A randomized, controlled pilot study. J Periodontol 2007; 78(10): 1897-903.

Mohammadi M, Mofid R, Shokrgozar MA. Peri-implant soft tissue management through use of cultured gingival graft: A case report. Acta Med Iran 2011; 49(5): 319-24.

Lotfi G, Shokrgozar MA, Mofid R, Abbas FM, Ghanavati F, Bagheban AA, et al. A clinical and histologic evaluation of gingival fibroblasts seeding on a chitosan-based scaffold and its effect on the width of keratinized gingiva in dogs. J Periodontol 2011; 82(9): 1367-75.

Brass L. Understanding and evaluating platelet function. Hematology Am Soc Hematol Educ Program 2010; 2010: 387-96.

Sanchez-Gonzalez J, Méndez-Bolaina E, Trejo-Bahena NI. Platelet-rich plasma peptides: Key for Regeneration. Int J Pept 2012; 2012: 532519.

Sanchez AR, Sheridan PJ, Kupp LI. Is platelet-rich plasma the perfect enhancement factor? A current review. Int J Oral Maxillofac Implants 2003; 18(1): 93-103.

Carter CA, Jolly DG, Worden CE, Sr., Hendren DG, Kane CJ. Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing. Exp Mol Pathol 2003; 74(3): 244-55.

Karring T, Cumming BR, Oliver RC, Loe H. The origin of granulation tissue and its impact on postoperative results of mucogingival surgery. J Periodontol 1975; 46(10): 577-85.

Scheyer ET, Nevins ML, Neiva R, Cochran DL, Giannobile WV, Woo SB, et al. Generation of site-appropriate tissue by a living cellular sheet in the treatment of mucogingival defects. J Periodontol 2014; 85(4): e57-e64.


  • There are currently no refbacks.

Copyright (c) 2018 Journal of Oral Health and Oral Epidemiology

Creative Commons Attribution-NonCommercial 4.0

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.