P et al.

BMC Oral Health (2024) 24:41 BMC Oral Health

https://doi.org/10.1186/s12903-023-03777-3

RESEARCH Open Access

Importance of periodontal phenotype

in periodontics and restorative dentistry:
a systematic review
Mohan Kumar P1*, Raghavendra Reddy Nagate2, Saurabh Chaturvedi3*, Manae Musa Musleh Al-Ahmari2,
Mohammed A. Al-Qarni4, Shankar T Gokhale2, Abdul Razzaq Ahmed3, Ahmed Al Bariqi2, Marco Cicciù5 and
Giuseppe Minervini6,7*

Abstract
Background Periodontal phenotype is regarded to be one of the key factors influencing the efficacy of restorative
therapies in dental practice. The objective of the systematic review was to explore the importance of thin and thick
periodontal phenotypes and how they affect the outcome of periodontal and restorative therapies by looking at a
number of academic publications from various online databases.
Methods Following the PRISMA guidelines (Preferred Reporting Items for Systematic Review standards), relevant
data will be searched and retrieved from three significant scientific databases, including PubMed, EBSCO, and Scopus.
The articles with full texts that matched the keywords and published in English between 2018 and 2023 were taken
into consideration.
Results The majorities of these articles were based on the type of periodontal phenotype and their impact on
periodontal and restorative treatment outcomes were selected. The initial search yielded a total of 530 articles.
Only 273 were relevant to the review’s objectives, and these were considered for determining eligibility. Only 20
publications were eligible for analysis.
Conclusion Understanding these anatomical aspects of periodontal phenotype is crucial to both periodontology
and restorative dentistry. The clinical outcome of restorative, prosthetic, orthodontic, surgical, and periodontal
therapies is determined in large part by the periodontal phenotype, which also plays a significant role in clinical failure
or success in dental treatments.
Trial registration This study protocol registered with the International Prospective Register of Systematic Reviews
(PROSPERO) dated 16th June 2023 with the registration ID CRD42023432568.
Keywords Periodontal phenotype, Periodontics, Restorative dentistry

*Correspondence:
Mohan Kumar P
[email protected]
Saurabh Chaturvedi
[email protected]
Giuseppe Minervini
[email protected]
Full list of author information is available at the end of the article

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sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and
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P et al. BMC Oral Health (2024) 24:41 Page 2 of 10

Introduction Dental professionals must have a sufficient understand-

Periodontal phenotypes are classified based on three ing of current key changes in the periodontal phenotype
essential features. These three factors are bone morpho- in order to focus knowledge towards the best possible
type, keratinized tissue width, and gingival thickness. early diagnosis of patients. Several methods for improv-
Each of these elements is essential to maintaining peri- ing or supplementing KT or GT have been suggested.
odontal health [1, 2]. However, it is currently unknown whether phenotype-
The term “gingival phenotype” refers to the morpho- modifying therapy (PMT) affects long-term periodontal
logical characteristics of the gingiva and the periodon- and restoration treatment results [25, 26].
tium, while the terms “periodontal biotype, “periodontal This systematic research set out to investigate the sig-
morphotype, “gingival morphotype,” and “gingival pheno- nificance of thick and thin periodontal phenotypes for
type” relate to the variations in the thickness of gingiva preserving periodontal health, especially prior to under-
(GT) and width of keratinized tissue (KTW). The bone going extensive restorative procedures.
morphotype, keratinized tissue, and gingival thickness
make up the periodontal phenotype. The gingival phe- Methods
notype is made up of the latter two elements, which are Study design and setting
located beneath the bone [3–6]. By adhering to PRISMA (Preferred Reporting Items for
Gingival thickness, KTW and bone morphotype were Systematic Review and Meta-Analysis), this systematic
three important parameters used to categorize biotypes review concentrated on determining the importance of
and they were important in development or progression thin and thick periodontal phenotype in restorative and
of mucogingival defects [7–9]. “Thin-scalloped, “thick- periodontal procedures. The purpose of this system-
scalloped,” and “thick-flat” periodontal biotypes are the atic review was to provide a comprehensive overview of
three types of periodontal biotypes that are taken into the role and impact of periodontal phenotype on dental
consideration in the World Workshop on the Classifica- treatment outcomes.
tion of Periodontal and Peri-Implant Diseases and Con- This review was conducted from June 2023 to August
ditions in 2017 [10–12]. 2023. The review covered publications from 2018 to
The final aesthetic outcome of periodontal and restor- 2023. This study’s analysis was conducted using JiraTM
ative treatment methods depends on a variety of factors. data analysis software. The Critical Appraisal Skills Pro-
The evaluation of the surrounding soft and hard tissues, gramme (CASP) checklists were used to independently
which will be crucial to the success of periodontal and evaluate the study’s quality. Two distinct observers metic-
restorative therapies, is the most crucial of them [13–15]. ulously extracted the final data and reported their work.
Although gingival and bone thicknesses are known to As indicated by the Kappa score of 0.75, there was good
influence treatment outcomes, various periodontal phe- inter-observer agreement. The Boolean operator’s AND/
notypes may respond variably to inflammatory, surgical, OR/NOT was employed in PubMed to either restrict or
and restoration techniques. After surgical procedures, expand the search to include all potential articles.
poor treatment results are linked to a thin periodontal The research question in this study was “How the thin
phenotype. In patients with thin GT, extra operations are and thick periodontal phenotype affected the periodontal
typically required, whereas in people with thicker tissues, and restorative treatment outcome?”. This research ques-
a straightforward technique can be used [16–19]. tion is translated using PICO which consists of Popula-
Prior to beginning the restorative treatment, it is cru- tion, Intervention, Comparison, and Outcome.
cial to ascertain the tissue biotype. The thickness of the PICO Search: P- Research on human adults; I-
gingival and bone tissues influences treatment outcomes, Research both with and without intervention; C- Groups
presumably due to changes in blood supply to the under- of sites with thin or thick periodontal phenotype were
neath bone and vulnerability to resorption [20–22]. included in the research. O- Research having data on gin-
Recession is more likely to occur in individuals with gival or periodontal outcome parameters were included.
thin tissue and limited gingival width. Phenotype modi-
fication therapy (PhMT) may be beneficial for patients Literature search protocol
with thin gingival tissue and mucogingival abnormalities. The search for the articles was done by three reviewers
The amount of mucosal recession surrounding implants independently. Publications of interest within the scope
may be partially reduced through surgically changing of this focused systematic review were searched in the
the phenotypic of the peri-implant soft tissue from thin electronic database PubMed, EBSCO, and Scopus.
to thick. PhMT may improve periodontal health in orth-
odontic patients, as well as lessen problems, improve sta- Eligibility criteria for study
bility, and speed up the course of orthodontic treatment In this systematic review, research publications in
[23, 24]. English that met the following criteria were included:
P et al. BMC Oral Health (2024) 24:41 Page 3 of 10

randomized controlled trials evaluating and comparing the use of role of periodontal phenotypes on restorative
the importance of periodontal phenotype in restorative and periodontal treatment outcomes was defined.
and periodontologyy were included, controlled clini- The PRISMA (Preferred Reporting Items for System-
cal trials assessing the impact of periodontal phenotype atic Reviews and Meta-Analyses) standards were used
on restorative and periodontal treatment outcomes, and when identifying research. Figure 1 provides a flow chart.
any original research papers, case studies, and systematic The first step in the research identification process was
reviews on the periodontal phenotypes both in restor- to search three internet databases: PubMed, EBSCO, and
ative and periodontology were included. Research articles Scopus.
written in languages other than English, studies that don’t The data extraction was done by two examiners and
adhere to the objectives of the review’s research, techni- the method followed for data extracted was based on the
cal remarks, short communications, editorial letters, and public sources like journal articles, clinical trials that give
mini-reviews were not included. useful information about methods and results of included
This study protocol registered with the International articles. The collected data was used to develop outlines
Prospective Register of Systematic Reviews (PROS- of tables and figures that will appear in the review to
PERO) dated 16th June 2023 with the registration ID facilitate the design of data collection forms.
CRD42023432568. Based on the research publications A quick keyword search produced a total of 906 results.
that were available and our understanding of the subject, Only 530 publications were left after the initial screen-
we came up with a list of keywords. The significance of ing to be examined in accordance with the objectives
the terms “periodontal phenotype”, “gingival phenotype”, of the systematic review. Only 395 papers were sought
and “bone morphotype” in periodontal and restorative for retrieval, of which 273 were relevant to the review’s
treatment techniques was investigated. objectives or criteria, and these were considered for
The following terms used in the PubMed, EBSCO, and determining eligibility. From all the studies that were eli-
Scopus databases: gible, only 20 publications that provided comparative and
“phenotype“[All Fields]) AND (“treatment systematic reviews on periodontal phenotypes and their
outcome“[MeSH Terms] OR (“treatment“[All Fields] impact on periodontal and restorative treatment out-
AND “outcome“[All Fields]) OR “treatment outcome“[All comes were chosen. (Fig. 1) The included research papers
Fields]) and reviews are summarized with concluding remarks
periodontal[All Fields] AND (“phenotype“[MeSH based on their study purpose and significance. Table 1
Terms] OR “phenotype“[All Fields]) AND periodontal[All lists the features of the research papers considered in this
Fields] AND (“treatment outcome“[MeSH Terms] OR systematic review.
(“treatment“[All Fields] AND “outcome“[All Fields]) OR
“treatment outcome“[All Fields]) Risk of bias assessment
periodontal [All Fields] AND (“phenotype“[MeSH This systematic review utilized the Cochrane Risk of Bias
Terms] OR “phenotype“[All Fields]) AND restorative[All Tool to evaluate any potential risks of included articles
Fields] AND (“treatment outcome“[MeSH Terms] OR consisting of randomized clinical trials and ROB-ME
(“treatment“[All Fields] AND “outcome“[All Fields]) OR tool (Risk Of Bias due to Missing Evidence in a synthe-
“treatment outcome“[All Fields]). sis) to evaluate any potential risks in included systematic
The Rayyan website was used for the research selec- reviews. This risk assessment tool enabled us to create
tion procedure. Results of searches from other databases papers of the highest caliber with solid conclusions. The
that are duplicates will not be included. Inappropriate following criteria were used to evaluate the subjective
abstracts and titles will also be disregarded. The collected risk of bias in relevant articles and classify it into one of
studies will be examined comprehensively to ensure they three levels based on factors like sequence generation,
satisfy the predetermined inclusion and exclusion stan- allocation concealment, participant blinding, blinding
dards. They will then be evaluated for potential bias and outcome, incomplete data outcome, and selective out-
incorporated into the qualitative synthesis (Systematic come reporting. There were approximately 86.66% low
Review). risk judgments, 8.33% equivocal judgments, and 5% high
risk judgments, according to the Cochrane risk of bias
Results assessment tool (Fig. 2).
Research identification and selection A quality assessment using the CASP (Critical
The search strategy employed for this systematic review Appraisal Skill Program) scale checklist was done to
aimed to locate research publications from 2018 to 2023 determine the strengths and limitations of the chosen
that are pertinent to answering the research issues asso- studies by evaluating their methodologies. All CASP
ciated with the review’s objectives. The date last searched checklists will check the validity, results and clinical rel-
was August 2023. As part of the plan, the search field for evance of included articles of this systematic review.
P et al. BMC Oral Health (2024) 24:41 Page 4 of 10

Fig. 1 Demonstrates flow diagram of the study selection process as indicated by the PRISMA (Preferred Reporting Items for Systematic Review and
Meta-analysis)

By selecting yes, no, or not as an answer to each of the Discussion

eleven questions posed, the validity, transparency, and To improve patient satisfaction levels in terms of aesthet-
standardization of the included studies were evaluated ics and restoring the architecture and function of lost
using the CASP scale. Table 2. tooth parts as a result of the disease, it is now crucial to
understand the significance of periodontal phenotype
Qualitative synthesis and how it affects periodontal and restorative treatment
Twenty research studies were subjected to qualitative outcomes [27–30].
synthesis, with key findings extracted from each study. The treatment results are influenced by the thickness
The type of the study, type of clinical trial, the number of the gingival and bone tissues, possibly as a result of a
of participants, intervention and the treatment outcomes differential in blood flow and the underlying bone’s sus-
are all taken from the data and summarized in Table 1. ceptibility to resorption. Prior to beginning the restor-
ative treatment, it is usually crucial to ascertain the
periodontal tissue biotype. The relationship between
GT and KTW been examined by various research stud-
ies. The majority of investigations generally discovered
P et al. BMC Oral Health (2024) 24:41 Page 5 of 10

Table 1 Qualitative Synthesis Results

Sl. Cita- Type of Kind of Number of Intervention Outcome measures and summary
No tion study Clinical trial Participants
No.
1 [16] Review A Literature - Gingival health Subjects with thin and narrow gingiva tend to have more gingival
Review recession compared with those with thick and wide gingiva.
2 [17] Review A Systematic - Graft material It was observed that any graft material was able to significantly en-
review hance gingival thickness (GT).
3 [23] Review A Meta- re- - Periodontal flap Soft tissue thickness (STT) plays a limited role in predicting root cover-
gression technique age across all approaches; when flaps are performed with no graft, the
analysis effect of STT is most critical.
4 [24] An original A ran- 30 Connective tis- Both procedures were effective for root coverage at single RT1 reces-
research domized sue graft sion with previously restored cement-enamel junction (CEJ). Adding a
controlled connective tissue graft (CTG) under CAF should be considered for Rec
clinical trial with thin gingival phenotype.
5 [25] Case report Case report 1 Periodontal In patients with dentofacial deformities and a thin periodontal pheno-
Acceler- type, multi-disciplinary treatment that includes periodontal accelerated
ated Osteogenic osteogenic orthodontics (PAOO) could be effective, and could improve
Orthodontics both the quality and safety of orthodontic-orthognathic therapy.
6 [15] A Review A cluster - Sagittal craniofa- A moderate correlation was found between mandibular gingival
analysis cial profile thickness and the sagittal craniofacial profile. Patients with a concave
craniofacial profile had a smaller keratinized gingiva width and gingival
thickness in the aesthetic zone.
7 [28] A Review A Review - Allogenous Allogenous dermal matrix (ADM) is a viable option for soft tissue
dermal matrix augmentation, as well as for treatment approaches involving buccal
bone gain.
8 [29] An original A ran- 60 Sub-epithelial All the three surgical techniques for root coverage: the coronally ad-
research domized connective tis- vanced flap (CAF), with a sub-epithelial connective tissue graft (SCTG)
controlled sue graft, or with leukocyte- and platelet-rich fibrin (L-PRF) membranes produced
clinical trial Leukocyte- and significant gingival recession (GR) reduction and clinical attachment
platelet-rich level (CAL) gain
fibrin membrane
9 [31] An original A ran- 20 Mini-Five Gracey The use of Mini-Five Gracey Curettes (MFC) resulted in a greater pocket
research domized Curettes depth (PD) reduction and lower rate of recession depth (RD) in the
controlled short term.
clinical trial
10 [32] An original A multicenter 28 2018 Classifica- The 2018 Classification of Gingival Recession Defects and Gingival
research inter- and tion of Gingival Phenotype is clinically reproducible within the examiners, and when
intra-examin- Recession the variables forming the matrix are analyzed individually.
er agreement Defects and Gin-
study gival Phenotype
11 [33] An original A ran- 50 Modified Both the modified coronally advanced tunnel technique (MCAT) and
research domized coronally free gingival grafts (FGG) were successful in terms of gingival pheno-
controlled advanced tunnel type modification in the anterior mandible.
clinical trial technique
12 [39] A Review A narrative - Periodontal Periodontal diagnostic criteria should be thoroughly reviewed before
review outcomes fixed restorative treatments are planned and executed.
13 [40] A Review A consensus - Modification of Patients with thin gingival tissue and mucogingival defects may benefit
statement gingiva from phenotype modification therapy (PhMT-s) intervention and may
require a secondary procedure to achieve optimal outcomes.
14 [42] An original A compara- 28 Soft tissue Soft tissue phenotype modification, either pouch roll or modified roll
research tive cohort phenotype technique, during uncovering surgery resulted in favorable clinical
study modification outcomes.
15 [43] An original A retrospec- 111 Connective tis- Surgical modification of peri-implant soft tissue phenotype via phe-
research tive study sue grafting notype modification therapy (PhMT-s) may decrease the amount of
mucosal recession (MR).
16 [45] An original Description 1 Omega roll The omega roll envelope flap technique has shown advantages as
research of surgical envelope flap maximizes the amount of connective tissue that can be rolled within
technique the buccal flap.
P et al. BMC Oral Health (2024) 24:41 Page 6 of 10

Table 1 (continued)
Sl. Cita- Type of Kind of Number of Intervention Outcome measures and summary
No tion study Clinical trial Participants
No.
17 [46] A case A prospec- 10 Microsurgical In presence of sufficient periimplant supporting tissues and when indi-
series tive case roll-in-envelope cated, the roll-in-envelope flap (RIE) seems to yield superior outcomes
series flap reducing pain/discomfort compared to connective tissue grafts.
18 [49] An original A ran- 26 Zirconia Zirconia abutments exhibited better results than titanium abutments
research domized abutments in terms of the peri-implant tissues. Moreover, in those with a thin
controlled phenotype, zirconia provided improved gingival esthetics.
clinical trial
19 [50] A case A Retrospec- 14 Vestibular Inci- Treatment of multiple gingival recession defects with vestibular inci-
series tive Case sion Subperi- sion subperiosteal tunnel access (VISTA) and subepithelial connective
Series osteal Tunnel tissue grafts (SCTG) led to stable gingival thickness gains and shows
Access promise as a strategy for phenotype modification therapy.
20 [51] An original A Controlled 41 Connective tis- There are no significant differences in the outcomes of immediate
research Clinical Trial sue graft implant placement for patients with different soft tissue phenotypes.

Fig. 2 Risk assessment of bias by Cochrane collaboration tool

a favourable relationship between the maxillary anterior Positive features of thick gingival tissue quality that
teeth KTW and GT. Several studies assessed the rela- have been documented in the literature include resis-
tionship between periodontal phenotype and gingival tance to trauma and recession, superior soft tissue han-
thickness. In most research evaluating maxillary anterior dling properties compared with thin tissue, promotion
teeth, periodontal phenotype, GT, and KTW were found of creeping attachment, reduction in clinical inflamma-
to be positively correlated with each other. The litera- tion, and improvement of predictable surgical outcomes.
ture generally indicates that in the anterior maxilla, GT Thick soft tissue is thought to be able to survive because
and periodontal phenotype are linked. There is little and of its large extracellular matrix and collagen content as
inconsistent data available for locations other than the well as its improved vascularity [39–44].
anterior maxilla [31–38]. The success of restorative dentistry greatly depends
on the periodontal health, which is dependent on the
P et al. BMC Oral Health (2024) 24:41 Page 7 of 10

restoration’s continuing integrity. According to research,

20
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
the periodontal apparatus of teeth is extremely sensi-
tive to even the smallest environmental changes, neces-
19
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
sitating extraordinary caution to preserve periodontal
health and avoid accidental harm. This demonstrates the
18

unmistakable link between periodontal health and repair.

Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Margin, contour, occlusion, material, bridge design,
17

removable partial denture design, and restorative dental

Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
techniques are crucial factors from a periodontal per-
spective [45–48].
N/D

N/D
16
Y
Y
Y

Y
Y
Y

Y
Y
Y
Using vestibular incision subperiosteal tunnel access
(VISTA), In 2023, Min S. et al. conducted a research to
N/D

N/D

explore the kinetics of tissue thickness increase as a phe-

15
Y
Y
Y

Y
Y
Y

Y
Y
Y
notypic modification therapy measure following treat-
ment of various gingival recession disorders. Multiple
14
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

gingival recession abnormalities were successfully treated

Table 2 Quality assessments done by the Critical Appraisal Skills Program scale (CASP) for selected studies of systematic review

with VISTA and sub-epithelial connective graft (SCTG),

13

which produced sustained improvements in gingival

Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

thickness and suggested a feasible technique for pheno-

12

typic modification [49, 50].

Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

In 2020, Tatum CL, et al. undertook a study to exam-

ine the results of immediate single-implant insertion in
11
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

individuals with thick or thin tissue morphologies in aes-

thetic areas. According to the study’s findings, immedi-
N/D

N/D
10

ate implant placement results for individuals with various

Y
Y
Y

Y
Y
Y

Y
Y
Y

soft tissue morphologies do not significantly differ from

one another [51–56].
9
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

In 2021, Barootchi S. et al. published the results of a

randomized clinical experiment that looked at how gin-
8
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

gival phenotype changed after root coverage with freeze-

7
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

dried or solvent-dehydrated acellular dermal matrix

(FDADM and SDADM), respectively. The investigations
6
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

came to the conclusion that after 9 years, the results of

gingival phenotypic change were still present in both
5
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

groups and across all sites [57].

Rasperini G, et al., conducted a research in 2020 to
4
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

investigate the influence of gingival phenotype (GPh)

upon the surgical outcome of coronally advanced flap
N/D

N/D

(CAF). The study’s findings demonstrated that, when

3
Y
Y
Y

Y
Y
Y

Y
Y
Y

compared to individuals with medium, thick, and

extremely thick GPh, patients with thin GPh had the low-
N/D

N/D
2
Y
Y
Y

Y
Y
Y

Y
Y
Y

est mean root coverage and total root coverage [58].

Ahmed AJ et al. released a research in 2018, to deter-
N/D

N/D

mine the effects of interdental papillae (PIP) presence on

1
Y
Y
Y

Y
Y
Y

Y
Y
Y

periodontal biotype (PB), papillary proportions (PP), the

distance between facial and palatal papillae (DFPP), and
*Y-Yes; N-No; N/D- Not Determined
Test procedure clearly described

Confounding factors accounted

Outcome accurately measured

the base of interproximal contact area to interproximal

Appropriate outcomes used

Interpretation of evidence

bone crest (CP-BC). The results of this study show that

Clearly focused question

Appropriate recruitment

Precise statistical results

PB changed the proportion of papillae and the distance

Appropriate analysis
Appropriate design

among the facial and palatal papillae, which influenced

Matched control

the heights and existence of maxillary interdental papillae

[59–61].
Study No.

In 2021, Beire JM, et al. did a study to assess the peri-

odontal phenotype (PP) and its morphometric changes
P et al. BMC Oral Health (2024) 24:41 Page 8 of 10

Author details
in dental students with healthy periodontal tissues using 1
Department of Periodontics and Implantology, Vishnu Dental College,
cone-beam computed tomography (CBCT). According to West Godavari, Vishnupur, Bhimavaram 534202, Andhra Pradesh, India
2
the study’s findings, thick PP predominated in the sample Department of Periodontics and Community Dental Sciences, College of
Dentistry, King Khalid University, Abha, Saudi Arabia
examined, and in all measurements tested, gingival thick- 3
Department of Prosthetic Dentistry, College of Dentistry, King Khalid
ness was always thinner than bone thickness [62–74]. University, Abha, Saudi Arabia
4
Within the parameters of the current systematic review, Consultant in Restorative Dentistry, College of Dentistry, King Khalid
University, P.O.Box 3263, Abha 61471, Saudi Arabia
the prevalence of different periodontal phenotypes is 5
Department of Biomedical and Surgical and Biomedical Sciences,
associated with successful periodontal and restorative Catania University, Catania 95123, Italy
6
treatment outcomes. Understanding the significance of Saveetha Dental College and Hospitals, Saveetha Institute of Medical
and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil
periodontal phenotypes can be used to create aesthetic Nadu, India
results for individuals who needed restorative and peri- 7
Multidisciplinary Department of Medical-Surgical and Dental Specialties,
odontal therapy operations. University of Campania “Luigi Vanvitelli”, Caserta 81100, Italy

The limitation of this study was that meta-analysis of

Received: 28 September 2023 / Accepted: 14 December 2023
the periodontal phenotype impact on restorative and
periodontal treatment outcome was not possible due to
the lack of a uniform number of journals.
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Conceptualization MKP, RRN, SC; methodology MMMA, MAAQ, MC; software, et al. Comparative evaluation of locally administered 2% gel fabricated
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at King Khalid University for funding this work through a Small Group Research 9. Rai JJ, Chaturvedi S, Gokhale ST, Nagate RR, Al-Qahtani SM, Magbol MA, et al.
Project under grant number RGP 1/169/44. Effectiveness of a single chair side application of NovaMin® [Calcium Sodium
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