# Gingival Thickness Improvement After Atelocollagen Injection—Retrospective Study

## TL;DR

Injecting atelocollagen increases gum thickness, with long-term benefits when maintenance doses are given every six months.

## Contribution

This study demonstrates the long-term effectiveness of atelocollagen injections for modifying gingival thickness with maintenance therapy.

## Key findings

- Group A showed sustained improvement in gingival thickness over five years with maintenance therapy.
- Group B experienced a gradual decrease in effectiveness without maintenance therapy.
- Statistical models confirmed significant Group × Time interactions in thickness outcomes.

## Abstract

Background: This study evaluates the increase in gingival thickness following the administration of injectable atelocollagen. Materials and Methods: A retrospective analysis was conducted using the medical records of 60 patients with a thin gingival phenotype at baseline, treated between 2017 and 2025. All patients received a standardised protocol for soft tissue thickness modification using atelocollagen injections. Based on the continuation of maintenance therapy, patients were divided into Group A (n = 30), consisting of patients who received booster doses at six-month intervals following completion of the full treatment protocol, and Group B (n = 30), consisting of patients who did not continue maintenance therapy. The observation period for all patients was five years. Gingival thickness was assessed by periodontal probe transparency using a standard WHO probe (WHO 621) and the Hu-Friedy Colorvue Biotype Probe. Longitudinal changes were analysed using linear mixed-effects models (LMMs) for continuous outcomes and generalised linear mixed-effects models (GLMMs) with a binomial distribution and logit link for binary outcomes, accounting for repeated measurements at the patient level. Results: Significant effects of Group and Time, as well as their interaction, were observed for the proportion of sites with a thick gingiva (Group effect: F (1,93.14) = 57.94, p < 0.001; Group × Time interaction: p < 0.001). GLMM analysis confirmed a significant Group × Time interaction (χ2 = 23.11, p < 0.001), indicating sustained gingival thickness improvement in Group A and a gradual decrease in effectiveness in Group B. Conclusions: Injectable atelocollagen represents a reliable, effective, and user-friendly method for long-term modification of gingival thickness, particularly when supported by maintenance therapy.