The influence of palatal harvesting technique on the donor site vascular injury: A split-mouth comparative cadaver study.

Abstract

The aim of this study was to evaluate the influence of two harvesting approaches on the donor site vascular injury. A split-mouth cadaver study was designed on 21 fresh donor heads. Every hemi-palate was assigned to receive the trap-door harvesting technique (TDT) or the epithelialized free gingival graft harvesting technique (FGGT). A soft tissue graft was harvested from each side for histology analyses. Betadine solution was used to inject the external carotid artery and a collagen sponge was positioned over the harvested area to compare the amount of "leakage." The mean leakage observed was 16.56±3.01 µL in the FGGT-harvested sites, and 69.21±7.08 µL for the TDT group, a ratio of 4.18 (P<0.01). Regression analyses demonstrated a trend for more leakage at thinner palatal sites for the FGGT group (P=0.09), and a statistically significant correlation for the TDT-harvest sites (P=0.02). Additionally, a shallow palatal vault height (PVH) was associated with a higher leakage in both harvesting groups (P=0.02). The histomorphometric analyses revealed that grafts harvested with TDT exhibited a significantly higher mean number of medium (ø=0.1 to 0.5mm, P=0.03), and large vessels (ø ≥ 0.5mm, P=0.02). Within the limitations of the present research, the TDT resulted in a significantly higher leakage than the FGGT, which was also correlated with the histology analyses where a greater number of medium and large vessels were observed in the harvested grafts.