Palatal Donor Site Research Articles

Clinical and Patient-Reported Outcome Measures of Palatal Donor Site Healing Using Polyvinylpyrrolidone-Sodium Hyaluronate Gel as a Dressing Material Following Free Gingival Graft Harvesting: A Randomized Controlled Clinical Trial.

This study evaluates the efficacy of polyvinylpyrrolidone-sodium hyaluronate (PVP-SH) gel as a dressing material in enhancing both clinical and patient-reported outcomes post-free gingival graft (FGG) harvesting from the hard palate. This randomized clinical trial included 18 patients and spanned from June 2022 to August 2023. Patients received an FGG procedure to manage a lack of attached gingiva. Following graft harvesting, patients were divided into two groups: the control group, which received Coe-Pak, and the test group, which was treated with PVP-SH gel. The primary outcome measured was complete epithelialization. Secondary outcomes included the Landry healing scale, post-operative pain level, and patient willingness to receive the same treatment again. The test group reported significantly lower analgesic use (p < 0.001) and reduced pain severity (p < 0.001) compared to the control group. Furthermore, test group patients indicated a higher level of satisfaction regarding the prospect of retreatment. In contrast, the control group showed significantly slower progress in wound healing and epithelization (p < 0.05) compared to the test group. The findings of this study suggest that PVP-SH gel is a superior dressing material post-FGG harvesting, yielding improved clinical and patient-reported outcomes relative to Coe-Pak.

Impact of platelet-rich fibrin derivatives on patient morbidity and quality of life in palatal donor sites following free gingival graft surgery: a randomized clinical trial.

Platelet concentrates are biomaterials with significant potential in tissue regeneration, functioning as scaffolds with greater leukocyte inclusion and a flexible fibrin mesh. However these concentrates have different preparation methods and biological properties. The objective of this clinical investigation was to evaluate the effects of utilizing platelet-rich fibrin (PRF) materials (L-PRF and A-PRF) as a palatal bandage following free gingival graft (FGG) on patients' morbidity and oral health-related quality of life. Thirty-nine participants received FGG to promote keratinized tissue and treat gingival recession. Participants were randomly assigned to L-PRF, A-PRF, and control groups, with 13 participants in each. They used a visual analog scale (VAS) to rate their pain, analgesic medication use, dietary changes, discomfort, and bleeding at 1-7 days, 14 days and 1 month during the healing process. Patients' quality of life was assessed using the Oral Health Impact Profile (OHIP-14) at baseline, 1-7 days, 14 days, 1 month, and 6 months. There was no difference in anxiety levels between the all groups. (p > 0.05). The control group had higher OHIP-14 total scores than the other groups, but the differences were not statistically significant, especially in the first seven days (p > 0.05). In addition, the PRF groups showed an improvement in quality of life after 14 days, 1 month, and 6 months (p < 0.05). Patients' pain and suffering decreased with healing. The control group took more postoperative analgesics than PRF groups. In addition, there was a significant decrease in patient complaints about medicine intake, bleeding, pain, perceived sensitivity, and dietary modifications in all groups during follow-up. PRF palatal bandages may improve patient's quality of life, donor site healing, postoperative pain and morbidity. This study found that preserving the palate in FGG and employing PRF materials that speed palate healing reduce discomfort and morbidity.

Qualitative somatosensory evaluation of recipient and donor sites of subepithelial connective tissue grafts: a preliminary study.

The subepithelial connective tissue graft (SCTG) plus coronal advanced flap is commonly evaluated by clinical parameters, but potential sensory changes (patients' perception of painful or painless sensations) need to be further explored. This preliminary study aimed to qualitatively evaluate the somatosensory profile of recipient and palatal donor sites of SCTG. Sensory tests were applied at SCTG recipient and donor sites at baseline, after 3 and 6 months. A single calibrated examiner applied Douleur Neuropathique 4 questionnaire (DN4), qualitative sensory test (QualST), discriminating the areas as hypersensitive, hyposensitive or normosensitive, and two-point acuity test. Descriptive statistics, non-parametric Kruskal Wallis test for QualST evaluation and ANOVA for Two-point test (p < 0.05) were used. QualST revealed that recipient areas presented no significant differences in tactile, pressure and thermal tests. Brush test revealed hyposensitivity after 3 months (p = 0.03). In donor areas, only thermal evaluation showed a significant difference (p = 0.01), being hypersensitive after 3 months and hyposensitive after 6 months. At baseline, all evaluations in recipient and donor areas were normosensitive. According to DN4, no patient reported pain in recipient and donor sites. Non-painful sensory perception was reported as numbness in recipient (3.14% of patients) and donor (18.4%) areas. No significant differences were found for two-point acuity test values. Somatosensory variations were observed in donor and recipient areas using qualitative tests, with no detection of painful sensations, only non-painful sensations of numbness and electric shock. This preliminary study demonstrated that alterations of hypo- and hypersensitivity may occur in donor and recipient areas of gingival grafts. However, when present, these alterations were non-painful and did not impact oral functions. ReBEC #RBR-7zz3b6p.

Comparison of the effect of A-PRF and L-PRF application to palatal donor sites on quality of life and wound healing after free gingival graft surgery.

This study compared the effects of leukocyte platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) on patients' quality of life and the healing of palatal wounds after free gingival graft harvesting. After free gingival graft harvesting, palatal donor sites of 36 patients were assigned to one of three groups: L-PRF group, A-PRF group, or palatal stent + periodontal pack group (control group). Wound healing was evaluated by H2O2 test. Pain was evaluated by visual analog scale and number of analgesics consumed. For patient quality of life, the Oral Health Impact Profile-14 (OHIP-14) questionnaire was utilized. Complete epithelialization was higher in the control group on day 7 than in the test groups (P < .05). Complete epithelialization was achieved in all groups 14 days postoperatively. Visual analog scale scores for pain and the number of analgesic tablets consumed were similar in all groups (P > .05). OHIP-14 total scores were similar in all study groups at 7 days postoperatively (P > .05). OHIP-14 total and physical pain score was lower in the L-PRF group than the A-PRF group at 14 days postoperatively (P < .05). Aside from the slight superiority of L-PRF over A-PRF, it can be concluded that both PRF procedures have similar effects on palatal wound healing and quality of life.

Recombinant human platelet-derived growth factor-BB-soaked gelatin sponge reduces patient pain in palatal graft donor sites

The free gingival graft (FGG) remains a gold standard for treating mucogingival defects and increasing the width of keratinized tissue. However, patients receiving FGG surgery report substantial post-operative discomfort, bleeding, and swelling, more so than those receiving connective tissue grafts, for example, and some of these post-operative sequelae can be difficult to manage. Various techniques are utilized in achieving hemostasis, but no current techniques effectively reduce the pain and discomfort to the patient. Ten FGGs were harvested from the palates of 10 patients to treat mucogingival deficiencies elsewhere in each patient. Immediately (&lt;1 min) after harvesting the FGG, a gelatin sponge soaked in recombinant human platelet-derived growth factor-BB (rhPDGF-BB) was placed into the wound site and sutured in place with absorbable sutures. Patients were followed up on days 3, 7, and 14 for assessing pain levels utilizing patient-reported outcome measures (PROMs), which incorporate the visual analog scale and the quantification of analgesics consumed. Clinically, the rhPDGF-BB/gelatin sponge-treated FGG palatal donor sites began to heal by day 3 of follow-up, and the healing was completed during the visit on day 14. No adverse effects, including swelling or bleeding, were observed at any of the post-surgical time points. According to the visual pain score, patients experienced minor discomfort, but no dissatisfaction was reported. Patients whose palatal FGG donor site was treated with a gelatin sponge soaked in rhPDGF-BB reported little or no post-surgery discomfort and low morbidity at the donor site within 2 weeks. These findings are in sharp contrast to the well-known substantial discomfort most patients experience following the harvesting of a palatal FGG. The data suggest that treating FGG palatal donor sites with rhPDGF-BB-soaked gelatin sponge can improve patient experience.

Chitosan-based dressing for management of palatal donor site: A randomized clinical trial.

This study aimed to evaluate the effectiveness of a chitosan-based dressing (CD) in achieving early wound healing and hemostasis at palatal donor sites in patients undergoing free gingival graft (FGG) surgery. Thirty-two patients requiring FGG were treated in this randomized controlled clinical trial. Complete epithelialization (CE) and color match (CM) at donor sites were assessed by a blinded examiner on postoperative days 7, 14, 21, and 28. Donor sites were compressed for 2 min with wet gauze (WG) alone in control group (CG) or WG + CD in test group (TG) immediately after graft harvesting, and immediate bleeding (IB) was recorded (yes/no). Delayed bleeding (DB) (for 1 week), and number of analgesic tablets consumed, and VAS scores for pain (for 2 weeks) were recorded by patient every day. Twenty-eight patients (14 in each group) were included in final analysis. The prevalence of CE (at weeks 2 and 3) and VAS scores for CM scores were higher in TG but the intergroup differences were statistically significant only for CM (at week 4). Number of patients exhibiting IB and DB was significantly fewer in the TG (p < .05). Although average pain scores and analgesic consumption were higher in TG up to 5 days, differences between two groups were not statistically significant at any time point. Our data suggests that the application of CD increased re-epithelialization and accelerated wound healing process, although it did not reach statistical significance. Moreover, CD was found to significantly reduce bleeding complications, but it did not decrease the pain levels.

Ultrasonographic analysis of palatal donor site healing accelerated with platelet-rich fibrin following subepithelial connective tissue harvesting.

Platelet-rich fibrin (PRF) contains a variety of growth factors and bioactive molecules that play crucial roles in wound healing and angiogenesis. We aimed to evaluate the effects of PRF on tissue thickness and vascularization of the palatal donor site by ultrasound (USG) following subepithelial connective tissue harvesting. A subepithelial connective tissue graft was harvested from the palatal region with a single incision for root coverage in 20 systemically healthy patients. In the test group (n = 10), the PRF membrane was placed at the donor site, whereas no material was applied in the control group (n=10). Palatal tissue thickness (PTT) and pulsatility index (PI) were evaluated by USG at baseline and on the 3rd, 7th, 14th, 30th, and 90th days after surgery. The early healing index (EHI) was used to evaluate donor site healing for 30 days. PTT was significantly higher in the PRF group on the 3rd and 14th days after surgery when compared to the controls. In the PRF-treated group, PI levels were significantly higher than in the controls, especially on the 14th day. PTT increased significantly 90 days after surgery compared to the test group baseline, but controls showed a significant decrease. The PRF group showed statistically significant improvements in EHI scores compared to controls on days 3, 7, and 14. This study found a negative correlation between PI values and EHI scores on postoperative days three and seven in the test group. USG is a non-invasive, objective method to radiographically evaluate the regenerative effects of PRF on palatal wound healing after soft tissue harvesting. To overcome graft inadequacy in reharvesting procedures, PRF application may enhance clinical success and reduce possible complications by increasing tissue thickness and revascularization in the donor area.

Patient Reported Outcome of Palatal Donor Site After Harvesting Connective Tissue Graft With or Without Platelet-rich Fibrin: A Prospective Clinical Study

Aim: To evaluate the palatal donor site after harvesting connective tissue graft with or without platelet-rich fibrin (PRF). Material and Methods: Forty-two patients requiring connective tissue grafting were randomly divided into two groups: the experimental palatal donor site ( n = 21) received PRF before suturing, and the control palatal donor site ( n = 21) was sutured without any PRF. Results: Among 42 enrolled patients requiring connective tissue grafting, 34 patients completed the study. After 10 days, there was an increase in the average thickness of the palatal surgical test site in PRF-treated patients, whereas it decreased in non-PRF-treated patients. Patients’ response and acceptance for the surgical treatment modality in terms of Patient Comfort Score (PCS) and Patient Appearance Score (PAS) showed less discomfort and better/pleasing appearance in the experimental group after treatment as compared with the control group. “Absolute contour match” of the healing lesion to adjacent mucosa was observed in 76.5% of experimental sites, and no “absolute contour match” was observed with the adjacent non-surgical tissue in the control group, whereas, at 3 and 12 weeks, a 100% “absolute match” with the adjacent tissue was observed for all esthetic parameters in both groups. Conclusion: PRF usage at the donor site seems to be a simple less-invasive approach of high significance resulting in more accelerated physiological healing phenomenon and better early healing response.

Effect of an Oral Ointment Containing Propolis on Palatal Donor Site Pain and Wound Healing After Harvesting a Free Gingival Graft: a Split-Mouth, Double-Blind Clinical Trial

Effect of an Oral Ointment Containing Propolis on Palatal Donor Site Pain and Wound Healing After Harvesting a Free Gingival Graft: a Split-Mouth, Double-Blind Clinical Trial

The effectiveness of Turmeric gel in the healing of donor site for Free Gingival Graft

BACKGROUND: Preparation of turmeric extract gel with a concentration of 10% and comparing it with non-eugenol gingival dressing (Coe-PakTM) in the healing and re-epithelialization of palatal donor site after free gingival graft, and reduction of postoperative pain.MATERIALS AND METHODS: This study was conducted on twenty-two patients with lack of attached gingival tissue for various reasons and received soft tissue augmentation via free gingival grafts. Participants were randomly divided into two equal groups: group I (test) was treated with 10% turmeric gel while group II (control) was treated with (Coe-PakTM). Both pain level index which assessed by using the Visual Analogue Scale (VAS) and Analgesic consumption index were recorded for 7 days after surgery. The healing index, the color match index, and the re-epithelialization index were assessed on days 7, 14, 21, and 28. Finally, wound size index was measured via periodontal Probe at baseline and days 7, 14, 21, 28, and after 2 months.RESULTS: Group I showed significant pain reduction measured by VAS and analgesic consumption on day 3, 4, 5, 6, 7 (p&lt;0.05) with no significant difference on the first two days (p&gt;0.05). Group I demonstrated significant acceleration in the initial healing process during the 1st week (p=0.002) and 2nd week (p=0.01) with no significant difference between both groups in the 3rd and 4th weeks (p&gt;0.05). Group I showed statistically higher VAS for the color match on day 7, 14, 21, and 28. No statistical difference was noted between the groups after two months. There was no statistical difference between groups I and II in the re-epithelialization and wound size index at any of the follow-up periods (p&gt;0.05).CONCLUSION: 10% turmeric extract gel showed relief of post-operative pain, acceleration of the healing process, and better outcomes in terms of the color match for the palatal wound after free gingival grafting procedure comparing to the Coe-PakTM periodontal dressing.KEYWORDS: Curcumin; Free gingival graft; periodontal dressing; donor site

Patient-reported outcome measures (PROMs) of leucocyte and platelet-rich fibrin (L-PRF) or hemostatic agent application at palatal donor sites after free gingival graft harvesting: a randomized controlled clinical trial.

The aim of this study was to evaluate the patient's morbidity and post-surgical complications after treatment of palatal donor sites after free gingival graft (FGG) harvesting using Leucocyte-and Platelet Rich Fibrin (L-PRF) membranes or a hemostatic agent with oxidized and regenerated cellulose. Forty-two palatal donar sites after FGG haversting in 42 patients were randomly assigned to experimental (L-PRF membrane) or control procedure (hemostatic agent). The primary outcome was postoperative pain related to the wound located at palatal area, while the secondary outcomes were post-operative discomfort, inability to chew, post-operative stress, surgical chair time, thickness of palatal fibromucosa and thickness of FGG. The PROMs were recorded after one week. After one week, a statistically significant difference was found between groups in terms of post operative stress (p=0.0083). No statistically significant differences in terms of postoperative pain (p=0.326), patient discomfort (p=0.509), inability to chew (p=0.936), surgical chair time (p=0.932) were recorded between test and control group. No statistically significant differences were recorded in terms of thickness of palatal fibromucosa (p=0.647) and thickness of FGG (P=0.756) between groups. Post-surgical wound healing complications (i.e., necrosis or infections) were not observed in both groups. Within their limitations, the present outcomes indicated that the application of L-PRF membrane at palatal donor sites after FGG harvesting did not produce significant advantages for the patients.

GUIDED PERI-IMPLANT AUTOGENOUS SOFT TISSUE GRAFTING: CASE REPORT.

This case report showed the proof-of-concept of a guided free gingival graft around a dental implant. A 65-year-old male presented to replace his 30 and 31. Once the osseointegration of the 2 implants placed by guided surgery has been achieved, a free gingival graft was indicated. The surgical planning of this graft was performed using the Cone Beam Computed Tomography and archs digital scanning already used for implant placement. The greater palatine foramen and gutter were radiologically located to protect their arterial content. Two surgical guides were designed, one for the palatal donor site and one for the recipient site. The first one will serve both as an incision guide and as a post-operative protective plate. The procedure was free of adverse events. At the 1-year recall, the average gain in keratinized tissue width amounted 2.5 mm. This guided surgery could be used in a patient with insufficient amount of keratinized tissue around a posterior implant. For the first time, it makes it possible to anticipate, accelerate and secure the intervention, to improve the practitioner's comfort and potentially the outcomes of free gingival grafts. Further research and clinical are needed to validate this protocol and to assess its long-term impact on peri-implant health.

Cyanoacrylate and hyaluronic acid combination on palatal donor site management after de-epithelialized graft harvesting.

Although soft tissue substitutes showed promising improvement in the past decade, epithelialized gingival graft (EGG) is still widely used in periodontal plastic surgery applications. Donor site management after EGG harvesting has been challenging for clinicians. This study aimed to compare the effectiveness of cyanoacrylate, hyaluronic acid, and their combination in palatal donor site management after EGG harvesting. Data from 89 patients were included and categorized as gelatin sponge (GS), gelatin sponge with either cyanoacrylate (GS+CY), hyaluronic acid (GS+HA), or both (GS+CY+HA). The data of pain perception (PP), quantity of analgesics (QA), secondary bleeding (SB), epithelization level (EL), and color match (CM) were assessed retrospectively. The GS+CY and GS+HA+CY groups showed lower PP scores compared to the GS and GS+HA groups (p<0.05). The QA was higher in the GS group compared to the GS+CY and GS+HA+CY groups (p<0.001). All study groups showed greater EL than GS group on day 7 (p<0.001). On day 14, full EL was present in 81% of the patients in the GS+HA+CY group, which was higher than the other groups (p<0.001). All study groups reported lower SB in the first 3 days, which was lower compared to the GS group (p<0.001) and showed higher CM scores than the GS group on days 7 and 14 (p<0.001). CY application reduces pain and analgesic intake and HA may support the wound healing with increased EL. Using the CY-HA combination provides additional benefits for donor site management.

Predictability of free gingival graft in management of gingival recession: A case series

This case series study predictability of free gingival graft in management of gingival recession. 3 cases with mucogingival problems needing free gingival grafts were selected. First, the recipient site was anesthetized and de-epithelialization was done and recipient bed was prepared. After tracing the palatal donor site with the aluminium foil template, bleeding points marked and graft was harvested. For root modification of the recipient tooth, conditioning of the dentin was done by the EDTA. Graft is closely adapted over the recipient with Oschenbein and circumferential sutures so there was no dead space left between the root surface and graft, by 5-0 monofilament suture. In case I and III where Miller’s Class II and I gingival recession respectively, there is complete root coverage achieved and in case II Miller’s Class III type of gingival recession present 80% root coverage possible. FGG best alternative for the treatment of gingival recession presents with inadequate width of attached gingiva and depth of vestibular fornix but main disadvantage of FGG is unesthetic appearance, two donor site, donor site morbidity, age and limitation of patient systemic condition. So proper case selection along with definitive treatment planning for every case is necessary.

Analysis of Clinical Outcomes in Connective Tissue Donor Site Healing With Two Different Suturing Protocols: A Prospective Case Control Study

Background: Connective tissue harvesting from the hard palate has been practiced since decades and remains the ‘gold standard’ for soft tissue grafts. Very little has been researched on healing patterns of the palatal donor site and the incidence of post-operative complications of donor site. Aim: The aim of the study was to evaluate the influence of two different suturing methods on the healing outcomes of donor site after Connective Tissue Graft (CTG) harvsting. Material and Methods: Thirty patients who had undergone CTG harvest for various procedures were analyzed for the assessment of clinical healing outcomes of palatal donor site. A similar technique for the harvest of CTG in both groups was used using Liu’s class Ia incision. The method of closure of the donor site in these patients was divided into two groups; Group A – combination of criss-cross and horizontal mattress sutures and Group B – simple interrupted sutures. The parameters assessed preoperatively were palatal tissue thickness, intraoperative superficial palatal flap thickness and postoperatively the incidence of post-operative complications and donor site healing was assessed using Wachtel’s index (2003) at 7 days, 14 days and 1 month postoperatively. Results: The incidence of complications was more in Group B in comparison to Group A. The healing outcomes differed significantly between Group A and B at 7 days, 14 days and 1 month postoperatively; however, there was no statistically and clinically significant difference at 03 months post operatively. Conclusion: The combination of criss-cross with horizontal mattress suture for closure of palatal donor site after harvesting with Liu’s Class Ia incision was found to yield superior patient comfort and lesser post-operative complications during the early healing period.

Effect of GaAlAs 940 nm Photobiomodulation on palatal wound healing after free gingival graft surgery: a split mouth randomized controlled clinical trial

BackgroundThe aim of this study was to evaluate the effects of photobiomodulation (PBM) on wound healing, pain, and discomfort at free gingival graft (FGG) donor sites.MethodsSixteen patients in need of bilateral FGG were selected for this randomized, controlled, triple-blinded, and split mouth clinical trial. The FGG donor sites in test group were treated with LLLT GaAlAs 940 nm, 5 J/cm2 immediately after surgery and every other day within the following ten days. The control group received sham irradiation. Remaining Wound Area (RWA), Epithelialization and color match were evaluated on the day of surgery and 7, 14, 21, 28, and 60 days after surgery. A questionnaire was administered to measure pain and bleeding in the first ten days after surgery.ResultsRWA was significantly smaller in the test than control group on the days 7 (p < 0.001) and 14 (p = 0.048) after the surgery. Bleeding was higher in the test group than in the control group on the day of surgery (p = 0.046). Pain and discomfort at the palatal donor site, however, had no significant difference between laser and control group during 11 days after the surgery (p > 0.05), nor did the Color match scores on the 28th and 60th days after the surgery (p > 0.05).ConclusionsIt can be concluded that PBM enhances FGG donor site wound healing one and two weeks after the surgery.Trial registrationIRCT2017092036203N2, registered 01.11.2017.

Three-Dimensional Volumetric Analysis of the Palatal Donor Site Following Soft Tissue Harvesting.

Autogenous soft tissue grafting is a commonly performed procedure in periodontal and implant surgery. Reharvesting a connective tissue graft (CTG) from the same palatal donor site is often required, but little is known about the volumetric changes that occur after harvesting a free gingival graft and how long the palatal mucosa takes to regain its original form and thickness. This study evaluated the volumetric changes that occur at the palatal donor site after harvesting a soft tissue graft with a noninvasive digital technology. Nineteen patients needing a CTG for a single site were enrolled. Intraoral digital scans of the palatal donor sites were obtained at baseline and at 1, 3, 6, and 12 months. The digital scans were imported and analyzed with an imaging software to evaluate volumetric changes. Average volume losses of 5.82 ± 2.63 mm3 and 11.03 ± 5.47 mm3 were observed after 1 and 3 months, respectively. Only minor changes were observed at 6 and 12 months. Linear dimensional changes at 5 and 7 mm from the gingival margin were substantially higher than the changes at 3 mm for the 1- and 3-month interval comparisons compared to baseline. Graft dimension was associated with volume loss at 1 and 3 months (P < .01). After palatal harvesting, the donor site undergoes volumetric changes, mostly during the first 3 months, and is attenuated thereafter.

Optimized Healing of the Donor Wound Area with Ora-Aid, the Miracle Mix Containing Polymers and Vitamin E: A Case Series

Aim: To assess the donor site (in the palate) wound healing in free gingival graft (FGG) procedures after the placement of Ora-aid wound dressing. Methods: A total of five patients who underwent treatment for isolated gingival recession with free gingival graft procedure were enrolled for the study. The palatal donor site was covered with Ora-aid instead of the traditional acrylic stent.The various parameters assessed were: thickness of palate, pain using the visual analogue scale (VAS), measurement of size of surgical wound, wound healing assessment, direct visual assessment of oedema, suppuration, haemorrhage and necrosis and patient satisfaction through direct interaction/communication. Thus, the purpose of this case series was an objective observation of the donor site after the placement of Oraaid dressing. Results: All of the enrolled subjects showed significant improvement of the wound healing parameters. No untoward post-operative complications were reported. Conclusion: Ora-aid can contribute to a substantial reduction in patient discomfort and thus can be a substitute for the acrylic stent

To Evaluate Aloe Vera- Chitosan Based Surgical Dressing to Chitosan Dressing Alone on the Healing of Palatal Donor Sites - A Pilot Study

The present study was undertaken to clinically assess the synergistic effect of topically applied Aloe vera Chitosan to Chitosan alone on the healing of palatal donor sites in free gingival graft surgical procedures. 20 subjects (10 per group) were enrolled into this triple blinded randomized clinical trial, designed to evaluate the efficacy of Aloe vera Chitosan to Chitosan on free gingival graft surgical wounds. Subjects were assigned to either Group A (aloe vera + Chitosan) or Group B (Chitosan alone). Visual Analog Scale(VAS) and Wound healing index were recorded at 7th day, 14th day and 21 days postoperative. Results showed no statistical significance when considering VAS. However there was a statistical significance in wound healing (p=0.04) in group A when compared to group B from 14- 21st day postoperative. It is the first human trial and was a pilot study to assess the synergistic effect of Aloe vera and Chitosan on wound healing. The study has shown that a combination of both acts synergistically in accelerating healing especially in areas where faster healing is necessary to provide overall comfort to the patient. It is therefore a futuristic and a promising material as a surgical dressing with further longitudinal trials.

Clinical evaluation of root coverage using coronally positioned flap associated with acellular dermal matrix allograft in single-type recession defects. A retrospective study.

The aim of this study was to conduct a retrospective assessment of the clinical results at 6,12 and 24 months of root coverage in single gingival recessions using coronally positioned flap and acellular dermal matrix allograft. Clinical records were collected from 16 patients with single gingival recessions who visited a private practice in Periodontics in 2005 and 2006. They were treated through a coronally positioned flap and acellular dermal matrix allograft. The following periodontal parameters were recorded at baseline, 6, 12 and 24 months: Recession Depth, Recession Width, Probing Depth, Clinical Attachment Level, Keratinized Tissue Width, Plaque Index, Gingival Index and Sensitivity. The percentage of root coverage was 91.18 ± 21.26 at 6 months, 90.18 ± 22.04 at 12 months and 90.83 ± 18.41 at 24 months. Complete root coverage was 81% (13 out of 16) at 6 and 12 months. At 24 months, complete root coverage was 75% (9 out of 12). The plaque and gingival indexes did not vary significantly between baseline and measurement times. Probing depth was maintained at healthy levels during the months of follow-up. Sensitivity decreased at 12 months (4 of 16) compared to baseline (14 of 16), and was maintained at 2 years (2 of 12). This retrospective study showed that acellular dermal matrix allograft could be considered a useful alternative for the treatment of single gingival recessions, reducing the discomfort and morbidity associated with the palatal donor site.