Palatal Donor Site Research Articles

Clinical Comparison of MEBO and Hyaluronic Acid Gel in the Management of Pain after Free Gingival Graft Harvesting: A Randomized Clinical Trial.

Aim This study aimed to compare the effect of MEBO versus 0.2% hyaluronic acid gel (Gengigel®) applied to the palatal donor site on postoperative pain reduction and wound healing after free gingival graft harvesting. Methodology. Thirty-nine patients with different mucogingival defects were included in this study for harvesting a free gingival graft (FGG) for soft tissue augmentation. Patients were randomly assigned into three equal groups: group I (MEBO), group II (0.2% HA Gengigel®), and group III (control). Postoperative pain was recorded by using the Visual Analogue Scale (VAS). Analgesic consumption was recorded for 7 days postoperatively. Wound size was measured at baseline and on days 3, 7, 14, and 21. Postoperative healing of the palatal wound was assessed by the VAS score for color match on days 3, 7, 14, 21, and 42. Results Results of this study showed significant postoperative pain reduction for the three groups; MEBO showed statistically significant less VAS score compared to the other two groups, while HA showed statistically significant less VAS score compared to the control group. Both MEBO and HA showed statistically significant less total analgesic consumption. No statistically significant difference was observed between groups for wound size. MEBO showed statistically significant higher VAS for color match. Conclusions Both treatment modalities could reduce postoperative pain following harvesting of FGG and improve the palatal wound healing. However, MEBO showed better outcomes in terms of postoperative pain and color match.

THE EFFECT OF A CALENDULA BASED TOPICAL FORMULA VERSUS OXIDIZED REGENERATED CELLULOSE ON PALATAL WOUND HEALING: A RANDOMIZED CONTROLLED CLINICAL TRIAL

INTRODUCTION:Free palatal and sub-epithelial connective tissue grafts are the most commonly used grafts in periodontal plastic surgeries. The surgical technique of free palatal grafting requires harvesting of soft tissue from the palatal donor site and transplantation to an intraoral recipient one. Post-surgical complications and atypical healing processes have been described in the literature. In order to reduce the morbidity associated with mucogingival surgery, there are several ways to manage the donor site after soft tissue harvesting. Various topically applied formulas and hemostatic agents have been employed to manage post-operative healing at the donor site. OBJECTIVES: to assess the effects of Calendula based topical formula on palatal wound healing after free palatal graft surgery in comparison to oxidized regenerated cellulose. MATERIAL AND METHODS This randomized, controlled trial included twenty-four surgical sites for palatal graft procurement, divided equally into two groups, managed by the topical application of either a Calendula based formula (Group-I) or oxidized regenerated cellulose (Group-II). Palatal wound healing was assessed using photo-digital planimetry on the day of the surgery and; at seven and fourteen days, post-surgical. Pain was assessed by visual analogue scale (VAS) one, four and seven days post-surgical. RESULTS: The VAS score results showed no significant difference at days one, four and seven when comparing group I and II. For the percentages of remaining wound area, there was no significant difference in the percentages of remaining wound area. However, at day seven, there was a significant decrease in the percentage of remaining wound area in group II when compared to group I. Comparing the percentages of remaining wound area at day seven and fourteen in group I, there was a significant decrease of the percentages of remaining wound area at day fourteen. The same was found in group II. For group I, there was no significant difference between any of the recording periods. However, for group II, there was a significant decrease in the VAS scores between day one and seven, and also between day four and seven. CONCLUSION: Both materials were beneficial in improving palatal wound healing. However, oxidized regenerated cellulose exhibited better pain reduction following palatal graft procedures as reported by the study subjects when compared to the topical Calendula group

Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet Laser for Root Conditioning and Reduction of Postoperative Morbidity in the Treatment of Gingival Recession Defects: A Randomized Controlled Clinical Trial.

Objective: This clinical trial evaluates the effect of erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) root surface biomodification and laser harvesting of de-epithelialized gingival graft (DGG) on root coverage clinical outcomes and postoperative morbidity, and compares this to the conventional blade-harvested DGG method without Er,Cr:YSGG root surface biomodification in treatment of Miller's class I, II gingival recessions (GR). Background: The application of laser technology to enhance tooth root coverage clinical outcomes as well as the impact of laser on postoperative morbidity after harvesting autogenous soft tissue grafts requires further research. Methods: This study is a randomized, single-blinded controlled trial, including 24 volunteers with isolated GR defects. They were allocated into three treatment groups to receive one of the following three interventions: blade-harvested DGG (control group: B-DGG); Er,Cr:YSGG-harvested DGG and root surface biomodified [test 1 group: L-laser-harvested DGG (L-DGG)/laser root biomodification (LRB)]; and B-DGG and Er,Cr:YSGG root surface biomodification (test 2 group: B-DGG/LRB). Clinical and radiographic parameters were recorded at baseline (1 week before surgery) and 3, 6, and 9 months postoperatively. Results: Root coverage did not show a statistically significant difference between control and test groups. Statistically significant differences were found for Visual Analog Scale on the day of surgery and day 3 and 4 postoperatively, as well as pain medication on the day of surgery favoring the L-DGG group. Conclusions: The use of Er,Cr:YSGG laser in root surface biomodification improved root coverage outcomes at 9 months. Even these changes were not statistically significant from the control group; the L-DGG technique was associated with decreased postoperative morbidity in the palatal donor site.

Effects of non-thermal atmospheric pressure plasma on palatal wound healing of free gingival grafts: a randomized controlled clinical trial.

The aim of this trial was to evaluate the effects of non-thermal atmospheric pressure plasma (NAPP) on wound healing, epithelization, local pain, bleeding, and alteration of sensation in palatal donor site. Forty patients with inadequate attached gingiva were included in the study. Patients were divided into two groups: (i) NAPP group (Free gingival graft [FGG] + NAPP) and (ii) control group (FGG alone). NAPP was performed immediately after the operation and on days 3 and 7. Pain, bleeding, and the amount of medication were recorded by patients every day. Epithelization in donor site, alteration of sensation and color match were assessed weekly for 2 months. Inter-group comparisons of continuous variables by time were performed with two-way repeated measures ANOVA test and a general linear model. Categorical variables were compared using Chi-square exact test. A p value of < 0.05 was considered significant. At week 2, the number of patients with complete epithelization was greater in the NAPP group compared to the control group (p < 0.05). Additionally, color match in donor site was better in the NAPP group than in the control group (p < 0.05) during the first five follow-up assessments. No significant difference was found between the two groups with regard to bleeding, pain level, drug use, and alteration of sensation. The NAPP application increased the epithelization and accelerated the wound healing process although it did not decrease the level of pain and sensation. Our data suggested that the NAPP application may help epithelization and thus may shorten the recovery time after oral surgeries.

Is the use of platelet-rich fibrin effective in the healing, control of pain, and postoperative bleeding in the palatal area after free gingival graft harvesting? A systematic review of randomized clinical studies.

A systematic review (SR) was conducted to answer the following focused question based on PICO strategy: In patients who were submitted to harvesting palatal free gingival graft, could platelet-rich fibrin (PRF) application in comparison with another method improve the healing, pain, and control of postoperative bleeding in the palatal area in randomized clinical trials? A SR was conducted according to the PRISMA guidelines. The MEDLINE (PubMed), Scopus, Embase, and Web of Science databases were searched, and hand searches were made, covering the period up to August 2020, for randomized clinical trials (RCTs) reporting the effect of PRF membrane in postoperative palatal healing management compared with any other methods. The risk of bias (RoB) of the studies included was assessed by using the RoB 2 tool. The electronic search strategy identified 150 articles. After title screening and abstract reading, 141 studies were excluded, and 9 full-text publications were comprehensively evaluated. Finally, 8 articles were included in the systematic review. Six studies showed that the PRF membrane was effective in improving wound healing during the first 2 weeks. As regards patient-centered outcomes, five studies showed that PRF promoted less postoperative pain. Finally, five studies that evaluated bleeding showed that the PRF membrane improved control of postoperative bleeding. RoB was classified as low in 4 studies, 3 with some concerns, and only one study did not describe the outcome data, and as this was missing, it was not possible to verify the protocol of data analysis for this study; therefore, it was classified as having high RoB. Within the limitations of this study, the collective evidence emerging from this SR may support the use of PRF membrane in the palatal area after free gingival graft harvesting. The results of this review must be interpreted with caution, due to the low number of RCTs included and high degree of heterogeneity among the PRF protocols. Further well-designed RCTs with accurate protocol and standard PRF parameters are required in order to gain clear understanding of the influence of PRF on wound healing and patient-centered outcomes. The use of PRF membrane for the protection of the palatal donor site following free gingival graft harvesting procedures improves wound healing and patients' quality of life.

Cover Image

The cover image is based on the Original Article Ultrasonographic Tissue Perfusion Analysis at Implant and Palatal Donor Sites Following Soft Tissue Augmentation: A Clinical Pilot Study by Lorenzo Tavelli et al., https://doi.org/10.1111/jcpe.13424.

Ultrasonographic tissue perfusion analysis at implant and palatal donor sites following soft tissue augmentation: A clinical pilot study

To describe the application of power Doppler Ultrasonography (US) for evaluating blood flow at implant and palatal donor sites following soft tissue augmentation with the connective tissue graft (CTG). Five patients exhibiting a peri-implant soft tissue dehiscence received treatment with a coronally advanced flap and corresponding CTG. Power Doppler US was used for assessing blood volume at baseline, 1week, 1month, 6months and 12months post-surgery for assessing blood-flow dynamics at the implant and palatal donor sites. The speed-weighted and power-weighted colour pixel density (CPPD) were computed from colour velocity (CV) and colour power (CP), respectively. A mean increase in CV of 199.25% was observed at the midfacial region of the implant sites after 1week compared to baseline. CV and CP were increased in all sites at 1week and 1month. At 6 and 12months, the mean CV appeared lower than baseline at the implant sites. CCPD was increased at the palatal donor sites and at the great palatine foramen areas at the 1-week and 1-month post-operative evaluations. Power Doppler US is a non-invasive and valuable tool for estimating tissue perfusion and CPPD variation during different phases of intra-oral soft tissue graft healing.

Coronally Advanced Flap in the Treatment of Multiple Adjacent Gingival Recessions along with a Connective Tissue Graft Harvested from Augmented or Nonaugmented Palatal Mucous Membrane: A Two-Year Comparative Clinical Evaluation

Achieving the coverage of multiple adjacent gingival recessions (MAGRs) in a single surgical procedure poses a major clinical challenge. The gold standard procedure involves the collection of autogenous connective tissue from the palatal mucosa. In case of reduced palatal tissue thickness, augmentation using a collagen sponge can be performed. The aim of this study was to compare the treatment outcome of MAGR coverage by a coronally advanced flap (CAF) along with a connective tissue graft (CTG) harvested from augmented or nonaugmented palatal mucous membrane. Thirty-five patients with 148 MAGRs were enrolled in the study. The recessions were covered with CTGs collected from 26 augmented- (test group) and from 24 nonaugmented (control group) palatal donor sites followed by a CAF. Clinical parameters were measured at baseline, 6, 12 and 24 months after intervention. Clinical results for both, the test and the control group were steady and similar with the exception of buccal gingival thickness (BGT1). After 24 months, statistically greater BGT1 and complete root coverage (CRC) was observed in the test group. The augmented CTG+CAF method achieves good and predictable clinical results in the coverage of MAGRs. It leads to the increase of gingival thickness in comparison to the nonaugmented intervention.

Modified tunneling technique for root coverage of anterior mandible using minimal soft tissue harvesting and volume-stable collagen matrix: a retrospective study.

PurposeIn this study, we aimed to evaluate the clinical validity of the modified tunneling technique using minimal soft tissue harvesting and volume-stable collagen matrix in the anterior mandible.MethodsIn total, 27 anterior mandibular teeth and palatal donor sites in 17 patients with ≥1 mm of gingival recession (GR) were analyzed before and after root coverage. For the recipient sites, vertical vestibular incisions were made in the interdental area and a subperiosteal tunnel was created with an elevator. After both sides of the marginal gingiva were tied to one another, a prepared connective tissue graft and volume-stable collagen matrix were inserted through the vestibular vertical incision and were fixed with resorbable suture material. The root coverage results of the recipient site were measured at baseline (T0), 3 weeks (T3), 12 weeks (T12), and the latest visit (Tl). For palatal donor sites, a free gingival graft from a pre-decided area avoiding the main trunk of the greater palatine artery was harvested using a prefabricated surgical template at a depth of 2 mm after de-epithelization using a rotating bur. In each patient, the clinical and volumetric changes at the donor sites between T0 and T3 were measured.ResultsDuring an average follow-up of 14.5 months, teeth with denuded root lengths of 1–3 mm (n=12), 3–6 mm (n=11), and >6 mm (n=2) achieved root coverage of 97.01%±7.65%, 86.70%±5.66%, and 82.53%±1.39%, respectively. Miller classification I (n=12), II (n=10), and III (n=3) teeth showed mean coverage rates of 97.01%±7.65%, 86.91%±5.90%, and 83.19%±1.62%, respectively. At the donor sites, an average defect depth of 1.41 mm (70.5%) recovered in 3 weeks, and the wounds were epithelized completely in all cases.ConclusionsThe modified tunneling technique in this study is a promising treatment modality for overcoming GR in the anterior mandible.

Platelet-rich fibrin for wound healing of palatal donor sites of free gingival grafts: Systematic review and meta-analysis.

BackgroundPlatelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate, associated with improvements on the healing of palatal wounds followed by FGG harvesting. The aim of this systematic review and meta-analysis was to assess the complete wound epithelialization and postoperative pain when PRF was used in palatal wounds following free gingival graft (FGG) harvesting. Material and MethodsPubMed (Medline), EMBASE and Scopus were searched by two independent individuals up to and including March 2020 in order to identify controlled and randomized controlled clinical trials on the use of PRF at palatal donor sites of FGG. The outcomes assessed were epithelialization and postoperative pain. The risk of bias of the included studies was evaluated using Cochrane Collaboration’s domain-based two-part tool. Random effects meta-analyses were conducted with 95% confidence intervals. ResultsThe search strategy identified 555 potentially eligible articles, of which 6 randomized controlled clinical trials were included. In the qualitative analysis, most studies (83.3%) reported lower postoperative pain in treatment groups, while all studies accessing epithelialization demonstrated earlier complete wound closure in groups treated with PRF. The discomfort and complete re-epithelialization were more favorable in groups PRF when compared to control groups (P<0.00001). ConclusionsWithin the limits of the present study, it can be concluded that the use of PRF for wound healing of palatal donor sites of FGG may decrease postoperative pain and induce earlier complete wound epithelialization. Key words:Wound healing, oral surgery procedures, pain, postoperative.

Healing of donor sites of connective tissue grafts harvested by the single incision technique: A randomized clinical trial evaluating the use of collagen hemostatic sponge with or without sutures.

The aim of this study was to evaluate the effect of suturing on the early wound healing of donor sites of subepithelial connective tissue grafts (SCTG), harvested by the single incision technique (SIT), following the application of a collagen sponge. Thirty-six patients were randomized to receive a collagen sponge with or without sutures in the palatal donor sites following connective tissue grafting via the SIT. Outcome variables were early healing index (EHI) at 7, 14, and 30 days, self-reported pain using a visual analogue scale (VAS) recorded on the 0 to 100 scale at 7 and 14 days, and immediate and delayed bleeding. No significant differences were found between groups at baseline. EHI index showed no differences between groups in all-time intervals. Eight subjects from suture group (SG) and 10 from no suture group (nSG) showed complete wound closure at day 14 (P>0.05) and at 30 days, complete closure was observed in 35 out of 36 patients. Four subjects from the SG and three from the nSG had immediate bleeding (P>0.05), while delayed bleeding was observed in two subjects from the SG and three from the nSG during the first week of healing (P>0.05). No differences were found in VAS scale between groups (SG, 36.2 ± 24.8; nSG, 21.5 ± 24.2, P>0.05). It can be concluded that when a collagen sponge is placed in palatal donor areas of SCTG harvest by means of the SIT (incision length of ≈15mm), sutured and non-sutured sites display similar early wound healing outcomes and patient-reported outcomes.

Effect of cyanoacrylate tissue adhesive in postoperative palatal pain management: a systematic review.

To critically appraise available literature concerning the effect of cyanoacrylate tissue adhesive (CTA) in postoperative palatal pain management. Electronic databases (Cochrane, PubMed, LILACS, Scopus, and Web of Science) were searched, complemented with grey literature databases up to June 2020. Studies reporting the effect of cyanoacrylate tissue adhesive compared to any other methods in postoperative palatal pain management were considered eligible. The risk of bias among and across included studies was assessed. Finally, four studies were considered eligible. Regarding free gingival graft (FGG), cyanoacrylate tissue adhesive with hemostatic sponge promoted less postoperative pain (PP) and analgesic consumption (AC). Also, cyanoacrylate tissue adhesive with platelet-rich fibrin produced less PP and more wound healing at the palatal area than cyanoacrylate tissue adhesive and wet gauze. Additionally, cyanoacrylate tissue adhesive promoted less PP and AC than wet gauze and suture. Concerning connective tissue graft (CTG), cyanoacrylate tissue adhesive, and suture produced similar PP, AC, and willingness for retreatment. Based on the low certainty level, cyanoacrylate tissue adhesive appears to promote less PP and AC than wet gauze and suture regarding FGG. Additionally, cyanoacrylate tissue adhesive appears to increase the effect of hemostatic sponge, contributing to the reduction of PP and AC. Regarding CTG, cyanoacrylate tissue adhesive appears to promote similar PP, AC, and willingness for retreatment than the suture. Therefore, cyanoacrylate tissue adhesive has shown promising usefulness for PP management in FGG, but not a clear benefit for CTG. The adoption of different agents for the protection of the palatal donor site following gingival harvesting procedures may provide better comfort to the patient.

A Modified Technique of Tacking Acellular Dermal Matrix to Increase Keratinized Mucosa Around Dental Implants as an Alternative to a Free Gingival Graft: A Case Report

Free autogenous graft was the gold standard to increase the keratinized mucosa (KM) and vestibular depth. The major downfall of this technique is the postoperative morbidity at the donor site. The purpose of this case report is to demonstrate a modified technique using acellular dermal matrix (ADM) to increase the KM around implants to achieve faster healing with less postoperative morbidity. Patient presented with inadequate keratinized tissue band and shallow vestibule at submerged implant sites bilaterally. Initially, surgical procedure of vestibuloplasty in conjunction with free gingival graft (FGG) was performed at one side. However, patient opted for the allograft as a substitute for the other side due to the postoperative discomfort from palatal donor site. On the left side, the FGG procedure was performed in a conventional way stabilizing with sutures. On the right side, the ADM was stabilized with tacks only at recipient site and left exposed. The new vestibule was established and stabilized with tacks. A significant gain of KM and vestibule depth was observed at the site of using ADM when compared with baseline. For the site of using FGG, KM was increased. However, the vestibule was rebounded compared with the site of using ADM with tacks. The use of ADM stabilized with tacks is a predictable procedure that can increase KM and establish stable vestibule around dental implants. It can lead to less chair time, faster healing, and reduced postoperative morbidity compared with autogenous soft tissue graft.

The effect of low-level laser therapy as an adjunct to periodontal surgery in the management of postoperative pain and wound healing: a systematic review and meta-analysis.

The meta-analysis and systematic review aimed to evaluate the effect of low-level laser therapy (LLLT) as an adjunct to periodontal surgery in the management of postoperative pain and wound healing. An electronic search in 4 databases (PubMed, Embase, Cochrane, and OpenGrey) was conducted for randomized clinical trials reporting the effectiveness of LLLT used as an adjunct to periodontal surgery to alleviate pain and accelerate wound healing compared with surgery alone. Finally, 13 studies were eligible and included. The results showed a significant difference of pain relief between groups at day 3 post-surgery, whereas no difference was found at day 7. Moreover, a significant reduction was observed in the mean analgesic intake during the first week in the LLLT group. On day 14, the adjunctive use of LLLT showed significantly faster re-epithelialization and better wound healing in palatal donor sites following free gingival graft procedures. Based on the results, LLLT used as an adjunct to periodontal surgery positively influenced postsurgical pain control. Low power (≤ 500mW) combined with energy density ≥ 5J/cm2 might be more appropriate for postoperative pain relief. Moreover, adjunctive LLLT to free gingival grafts could significantly accelerate wound healing of palate sites at early healing phase. Multicenter studies using different LLL parameters without postsurgical analgesics are needed to determine optimal laser settings.

Platelet Rich Fibrin Versus Hyaluronic Acid as palatal wound Dressings following epithelialized free gingival graft harvest: A randomized controlled clinical trial

Introduction: Patient centered outcome became of great interest nowadays. Patient’s pain and discomfort following free gingival graft procedure are common complain. Different palatal dressings are suggested to cover and protect the palatal donor site as stents, collagen gelatin scaffolds, platelet rich fibrin (PRF), hyaluronic acid (HA) and Alvogyl. However, in the literature no ideal agent has been emphasized. Objectives: This randomized controlled clinical trial compares for the first-time the effect of PRF versus HA palatal wound dressings on postoperative pain, post-surgical bleeding, and wound healing. Materials and methods: Following sample size calculation, 30 systemically healthy patients requiring palatal mucosal graft harvesting were randomized to receive either PRF or HA (intervention groups) or gelatin sponge (control group) as palatal dressings. Patient-reported visual analogue score (VAS) pain scores as primary outcome. Post-surgical bleeding and wound healing were considered as secondary outcomes. Results: VAS pain scores were reported minimal in PRF group throughout follow up intervals, PRF was statistically significant when compared to HA group at 3 and 7 days postoperative, PRF was statistically significant when compared to control group from 3 to 30 days postoperative and VAS in PRF was nearly 0 in day 14. PRF group showed the highest value of healing index during all the follow up intervals with mean 4.4 at 30 days that indicates a full healing of palatal wound area. Conclusions: Within this study’s limitations, PRF had better outcomes than both HA and gelatin sponge in means of cost, pain reduction, hemostasis and healing properties.

&lt;p&gt;Amniotic Membrane In Palatal Epithelial-Connective Tissue Reconstruction&lt;/p&gt;

Mucogingival surgery has the objective to obtain coverage of the recession, with a favorable long-term prognosis, but also to minimize postoperative problems and surgery-related risks. Human amniotic membrane is increasingly employed for periodontal tissue repair in order to promote epithelialization and to reduce pain and scar tissue formation. A 38-year-old female patient reports dental hypersensitivity resulting from gingival recession affecting tooth 4.1. A mucogingival surgical procedure was proposed and a partial-thickness flap of epithelial-connective tissue was harvested from the palate and grafted on to the receiving site. The amniotic membrane was positioned at the donor site to reduce postoperative morbidity and to encourage rapid palatal healing. One week after the application of HAM (human amniotic membrane), the wound was healed and 1 month after the donor site was completely re-epithelialized. The present case report suggests that in the surgical treatment of gingival recession with palatal epithelial-connective tissue graft, HAM promotes rapid epithelialization of the palatal donor site wound with a reduction in morbidity.

Comparison of platelet-rich fibrin and cellulose in palatal wounds after graft harvesting.

The aim of the present study was to compare patient morbidity and healing outcomes of free gingival graft (FGG) harvesting at palatal donor sites and after using platelet-rich fibrin (PRF) and oxidized regenerated cellulose (ORC). FGG harvesting leaves open palatal wounds, which heal by secondary intention. Patients might experience discomfort or pain during the first 2weeks of healing. Eighteen participants requiring two FGG were recruited. The test and control sites were covered with PRF membrane and ORC. The complete epithelialization of the palatal wound, the percentage of wound healing, and postoperative pain were evaluated, 1, 3, and 7days and 2, 3, and 4weeks after surgery. Similar wound size reduction at 1week (test: 36.87%, control: 38.78%) was found. At 2weeks, the majority of the test group (88.89%) showed complete epithelialization, whereas 66.67% of the control group had complete epithelialization (P=.228). Pain was more prevalent in the control group (27.77%) than in the test group (11.1%) on day 1. None of the participants reported any pain or discomfort at the test sites on day 3. PRF seems to reduce patient morbidity, but there is no difference in palatal wound healing (P>.05).

PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial.

The aim of this study is to determine the use of platelet-rich fibrin (PRF) in the management of soft tissue donor site healing after harvesting connective tissue graft (CTG) from the palate and evaluate the postoperative discomfort (pain, bleeding, analgesic consumption, tissue color match) of patients. Forty patients were randomly assigned to PRF or control group. In the PRF group, PRF membrane was placed into CTG donor site. After surgery, delayed bleeding, early healing index (EHI), tissue color match, and analgesic consumption were recorded. The visual analog scale (VAS) was used to observe the postoperative pain and tissue color match. Data were analyzed using the independent sample t test and the repeated measure ANOVA test. The patients in the PRF group reported significantly lower pain scores at all-time points. Postoperative 3rd and 7th day, EHI scores were lower in the favor of the PRF group. VAS score values of tissue color match were lower in the control group at 7th and 14th day, compared with the PRF group. Analgesic intake was significantly lower in the PRF group postoperatively at 1st and 3rd day that of control group. PRF application at the palatal donor site demonstrates promising results in terms of better wound healing and reduced postoperative discomfort in the patients after harvesting CTG. Patients may avoid surgical operations because of the discomfort or pain feeling. Reducing postoperative pain and discomfort and accelerating recovery meet the wishes of every patient and physician. PRF can provide these requirements as an easy method to obtain and implement.

Evalution Of the Patiens Oral Health Related Quality of Life After Harvesting Free Gingival Graft

Objectives: Oral Health Related Quality of Life is the individual's perception of how oral health affects the quality of life and general health. Periodontal plastic surgery procedures have been reported to negatively affect the quality of life of patients after the operations. The aim of this study was to evaluate the effects of different treatment procedures applied for wound healing of the donor palate site after free gingival graft (FGG) operations on the quality of life.Materials and Methods: After FGG harvesting, 60 patients’ palatal donor sites were randomly assigned one of the six groups, giving 10 participants per group. Palatal wounds were treated with platelet-rich fibrin (PRF), essix retainer, ozone therapy, low-level laser therapy (LLLT) or collagen fleece. As a control group, palatal donor sites were left to secondary healing without any of the treatment procedures. After the postoperative procedures, The Oral Health Impact Profile (OHIP-14) questions were asked to patients to evaluate their quality of life, whereas parameters in relation to postoperative morbidity were analyzed by using Visual Analogue Scale (VAS).Results: Regarding to the questions belonging Turkish version of OHIP-14 (OHIP-14 TR), there were statistically significant relationships between the group categorical variables and the categorical results of question 7 and 10 (p=0.002 and p=0.015). For these questions, the lowest scores were mostly given in the LLLT group. No statistically significant difference was observed between the study groups and total OHIP scores (TOHIP) and the means of 7 subscales of OHIP-14 (p&amp;gt;0.05). Significant differences were found between PRF-ozone groups on the 5th day (p=0.011) for mean VAS scores exhibiting postoperative pain.Conclusions: It has been observed that applying LLLT procedures to the donor wound area following FGG operations may have positive effects on the quality of life and PRF treatments may be more effective in terms of patient comfort after operation.

Assessment of Palatal Mucosal Wound Healing Following Connective-Tissue Harvesting by Laser Speckle Contrast Imaging: An Observational Case Series Study.

Postoperative complications may occur during the healing of palatal donor sites due to disturbed blood circulation of palatal tissues. Therefore in this study, blood flow was measured by Laser Speckle Contrast Imaging (LSCI) in seven patients after connective-tissue harvesting. The slope in blood-flow elevation within the first 3 days as well as time needed for maximum reperfusion were calculated. Each surgical site was assessed by clinical examination on day 3. In donor sites with secondary-intention wound healing, postoperative blood flow was elevated with significant delay compared to the surrounding tissues and to the primarily healed wound. Reperfusion time and healing score were strongly correlated (r = 0.87, P < .001), as were the slope and clinical rank (r = -0.85, P < .001). LSCI proved to be an objective method to assess individual wound-healing time and to predict the quality of wound healing.