Pain perception following epithelialized gingival graft harvesting: a randomized clinical trial
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Abstract
Objectives The aim of this study was to compare the effects of a hemostatic collagen sponge and a collagen sponge sealed with a bio-adhesive material on the palatal donor sites with the purpose of minimizing postoperative pain after epithelialized gingival graft (EGG) harvesting.
Material and methods The present study consisted of 44 EGGs harvested in 44 patients. In the control group, a hemostatic collagen sponge was applied over the palatal wound, while the test group was treated with additional cyanoacrylate. Patients were observed for 14 days, evaluating the pain level by using the visual analogic scale. The consumption of analgesic during the postoperative period, the willingness for retreatment and the characteristic of the graft were also analyzed.
Results Statistically significant differences in pain perception were found between test and control groups in each of the studied days (p < 0.01). Analgesic consumption was lower in the test group (p < 0.01). Graft width < 14 mm was found to be associated with lower discomfort (p < 0.01).
Conclusions Adding an additional layer of cyanoacrylate over a hemostatic collagen sponge on the palatal wound following EGG harvesting was found to be successful in minimizing the postoperative discomfort and the need for analgesics.
Clinical relevance Postoperative pain after palatal tissue harvesting can be successfully minimized if the donor site open wound is protected with an external layer of cyanoacrylate over a collagen sponge.
Keywords Pain management . Autografts . Free soft tissue graft . Wound healing
Introduction
Periodontal plastic surgery has long been successfully performed for the treatment of gingival recessions and mucogingival deformities [1–3]. Numerous techniques have been proposed in an attempt to obtain predictable root coverage outcomes. However, the results do not only depend on the technique selected but also on a variety of factors including but not limited to patient- and site-related factors [4]. Evaluation of the keratinized tissue (KT) around the recession defects is crucial to determine whether soft tissue augmentation together with a root coverage procedure is required [5, 6]. Also, when the gingiva is relatively thin (< 1 mm), the utilization of connective tissue graft (CTG) harvested from the palate underneath the primary flap has been suggested to restore an adequate amount of the KT and tissue thickness, together with better esthetic outcomes [7, 8]. A CTG, with or without epithelium, was also found to be effective around implants for several purposes including increase of the KT [9], for the treatment of implant mid-facial recession defects [10], in interimplant papilla reconstruction [11], and for soft tissue thickening purposes [12].
To read the entire study: Pain perception following epithelialized gingival graft harvesting: a randomized clinical trial