Free gingival graft shrinkage on periosteal bed and denuded alveolar bone recipient site: a randomized clinical trial
Shabnam Ganjehzadeh1, Farid Shiezadeh2,3, Amir Moeintaghavi1
1Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Objective:
There are several techniques to increase keratinized tissue, and free gingival grafting (FGG) is one of the most predictable methods. One of the main disadvantages of this method is the significant tissue shrinkage of the graft, so it is desirable to find a method that is associated with less shrinkage. The purpose of the present study was to compare graft shrinkage rates and postoperative pain intensity following FGG augmentation on periosteal beds and denuded alveolar bone.
Methods & Materials:
A total of 22 FGGs with a thickness of 1 to 1.5 mm were placed in the area between the mandibular premolars. The recipient site for FGG was a periosteal bed in the control group and denuded alveolar bone in the experimental group. Dimensions of the grafts were recorded clinically by a periodontal probe as well as taking photographs, and the pain intensity was assessed with VAS scale, 1, 2, 4 and 8 weeks after surgery. The percentage of tissue shrinkage was calculated, and the two groups were compared.
Results:
A total of 22 patients (7 males and 15 females) completed the study and of these, 10 patients were in the experimental group (denuded bone bed), and 12 patients were in the control group (periosteal bed). At all times, the percentage of shrinkage in length, width and area in the control group (periosteum) was higher than the test group (bone). The highest percentage of shrinkage in all 3 parameters occurred in the control group related to the time between baseline and 1st week. In the experimental group, the highest percentage of length changes occurred between baseline and the 1st week and the highest percentage of width and area changes occurred between weeks 1 and 2. Changes in length, width and area between baseline and the first week and between baseline and week 8 were significant between the two groups. The mean pain in the control group (periosteum) was higher than the experimental group and only in the first week this difference was statistically significant.
Conclusion:
It can be concluded that epithelialized gingival graft placed on the denuded bone bed is associated with less pain and discomfort in the recipient area at one week postoperatively and was associated with less tissue shrinkage during 8 weeks of follow-up compared to FGG placement on the periosteal bed.
