Epithelialized fragments from free gingival graft as alternative to palatal wound protection: A randomized clinical...

This study aimed to evaluate clinical and patient-centered outcomes of palatal donor sites protected with epithelialized fragments (EF) of the free gingival graft (FGG) or a hemostatic sponge (HEM).

Forty-four patients with deep single gingival recessions in lower incisors were treated using subepithelial connective tissue graft (SCTG) of standardized size (17 × 6 mm). Patients were randomized to HEM (n = 22) or EF (n = 22), both stabilized with sutures and a palatal stent. Remaining wound area of healing was assessed through standardized photographs by a blinded, calibrated examiner over 28 days.

Significant effects were observed for group (p = 0.031) and time (p < 0.001), with no group×time interaction (p = 0.132). EF showed lower values than HEM (β = -7.02; 95% confidence interval [CI]: -13.2, -0.80). A significant reduction in wound area occurred at 7, 14, and 28 days (p < 0.001). Between-group differences were significant only at day 14 (β = -12.26; 95% CI: -23.4, -1.17), with no statistically significant differences at days 7 and 28. Between-subject variability was low-to-moderate (intraclass correlation coefficient [ICC] = 0.276). Pain scores and analgesic consumption decreased significantly over time in both groups, with no differences between interventions or interactions.

EF demonstrated improved palatal healing compared to HEM at day 14, while pain levels and analgesic consumption were similar between groups, indicating comparable postoperative discomfort.

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