Pre-Wounding and Free Gingival Grafts: A Pilot Investigation

Bibliographic Details
Main Author:	Delima, Suzanne Lynn
Language:	English
Published:	The Ohio State University / OhioLINK 2013
Subjects:	Dentistry Prewounding ischemic preconditioning periodontal plastic soft tissue grafts free gingival grafts
Online Access:	http://rave.ohiolink.edu/etdc/view?acc_num=osu1372075336

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spelling	ndltd-OhioLink-oai-etd.ohiolink.edu-osu13720753362021-08-03T05:24:22Z Pre-Wounding and Free Gingival Grafts: A Pilot Investigation Delima, Suzanne Lynn Dentistry Prewounding ischemic preconditioning periodontal plastic soft tissue grafts free gingival grafts Objectives: The free gingival graft (FGG) is a well-established periodontal plastic surgery procedure. Although simple and predictable, the FGG is fraught with complications, especially postoperative morbidity associated with the donor site. Pre-wounding is a surgical technique based on the concept of inducing ischemic conditions (wounding) that results in increased blood supply, which helps improve surgical outcomes. The present study aims to examine the effects of pre-wounding on FGG donor site outcomes and microbiological community profiles.Methods: Ten systemically healthy, nonsmoker, adults completed the study. One side of the palate was randomly chosen for pre-wounding by initial surgical incisions. Five days later standardized dimension FGGs were harvested from both the pre-wounded site and the contralateral site (routine FGG). Complete wound healing (epithelial closure), postoperative (PO) pain and healing complications were assessed on PO day 3, 7, 14, and 21 by direct examination and questionnaires. Microbiological samples were collected from FGG sites preoperatively and postoperatively at baseline, 0, 3, 7, 14, and 21 days. The samples were analyzed by terminal restriction fragment length polymorphism (t-RFLP) for bacterial community profiling.Results: On PO day 3 and 7, none of the FGG donor sites exhibited epithelial closure. On PO day 14, 40% of pre-wounded FGG donor sites and none of the routine FGG sites were completely healed; the corresponding values for day 21 were 89% and 78%. Pain (visual analog scale; VAS) scores on PO day 3 for pre-wounded and routine FGG donor sites were 3.9 ± 2.2 and 4.5 ± 1.8, respectively (p<0.4; paired t-test). The corresponding VAS scores for PO day 7 were 1.1 ± 2.1 and 2.8 ± 2.7 (p<0.001), while for PO day 14 were 0.5 ± 1.3 and 0.7 ± 0.7 (p=0.8), and PO day 21 were 0 and 0.2 ± 0.2 (p=0.19). Subjects consistently reported that pre-wounded FGG donor sites resulted in quicker healing and less PO bleeding than the routine FGG donor sites. Microbial profiles differed significantly between routine and pre-wounded sites on day of harvest, PO day 3, and PO day 7 (Tukey-Kramer, p<0.02, p<0.05, respectively). There was an increase in the number of bacterial species from surgical intervention to epithelial closure. The number of bacterial species in pre-wounded sites stayed the same from Day 0 to PO day 7, while the number of bacterial species in routine sites increased. Nonmetric multidimensional scaling showed a distinct difference in the bacterial species and abundance between routine and pre-wounded sites on PO day 3 and PO day 7.Conclusions: Pre-wounding FGGs prior to harvest is well tolerated by systemically healthy nonsmoker patients, appears to improve the FGG donor site postoperative healing course and to reduce the associated morbidity, and it alters the palatal mucosa-associated oral biofilm. 2013-08-29 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu1372075336 http://rave.ohiolink.edu/etdc/view?acc_num=osu1372075336 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
collection	NDLTD
language	English
sources	NDLTD
topic	Dentistry Prewounding ischemic preconditioning periodontal plastic soft tissue grafts free gingival grafts
spellingShingle	Dentistry Prewounding ischemic preconditioning periodontal plastic soft tissue grafts free gingival grafts Delima, Suzanne Lynn Pre-Wounding and Free Gingival Grafts: A Pilot Investigation
author	Delima, Suzanne Lynn
author_facet	Delima, Suzanne Lynn
author_sort	Delima, Suzanne Lynn
title	Pre-Wounding and Free Gingival Grafts: A Pilot Investigation
title_short	Pre-Wounding and Free Gingival Grafts: A Pilot Investigation
title_full	Pre-Wounding and Free Gingival Grafts: A Pilot Investigation
title_fullStr	Pre-Wounding and Free Gingival Grafts: A Pilot Investigation
title_full_unstemmed	Pre-Wounding and Free Gingival Grafts: A Pilot Investigation
title_sort	pre-wounding and free gingival grafts: a pilot investigation
publisher	The Ohio State University / OhioLINK
publishDate	2013
url	http://rave.ohiolink.edu/etdc/view?acc_num=osu1372075336
work_keys_str_mv	AT delimasuzannelynn prewoundingandfreegingivalgraftsapilotinvestigation
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Pre-Wounding and Free Gingival Grafts: A Pilot Investigation

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