Jankowski Tomasz, Jankowska Agnieszka, Palczewska-Komsa Mirona, Jedliński Maciej, Kazimierczak Wojciech, Janiszewska-Olszowska Joanna
Private Practice Dental Clinic Jankowscy, Czerwonego Krzyża 24, 68-200 Żary, Poland.
Department of Dental Prosthetics, Pomeranian Medical University in Szczecin, 71-111 Szczecin, Poland.
J Funct Biomater. 2024 Nov 27;15(12):360. doi: 10.3390/jfb15120360.
(1) Background: A free gingival graft (FGG) is a common technique used to reconstruct or enhance the area of keratinized mucosa, while a connective tissue graft (CTG) is utilized to boost soft tissue thickness, thereby promoting stability in interproximal marginal bone levels. Most reported complications following FGG procedure are associated with the donor site. In addition to a painful, open wound in the palate, the most frequent complications linked to FGG harvesting include excessive bleeding, postoperative bone exposure, and recurrent herpes lesions. Numerous methods for securing the donor site after a free gingival graft surgery have been documented in research publications. The main objective of this systematic review was to assess various techniques for protecting the palate after graft harvesting and their impact on patient experience, with a focus on pain management. The secondary objective was to evaluate these techniques in relation to donor site wound healing. (2) Methods: The search was performed across four databases: Medline (PubMed Central), Scopus, Web of Science, and Embase, in accordance with PRISMA guidelines and the recommendations set forth in the Cochrane Handbook for Systematic Reviews of Interventions. The initial search took place on 9 October 2023, followed by an update on 28 June 2024. The search utilized the following keywords: ("wound" OR "injury") AND ("graft" OR "free gingival graft" OR "graft harvesting") AND ("healing" OR "recovery") AND "palate". (3) Results: After conducting the follow-up search, a total of 958 papers were identified: 193 from PubMed, 314 from Scopus, 101 from Web of Science, and 350 from Embase. Ultimately, of the 49 papers that remained, 11 were excluded due to not fulfilling the inclusion criteria, leaving 38 full-text papers on free gingival grafts (FGG) for qualitative analysis. (4) Conclusions: Various methods for palatal protection after free gingival grafts (FGG) are described in the literature, stemming from biological, physical, or chemical sources. Most studies in this review examined platelet-rich fibrin and suggested that it provides no benefits for patients' subjective experiences or wound healing outcomes. While photobiomodulation appears to support wound epithelialization, it does not influence pain perception. Alternatives such as propolis, hyaluronic acid, and medicinal plant extracts show potential for palatal protection; however, further research is needed to thoroughly evaluate their effectiveness.
(1) 背景：游离龈瓣移植术（FGG）是一种用于重建或扩大角化黏膜区域的常用技术，而结缔组织移植术（CTG）则用于增加软组织厚度，从而促进邻间隙边缘骨水平的稳定性。FGG术后报道的大多数并发症与供区有关。除了腭部疼痛、开放性伤口外，与FGG取材相关的最常见并发症包括出血过多、术后骨暴露和复发性疱疹病变。研究文献中记录了多种游离龈瓣移植术后固定供区的方法。本系统评价的主要目的是评估移植取材后保护腭部的各种技术及其对患者体验的影响，重点是疼痛管理。次要目的是评估这些技术与供区伤口愈合的关系。(2) 方法：根据PRISMA指南和《Cochrane系统评价干预措施手册》中提出的建议，在四个数据库中进行检索：Medline（PubMed Central）、Scopus、Web of Science和Embase。首次检索于2023年10月9日进行，随后于2024年6月28日进行更新。检索使用了以下关键词：（“伤口”或“损伤”）与（“移植”或“游离龈瓣移植”或“移植取材”）与（“愈合”或“恢复”）以及“腭部”。(3) 结果：在进行后续检索后，共识别出958篇论文：来自PubMed的193篇、来自Scopus的314篇、来自Web of Science的101篇和来自Embase的350篇。最终，在剩余的49篇论文中，有11篇因不符合纳入标准而被排除，剩下38篇关于游离龈瓣移植术（FGG）的全文论文进行定性分析。(4) 结论：文献中描述了游离龈瓣移植术（FGG）后腭部保护的各种方法，这些方法源于生物、物理或化学来源。本综述中的大多数研究考察了富血小板纤维蛋白，并表明它对患者的主观体验或伤口愈合结果没有益处。虽然光生物调节似乎支持伤口上皮化，但它不影响疼痛感知。蜂胶、透明质酸和药用植物提取物等替代方法显示出腭部保护的潜力；然而，需要进一步研究以全面评估它们的有效性。
