Palatal Wound Healing Evaluation After Application of Platelet Rich Fibrin Versus 0.2% Hyaluronic Acid Dressings
Condition: Free Gingival Graft
Study type: Interventional
Phase: Phase 4

Summary: 
      Free gingival graft (FGG) was first proposed by Bjorn 1963 and Nabers 1966. FGG is indicated
      to correct mucogingival problems such as inadequate or lack of attached gingiva and gingival
      recession. The most frequent donor site for free gingival graft is the palate

      Although, great concern has been given to the recipient sites by using different techniques
      as suturing, tissue adhesives and special dressings, a little attention was given to protect
      the donor sites after free gingival graft harvesting. The palatal donor site heal by
      secondary intention, it could take around 2 to 4 weeks depending on the width and thickness
      of the tissue removed.The common clinical events that occurs following FGG procedure are
      patient's discomfort, pain and bleeding at the donor site.
    

Detailed description: 
      In an attempt to protect the plate (donor site) so that it could help in decreasing the
      patient's post operative pain, Farnoush suggested variant clinical techniques. One of these
      techniques was interproximal wire ligation by placing a stainless steel wire anchored on the
      teeth stabilizing the periodontal dressing. He also suggested using a modified Hawley
      appliance which would act as a palatal stent protecting the palate to help in healing.

      After periodontal surgeries, the donor site (palate) has to be protected from the external
      environment by many dressing materials. Conventional periodontal dressings provide an inert
      barrier that help healing by preventing the external insults on the wound area. However,
      these dressings do not affect the cellular behavior and do not display a role in the
      biological events that happen during wound healing.

      Platelet-rich fibrin (PRF) is a simple procedure where patient's own blood is collected and
      centrifuged. PRF clot forms a strong fibrin matrix that can be compressed to form a membrane.
      PRF membrane consists of a fibrin 3D mesh polymerized in a specific structure that
      incorporates platelets, leukocytes, growth factors; and the circulating stem cells.PRF
      membrane enhance angiogenesis, immunity and wound epithelialisation. Thus, based on such
      findings the PRF membrane can be used as a palatal dressing

      PRF membrane enhances the healing of the donor site (palate).According to Shakir et al.,
      complete epithelialisation of the palatal donor site was reached by 18th day after FGG in the
      groups where PRF membranes was placed with less pain scores on the 2nd and 7th day than the
      control group. Therefore PRF membranes showed higher capabilities of the donor site healing
      stimulation.

      Hyaluronic acid (HA) is a high molecular weight, non-sulphated polysaccharide component of
      the family of the glycosaminoglycanes,it is present in various body fluids such as synovial
      fluid, serum, saliva and gingival crevicular fluid. In addition, it represents an important
      component of the extracellular matrix of skin, connective tissue, synovial joints and other
      tissues. HA is identified in all periodontal tissues, being prominent in the non-mineralized
      tissues such as gingiva and periodontal ligament, and in low quantities in mineralized
      tissues such as cementum and alveolar bone.

      Hyaluronic acid has been suggested as monotherapy or as an adjunct to non-surgical and/or
      surgical periodontal treatment to reduce inflammation and promote wound healing. Hyaluronic
      acid can be used to accelerate the palatal wound healing at the donor site after free
      gingival graft surgery
    

Intervention name(s): hyaluronic acid (Gengiegel 0.2% oral gel ); Platelet rich fibrin; Gel foam
Intervention type(s): Drug; Other; Other
Intervention description(s): coverage of the free gingival graft area in the palate; coverage of the free gingival graft area in the palate; coverage of the free gingival graft area in the palate
Other intervention name(s): Platelet rich fibrin (PRF); PRF
Intervention MeSH terms: Gelatin Sponge, Absorbable; Hyaluronic Acid
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 3 groups each receiving a different type of intervention
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment