Propylene mesh versus acrylic resin stent for palatal wound protection following free gingival graft harvesting: a short-term pilot randomized clinical trial

Nermin Yussif, Rasha Wagih, Khaled Selim, Nermin Yussif, Rasha Wagih, Khaled Selim

Abstract

Background: Protection of the palatal wound is an essential step following harvesting a palatal soft tissue graft. The aim of the current pilot randomized clinical study was to assess the efficacy of using propylene mesh as protective sheet when compared to conventional custom made acrylic stent after harvesting a palatal graft. The primary outcome of this study was bleeding postoperatively and secondary outcomes were pain, healing profile of the donor site as well as patient satisfaction.

Methods: Between 2018 and 2019 we conducted a prospective randomized controlled trial of 24 patients with palatal defects. Two groups of 12 patients with 24 sites were included in this study and were treated with soft tissue grafting technique using free grafts harvested from the hard palate. The palatal wounds were protected with propylene mesh (test group) or custom-made acrylic palatal stent (control group). Participants were assessed for the amount and duration of bleeding, pain duration, and the risk of infection 2, 4, 6, 8, 14 days post-operatively. The trial had been registered in clinical trials.gov (NCT04348279).

Results: Four sites were excluded from the study as dropouts. The polypropylene mesh was more effective at reducing bleeding by (2.4 ± 1.075) and pain by (1.600 ± 0.516), while the custom-made acrylic stent reduced the bleeding (5.8 ± 1.22) and pain (7.100 ± 0.316). The decline in amount of bleeding amount (P value = 0.021) and its duration (P value = 0.001) achieved by the propylene mesh was statistically significant. There was no statistical significant difference in patient satisfaction and the duration of healing process between the 2 groups. However, the healing profile of the test group was statistically significant when compared with the control group (P value = 0.002).

Conclusions: Propylene mesh is a promising material for protection of the palatal wound due to its light weight, limited bacterial wicking, tissue compatibility. Further studies are required to adequally assess the benefits of this material in periodontal plastic surgeries.

Keywords: Gingiva; Palatal protection; Palatal wound; Propylene mesh; Soft tissue grafting.

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
CONSORT flow chart
Fig. 2
Fig. 2
Case 1: a FGG adapted and sutured to the recipient site of 2 adjacent teeth, b harvested palatal graft, Case 2: c FGG sutured to the recipient site of 1 tooth, d harvested palatal graft
Fig. 3
Fig. 3
Palatal stent preparation; a during the laboratory processing (waxing pattern), b the final form of the stent
Fig. 4
Fig. 4
Propylene mesh (©Ethicon US, LLC. 2019)
Fig. 5
Fig. 5
Healing stages in the test group

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