Background: Although soft tissue substitutes showed promising improvement in the past decade, epithelialized gingival graft (EGG) is still widely used in periodontal plastic surgery applications. Donor site management after EGG harvesting has been challenging for clinicians. This study aimed to compare the effectiveness of cyanoacrylate, hyaluronic acid, and their combination in palatal donor site management after EGG harvesting.Methods: Data from 89 patients were included and categorized as gelatin sponge (GS), gelatin sponge with either cyanoacrylate (GS + CY), hyaluronic acid (GS + HA), or both (GS + CY + HA). The data of pain perception (PP), quantity of analgesics (QA), secondary bleeding (SB), epithelization level (EL), and color match (CM) were assessed retrospectively. Results:The GS + CY and GS + HA + CY groups showed lower PP scores compared to the GS and GS + HA groups (p < 0.05). The QA was higher in the GS group compared to the GS + CY and GS + HA + CY groups (p < 0.001). All study groups showed greater EL than GS group on day 7 (p < 0.001). On day 14, full EL was present in 81% of the patients in the GS + HA + CY group, which was higher than the other groups (p < 0.001). All study groups reported lower SB in the first 3 days, which was lower compared to the GS group (p < 0.001) and showed higher CM scores than the GS group on days 7 and 14 (p < 0.001). Conclusions: CY application reduces pain and analgesic intake and HA may support the wound healing with increased EL. Using the CY-HA combination provides additional benefits for donor site management.

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Actinomyces spp. are members of normal oral flora that may give rise to a rare disease— oral actinomycosis . Here we present a case of early implant failure associated with actinomycosis in an otherwise -healthy 43-year-old female and the treatment adopted following explantation. Clinically, one month after the implant placement, the peri-implant soft tissues were hyperplastic and associated with an excessive tissue reaction, bleeding, suppuration, deep probing depth , and implant mobility at #19 and #20 implants. Both implants were removed and all granulomatous tissues were thoroughly debrided. Histopathological examination revealed signs of acute ulcerative inflammatory reaction and Actinomyces colonies. The patient was prescribed short-term oral penicillins. After six months following explantation, the deficient bone was augmented with using a combination of absorbable collagen membrane, autogenous block and xenograft. The patient was followed up for one year ; and subsequently, two implants were reinserted at the same positions. The patient was followed up and no recurrences were observed. Implant failure due to actinomycosis is an extremely rare condition , and a definitive diagnosis is therefore essential for successful treatment.