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Purpose: The aim of this research was to evaluate the cumulative effect of using both epithelial autograft and xenogeneic collagen matrix as an alternative to single keratinized epithelial palatal autografts, which can prove beneficial for its reduced morbidity. Materials and methods: This study includes one female patient with an extremely atrophic mandible who requires deepening of the vestibulum in the anterior region in order to improve the stability of the removable denture. The surgical procedure included local anesthesia, one horizontal incision and a partial-thickness flap elevation. The exposed periosteum was covered by a small keratinized epithelial autograft from the hard palate at its apical aspect and a xenogeneic collagen matrix at its coronal portion. Follow up of the healing process was performed on the 7th, 14th, 30th day, after three and six months. Results: The postoperative period underwent without any complications in all areas. The healing process resulted in the formation of an additional area of keratinized mucosa - a mean gain value of 2.92 mm after six months, which led to a significant improvement of denture stability. Conclusion: The final result suggested that this technique shows great promise in compensating the disadvantages of using single grafting materials: the increased morbidity caused by the additional surgical site on the palate in the case of autografts and the greater shrinkage of the area of keratinized mucosa in a six months period when collagen matrixes are applied as a single grafting material in large edentulous areas.

Introduction: Chlorhexidine (CHX) has been used for some time in clinical practice as a local antiseptic agent with excellent efficacy. The combination of CHX with APRF (Advanced-platelet rich fibrin) membrane has the potential to stimulate tissue regeneration and to provide a bactericidal effect. We hypothesize that this may reduce the rate of infections development and protect cell viability. Aim: The aim of this study was two-fold—to create a stable APRF membrane treated with different concentrations of CHX (0.01% and 0.02%) and to monitor its effect on the viability of PDL cells in vitro. This benefits the introduction of a new protocol for APRF membrane production -CHX-PRF and enriches the available evidence on the effect of this antiseptic agent on PDL (Periodontal ligament) cells. Materials and methods: APRF membranes were prepared by the addition of two concentrations (0.01% and 0.02%) of CHX. Membranes without the antiseptic were also prepared and used as control samples. PDL cells were cultivated on the membranes for 72 h. Cell number and vitality were examined by fluorescent cell viability assays. Results: Our results demonstrated that a concentration of 0.01% CHX allowed the production of a stable APRF membrane. This concentration slightly reduced the viability of PDL cells to 96.7%, but significantly decreased the average number of cells attached to the membrane—149 ± 16.5 cells/field compared to controls −336 ± 26.9 cells/field. APRF-CHX 0.02% membranes were unstable, indicating a dose-dependent cytotoxic effect of CHX. Conclusions: The introduced novel protocol leads to the production of a new type of APRF membrane—CHX-PRF. The incorporation of an antiseptic into the APRF membrane can improve its bactericidal activity and might serve as an important step for the prevention of postoperative infections.