Ultrasonographic evaluation of the titanium‐prepared platelet‐rich fibrin effect in free gingival graft procedures

Abstract

Background Complications after free gingival graft (FGG) operations are generally related to the donor site. The titanium‐prepared, platelet‐rich fibrin (T‐PRF) placement in the donor site accelerate the wound healing and prevent postoperative complications such as pain and hemorrhage. We aim to evaluate the effect of T‐PRF regarding vascularization and tissue thickness and to report the advantages of the ultrasonography (US) in FGG. Methods Ten individuals were divided into two groups as T‐PRF and control. While the T‐PRF membrane was placed at the donor site in the T‐PRF group, a gelatin sponge was placed in the control group. All patients underwent US examination in terms of vascularization and tissue thickness of left and right donor sites. The correlation between the right and left donor sites was analyzed with the Pearson correlation test. Tissue thicknesses and pulsatility index (PI) were analyzed with independent samples t‐test. The results were evaluated statistically at the P <0.05 significance level. Results The T‐PRF group showed increased vascularity which can be interpreted to improve healing in soft tissue. However, not a difference, but a positively very high correlation was observed between the right and left tissue thicknesses (P = 0,00; r = +0902). Conclusions Evaluation of tissue thickness and vascularization density of donor sites with US not only increases clinical success rate but also reduces the risk of complications during surgery and postoperative pain in FGG. Studies evaluating T‐PRF membrane as palatal dressing after FGG are only clinical, however, the efficiency of T‐PRF was evaluated radiologically in this study for the first time.

Wound‐healing agents for palatal donor area: A network meta‐analysis

“…Only one case series (with 3 patients per group) showed superior results for collagen hemostatic sponge in comparison to L‐PRF (Belkhede et al., 2019) and one RCT showed no differences between both groups (Alvarez‐Medina et al., 2023). Two studies reported better healing with palatal donor sites treated with titanium‐prepared platelet‐rich fibrin (T‐PRF) in comparison to collagen hemostatic sponge (Koca‐Ünsal et al., 2022) and acrylic stent (Gülbahar Ustaoglu et al., 2016). In addition, two studies also showed superior healing in palatal donor sites covered with A‐PRF.…”

“…(1996) also reported that the use of microcollagen felt associated with periodontal dressing promoted faster healing in comparison to periodontal dressing alone, but not in comparison to fragments of connective tissue with epithelium removed from the graft associated with periodontal dressing. In comparison to L‐PRF, better wound healing was obtained for L‐PRF in comparison to collagen hemostatic sponge in four studies (Femminella et al., 2016; Hassan et al., 2020; Koca‐Ünsal et al., 2022; Sousa et al., 2020), however, collagen hemostatic sponge promoted superior repair in comparison to L‐PRF in one case series (Belkhede et al., 2019). In addition, collagen cones associated with gel based on recombinant human angiogenin promoted better repair in comparison to collagen cones alone (Goryachkin et al., 2019).…”