The influence of palatal harvesting technique on the donor site vascular injury: A split‐mouth comparative cadaver study

Abstract

Background The aim of this study was to evaluate the influence of two harvesting approaches on the donor site vascular injury. Methods A split‐mouth cadaver study was designed on 21 fresh donor heads. Every hemi‐palate was assigned to receive the trap‐door harvesting technique (TDT) or the epithelialized free gingival graft harvesting technique (FGGT). A soft tissue graft was harvested from each side for histology analyses. Betadine solution was used to inject the external carotid artery and a collagen sponge was positioned over the harvested area to compare the amount of “leakage.” Results The mean leakage observed was 16.56 ± 3.01 µL in the FGGT‐harvested sites, and 69.21 ± 7.08 µL for the TDT group, a ratio of 4.18 (P < 0.01). Regression analyses demonstrated a trend for more leakage at thinner palatal sites for the FGGT group (P = 0.09), and a statistically significant correlation for the TDT‐harvest sites (P = 0.02). Additionally, a shallow palatal vault height (PVH) was associated with a higher leakage in both harvesting groups (P = 0.02). The histomorphometric analyses revealed that grafts harvested with TDT exhibited a significantly higher mean number of medium (ø = 0.1 to 0.5 mm, P = 0.03), and large vessels (ø ≥ 0.5 mm, P = 0.02). Conclusions Within the limitations of the present research, the TDT resulted in a significantly higher leakage than the FGGT, which was also correlated with the histology analyses where a greater number of medium and large vessels were observed in the harvested grafts.

Ultrasonographic tissue perfusion analysis at implant and palatal donor sites following soft tissue augmentation: A clinical pilot study

“…The peak of CV m was observed at 1 week for all the examined scans, with the 8‐mm area displaying higher values of blood volume compared to the other palatal sites. This is in line with a cadaver study showing that a higher mean number of medium and large vessels are found in the deep palate (Tavelli, Barootchi, Namazi, et al, 2020). It is important to highlight that even though the harvesting was performed in the pre‐molar regions, the greater palatine artery at the area of the GPF showed an increase in blood volume at both 1‐week and 1‐month.…”

Gingival phenotype modification therapies on natural teeth: A network meta‐analysis

“…91 The lower morbidity, unlimited blood supply, and regeneration of a site-appropriate tissue compared with the autogenous gingiva have been considered as the main advantages of graft alternatives. 92,93 In particular, the cultivation of human living keratinocytes and fibroblasts into scaffold matrices have also been investigated for creating an autogenous soft tissue graft equivalent, showing promising outcomes however inferior to FGG. 92,94,95 Our results demonstrated the efficacy of LCC in KT augmentation compared with untreated sites and APF.…”

Ultrasonographic characterization of lingual structures pertinent to oral, periodontal, and implant surgery

“…Clinicians are constantly faced with management of complex surgical cases requiring advanced and extensive tissue management. Successful management of these clinical scenarios for periodontal, oral surgery, or implant indications relies on a profound knowledge of the anatomical structures (Greenstein, Cavallaro, Romanos, & Tarnow, ; Tavelli, Barootchi, Namazi, et al, ; Tavelli, Barootchi, Ravida, Oh, & Wang, ). In particular, due to an increasing demand for augmenting atrophic posterior mandible and subsequent implant rehabilitation (Urban et al, ), a firm understanding of the biological structures in this region cannot be overemphasized.…”