Evaluation of the Effectiveness of Different Procedures on Palatinal Wound Healing After Free Gingival Graft Surgery.

The primary result expected from the study is that the healing of the palatinal region left for secondary healing is faster in the I-PRF and 0.8% HA groups compared to the control group.

The primary outcome of the study was to measure the palatal wound healing status using the Landry Wound Healing Index (WHI) (Landry RG (1985) Efectiveness of benzydamine HC1 in the treatment of periodontal post-surgical patients. Faculty of Dentistry, University of Toronto), which grades the wound healing on a scale of the 3rd, 7th, 14th, 21st, and 28th days postoperatively. This index, which has a score range of 1 (very poor) to 5 (excellent), evaluates tissue color, response to palpation, granulation tissue presence, incision margins' epithelialization, and amount of suppuration.

The secondary result expected from the study is that postoperative pain and burning are less in the I-PRF and 0.8% HA groups compared to the control group.

The secondary outcomes of the study were to measure patients' perception of pain, discomfort while chewing, and burning sensation after FGG harvesting using a numerical rating scale (VAS) from 0 (no pain, no discomfort while chewing, no burning sense) to 10 (the worst pain imaginable, extreme discomfort while chewing, extreme burning sense) between days 1 and 7, and the amount of analgesic consumption between days 1 and 7 postoperatively.

Tissue color match (CM) was assessed with adjacent and contralateral palatal tissue (0-no color matching to 10-excellent color matching)

The patients were asked to keep a record of whether there was any bleeding in the palatal region, and at the same time, the presence of postoperative bleeding, also known as delayed bleeding (DB), was recorded as present (+) or absent (-) on the days when the patients came to the follow up appointments.

The epithelialization of the palatal region was recorded according to the application of 3% hydrogen peroxide to the region and whether there was foaming or not, and was calculated as a percentage (H2O2 bubbling). Complete epithelization (CE) was also evaluated clinically by monitoring the surface characteristics and clarity of the wound contour and recorded as "yes" or "no".

Oral Health Related Quality of Life (OHRQoL) was administered on the 7th and 14th days after the surgical procedures to analyse how the person's daily physical-social life and mental health status were affected. This scale developed by McGrath and Bedi evaluates the effects of oral health on quality of life in both positive and negative domains. The scale includes 16 questions consisting of 4 different categories. The categories consist of current symptoms (2 questions) and physical (5 questions), psychological (5 questions) and social (4 questions) conditions. The questions in the OHRQOL-TR questionnaire are scored on a Likert scale with values between 1 and 5 (such as 'very bad' (score 1), 'bad' (score 2), 'none' (score 3), 'good' (score 4) or 'very good' (score 5)). When the scores of 16 questions are totalled, there is a value in the range of 16-80. The reliability and validity of the Turkish version of the scale was proved and reported in the study conducted by Mumcu et al.

Patients were informed that the number of analgesics theytook for post-operative pain relief was recorded for 7 days

The PSTT in the harvested area was measured after theadministration of local anaesthesia.The measurement was made approximately 5 mm apical to the gingival marginof the first premolar using a #15 endodontic reamer. Thepenetration depth was measured using a digital caliper. Themeasurements were obtained before harvesting the FGG and at 1 and 3 months after the operation.The graft thickness was measured in the same way at the middle points of all four edges of the graft. The mean of theobtained values was calculated and considered to be the graft thickness. The dimensions of the graft were standardized using a sterile aluminium foil template of 7 * 12 mm.

After the operation, the consistency of the donor area in the palatal region was marked to be soft and firm.

Palate sensitivity was measured by using a numerical rating scale (VAS) from 0 (no sensitivity) to 10 (most sensitivity) on the 7th, 14th and 21st days after surgery

Loss of sensation was recorded as none (0), moderate (1), and severe (2) on the 3rd, 7th, 14th, 21st, 28th day, 1st month, and 3rd month after the operation.