Use of a Custom-Made Acrylic Palatal Stent to Minimize Donor Site Morbidity After Suture-Free Epithelialized Gingival Graft Harvesting: A Randomized Clinical Trial

Epithelialized gingival graft (EGG) harvesting is widely used in periodontal plastic surgery but is associated with postoperative discomfort at the palatal donor site. Healing occurs by secondary intention and may result in pain, bleeding, and delayed recovery.

Palatal stents have been proposed as a mechanical approach to protect the wound and reduce morbidity; however, evidence supporting their effectiveness, especially in suture-free techniques, is limited.

This randomized controlled, assessor-blind, parallel-arm clinical trial aims to evaluate the effect of a custom-made acrylic palatal stent (APS) on postoperative morbidity following EGG harvesting. Patients were randomly assigned to receive APS or no stent after surgery.

The primary outcome is postoperative pain. Secondary outcomes include patient-reported measures, clinical healing parameters, and exploratory assessments of tissue healing.

Inclusion criteria

• Adults ≥18 years of age
• Patients requiring periodontal plastic surgery involving epithelialized gingival graft (EGG) harvesting from the palate
• Indications including keratinized tissue augmentation, soft tissue thickness augmentation, or root coverage procedures
• Adequate palatal tissue thickness to allow graft harvesting (≥2 mm)
• Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS) ≤20%
• Ability to understand and complete patient-reported outcome questionnaires
• Signed informed consent
• Willingness to comply with study procedures and follow-up visits

Exclusion criteria

• compromised general health contraindicating the procedures (ASA III-VI)
• heavy smokers (≥ 10 cigarettes/day),
• systemic diseases or medications affecting treatment outcomes,
• known allergies or hypersensitivity to ibuprofen.