Abstract / Summary
Objectives: Management of the palatal donor site following periodontal plastic surgery remains challenging because of postoperative pain, bleeding, and patient discomfort. This study aimed to evaluate the efficacy of a chairside-fabricated composite barrier in reducing morbidity at the palatal donor site.
Materials and methods: In this randomized, parallel-group clinical trial, 50 patients undergoing soft tissue augmentation were allocated to either a test group (composite barrier + collagen sponge) or a control group (collagen sponge alone). Intraoperative measurements included palatal tissue thickness, graft dimensions, and donor site management time. Postoperative outcomes (pain, bleeding, discomfort, chewing difficulty, stress, analgesic consumption, and willingness for retreatment) were assessed at prespecified time points during the first 2 postoperative weeks. Donor sites complications were specifically assessed on postoperative day 7.
Results: All participants completed the study without dropouts. Compared with controls, the composite barrier group required significantly shorter wound management time (210.42 ± 52.04 vs. 445.76 ± 77.43 s; p < 0.001) and lower analgesic consumption during the first week (1328.00 ± 846.33 vs. 4160.00 ± 1366.26 mg; p < 0.001). Pain scores were significantly lower in the composite barrier group on postoperative days 1-7 (p < 0.001), slightly higher on day 10 (p = 0.007), and similar on day 14. Bleeding scores were lower during the first 4 postoperative days (p < 0.001). Patient-reported discomfort, chewing difficulty, and stress were significantly reduced in the composite barrier group (p < 0.001), which also showed greater willingness for retreatment (7.80 ± 1.15 vs. 2.04 ± 1.34; p < 0.001). No necrosis, infection, or hematoma occurred.
Conclusions: Application of a composite barrier for palatal donor site management reduces the time required to achieve intraoperative hemostasis and is associated with lower postoperative pain, bleeding, and patient discomfort. This approach may improve patient-reported outcomes following periodontal plastic surgery.
Trial registration: This project was registered in the Iranian Registry of Clinical Trials under the ID (IRCT20250513065721N2), and the registration date was 21/6/2025.