Clinically, the gingiva is part of the oral mucosa and periodontium that covers the alveolar processes of the jaws and surrounds the cervical portions of the teeth. Topographically, it is divided into free, attached, and interdental gingiva. Following tooth eruption, the gingival margin is located 0.5-2 mm coronally to the cementoenamel junction (CEJ). Histologically, the gingiva consists of epithelium and connective tissue. Anatomically and clinically, it is divided into three distinct regions: free gingiva, interdental gingiva, and attached gingiva.
Mucogingival issues arise as a result of insufficient attached gingiva. A thick keratinized attached gingiva is necessary to protect against masticatory trauma. When attached gingiva is reduced, plaque control becomes difficult, and the area becomes prone to inflammation. For periodontal health, 2 mm of attached gingiva is considered essential. The protective barrier function of attached gingiva prevents free gingival margin movement caused by the effects of perioral muscles in cases of insufficient attached gingiva. Movement of the gingival margin increases the risk of inflammation progression and gingival recession.
Free gingival graft (FGG) is one of the mucogingival surgical procedures used to increase the amount of attached gingiva, cover exposed root surfaces in localized gingival recession, deepen the vestibule, and eliminate frenulum and muscle attachments. The harvested tissue is keratinized attached gingiva. During the FGG procedure, vestibular depth increases, allowing patients to perform brushing more comfortably. The tuberosity region, edentulous alveolar crest, and hard palate are commonly preferred as donor sites due to ease of access.
Post-FGG complications are generally related to the donor site and include postoperative bleeding, recurrent herpetic lesions, delayed healing, paresthesia, mucocele, arteriovenous shunt, and postoperative pain. The palatal donor site often causes more discomfort and pain during the healing process. To support healing, various procedures have been implemented for the palatal donor site, including palatal stent + periodontal dressing application, suturing of hemostatic sponges, and surgical cauterization or laser application.
Recent studies report that Platelet-Rich Fibrin (PRF) accelerates healing and reduces postoperative morbidity when used to cover palatal wounds. Studies have shown that PRF supports "immunity," "angiogenesis," and "cellular proliferation," which play key roles in wound healing. Its use in non-healing wounds and surgical areas left for secondary healing has garnered significant attention. Choukroun developed a method to obtain leukocyte- and platelet-rich fibrin (L-PRF) by centrifuging 9 ml of whole venous blood in non-anticoagulant tubes at 2700 rpm for 12 minutes at room temperature. The process produces three layers within the tube: platelet-poor plasma at the top, red blood cells at the bottom, and L-PRF, a fibrin structure rich in platelets and growth factors, in the middle. The L-PRF layer is extracted with forceps, separated from the red blood cell layer using scissors, and compressed between two metal trays in a sterile container to form a 1-mm-thick membrane for clinical use.
Ora-Aid wound dressing is a relatively new material used for palatal donor site healing following FGG surgery. The adhesive side of Ora-Aid is applied directly to the oral mucosa, forming a protective layer. Ora-Aid offers advantages such as aiding hemostasis, providing physical protection against food particles, bacterial irritants, and smoking, and reducing oral malodor with its natural mint flavor. Another advantage is that it naturally detaches without requiring an additional appointment for removal. Ora-Aid consists of hydrophilic high-density polymers encapsulated within water-insoluble mucoadhesive synthetic cellulose and contains vitamin E, which has wound-healing and hemostatic effects. It is available in two sizes: 50 mm × 20 mm and 25 mm × 15 mm.
After harvesting the FGG, the palatal wound is irrigated with saline solution, and Ora-Aid is trimmed to the appropriate size and shape. It is then peeled from its transparent film and applied to the wound using forceps. The dressing is gently pressed for 5-10 seconds until it adheres to the wound. Ora-Aid use has demonstrated superior results for both patients and clinicians, being effective in reducing postoperative pain and enhancing wound healing. It holds significant potential as a palatal wound dressing material.
The aim of this study is to evaluate the quality of life in patients receiving L-PRF and periodontal dressings on the donor site after free gingival graft surgery.
