Clinical comparison of platelet-rich fibrin and a gelatin sponge in the management of palatal wounds after epithelialized free gingival graft harvest: A randomized clinical trial

BACKGROUND: Platelet-rich fibrin (PRF) promotes tissue regeneration by releasing various growth factors. The palatal donor site of the epithelialized connective tissue (CT) graft significantly influences the patient's morbidity. The aim of this study is to compare the effects of PRF and gelatin sponge on the healing of palatal donor sites and the patient's morbidity. METHODS: Forty patients with at least one site of Miller Class I or II gingival recession were treated by a coronally advanced flap with CT graft resulting from the de-epithelialization of a free gingival graft. In the test group (20 patients), a PRF membrane was placed over the palatal wounds; conversely, the 20 control group patients were treated with an absorbable gelatin sponge. Patients were monitored at 1, 2, 3, and 4 weeks after surgery for the complete re-epithelialization of the palatal wound (CWE), the alteration of sensitivity around the wound area, postoperative discomfort, and changes in feeding habits (CFH). Furthermore, the consumption of analgesics during the postoperative week 1 was assessed. RESULTS: The test group showed a significantly faster CWE (P <0.001); 35% of the test patients showed CWE at the end of week 2 (controls, 10%), whereas at the end of week 3, all palatal wounds in the test patients epithelialized completely (controls, 25%). Similarly, test patients reported significantly less discomfort and CFH (P ≤ 0.02) and took a significantly lower dose of analgesics (P = 0.02). CONCLUSION: The PRF-enriched palatal bandage significantly accelerates palatal wound healing and reduces the patient's morbidity.