Tuberosity versus palatal donor sites for soft tissue grafting: A split-mouth clinical study

Objective: To compare postoperative pain associated with palatal and tuberosity donor sites for soft tissue grafting, and to evaluate the outcomes in both the donor and recipient sites. Method and Materials: Twenty healthy nonsmokers requiring bilateral soft tissue grafts were recruited for the study. For the 10 patients who required free gingival graft (FGG), 10 epithelialized grafts were taken from the tuberosity and 10 from the palate. The other 10 patients who required coronally advanced flap (CAF) and connective tissue graft (CTG) received 10 de-epithelialized grafts from the tuberosity and 10 from the palate. A total of 20 receded areas were treated with CAF and CTG. A total of 20 mucogingival defects were treated by FGG. Pain level was reported by the patient using a subjective score on a scale of 0 to 10 (0 = no pain, 10 = very severe pain). The length, width, and thickness of the outcome was measured for the FGG group at 8 weeks. The percentage of root coverage along with the length, width, and thickness of the final outcome was measured for the FGG group as well as the CAF and CTG group. Results: Pain level in the tuberosity donor site was significantly lower than in the palatal donor site during the first 2 postoperative weeks (2.6 ± 2.16 versus 5.9 ± 2.74 respectively, P .001). Mean gingival thickness of the healed tuberosity donor graft was greater than of the palatal donor grafts in both groups; for CAF and CTG group 2.9 ± 0.5 versus 2.3 ± 0.6 mm, respectively (P = .016); for FGG group 2.7 ± 0.7 versus 2.1 ± 0.7, respectively (P = .026). No differences were observed in the length or width of both grafted sites at an 8-week follow-up. No significant difference in the mean percentage of root coverage resulting from tuberosity or palatal donor sites was noted (67 ± 12% versus 62 ± 13%, respectively, P = .102). Conclusion: Soft tissue grafts harvested from the tuberosity site might provide a better option than soft tissue donor grafts obtained from the palate in terms of function and less postoperative pain.