Postoperative Complications Following Gingival Grafts: A Prospective Cohort Study

Aim: Treating gingival recessions (GRs) is a challenge for the practitioner who must take into consideration objective clinical factors, subjective symptoms and also factors related to the patient’s expectations. The aim of this study was to evaluate the postoperative complications associated with connective tissue graft (CTG) plus coronally advanced flap (CAF) and free gingival graft (FGG) used to cover GRs and to compare post-operative morbidities for the two groups of procedures. Material and Methods: A total of 17 patients diagnosed with Miller class 1 to 3 GRs ≥2mm were surgically treated using CTG plus CAF or FGG. When minimum 2 mm of keratinized gingiva was present apically to GR, CTG plus CAF was used. FGG was chosen to cover GRs when keratinized gingiva was absent. Post-operative complications were evaluated with a questionnaire with six questions given to the patients at 14 days follow-up visit. The study used a 1 to 10 visual analogic scale (VAS) and the levels of outcomes were classified as “none to minimum” “moderate” and “very important/severe”. Results: A total of 21 procedures, 10 CTG plus CAG and 11 FGG were included in the analysis. No palatal bleeding and no severe pain or swelling were recorded. The patients experienced more pain in the grafted area than in the donor area, for both surgical techniques, with a mean value of 3.09 (1.3 standard deviation sd) versus 2.27 (1.4 sd) for CTG plus CAF group and of 3.7 (2.21 sd) versus 2.9 (1.7 sd) for FGG group, respectively. CTG plus CAF generated significantly higher scores of tumefaction than FGG, the mean values being 2.45 (0.93 sd) and 4 (2.21 sd) (t-value=2.12, p<0.05) respectively. Conclusion: The complications associated with the two periodontal surgical approaches seem manageable and clinically acceptable.