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Global Translational Medicine RhPDGF-BB/gelatin sponge-treated FGG

All FGGs were performed in accordance with Sullivan maintaining oral hygiene. A soft food diet was prescribed
and Atkins’ description, with all grafts being placed on a during the 1 week to avoid any mechanical trauma to
st
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prepared periosteal bed. Graft thickness was standardized the sites. A rescue medication (600 mg of ibuprofen) was
to approximately 1 – 1.5 mm, depending on the palatal prescribed. Patients were instructed to take the drug only
tissue thickness, as identified through bone sounding when necessary. No packs or dressing materials were
before surgery. After harvesting the FGG, the absorbable applied to the donor sites, and no palatal stents were
porcine gelatin sponge soaked in rhPDGF-BB was placed provided either.
to cover the denuded palatal wound and on the recipient
site. Mild manual compression of the wound area was 2.2. Consecutive case series
conducted, with caution exercised not to wring out all Ten patients in need of an FGG were consecutively treated
the rhPDGF-BB solution from the sponge. Afterward, with the same technique as described below. All patients
the rhPDGF-BB-soaked sponge was sutured in place with were requested to complete the PROMs questionnaire
compressive palatal polyglycolic acid (PGA) 4/0 absorbable on days 3, 7, and 14 during the post-surgical follow-up.
sutures (Figures 2 and 3). All FGGs were then stabilized According to their survey responses, the patients reported
with suspensory periosteal sling PGA 4/0 absorbable continuous alleviation of discomfort, and they did not
sutures (Figures 2 and 3). The transplanted grafts covered experience any pain in the 2 week.
nd
the recessions successfully, and the harvested sites were
healed nicely without complications. 2.3. PROMs and clinical observation methods
The post-operative instructions given to patients Patients were followed up on days 3, 7 (±3), and 14 (±3)
included discontinuing tooth brushing and flossing around post-surgically to assess healing and record their pain
the surgical sites for the 2 weeks following surgery, avoiding scores. Patients were requested to make a mark on the VAS
the area with the tongue to minimize any movement of to denote the level of perceived pain. During follow-ups,
the sponge, and using mouthwash as an alternative for all records were taken by the same clinician (D.M.).
3. Results

The recorded scores are presented in Table 1. Upon day
3, all patients reported mild (1 – 3) or no (0) pain. These
patients had taken ibuprofen, which has been confirmed
in a meta-analysis to be superior to acetaminophen in
reducing pain. No patients reported moderate or severe
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pain. During the follow-up on day 7, six patients reported
Figure 1. Photos showing the gelatin sponge cut to match the dimension
of the graft to be harvested. The sponge was then soaked in rhPDGF no pain whatsoever, three reported only mild pain, one
solution for ≥10 min before being applied to the donor site. reported moderate pain, and no patients reported severe
A B C

D E F

Figure 2. Photos showing the FGG harvesting, application of the rhPDGF-BB-soaked gelatin sponge to the donor site, and post-operative healing in
patient 3. (A) Pre-operative situation; (B) FGG harvesting; (C) A pre-cut rhPDGF-BB-soaked gelatin sponge placed in the wound site and sutured with
PGA sutures; (D) Donor site healing on day 3; (E) Donor site healing on day 8; and (F) Donor site healing on day 15.
Abbreviations: FGG: Free gingival graft; rhPDGF-BB: Recombinant human platelet-derived growth factor-BB; PGA: Polyglycolic acid.

Volume 3 Issue 2 (2024) 3 doi: 10.36922/gtm.2693