Author ORCID Identifier

0009-0004-1894-2044

Defense Date

2026

Document Type

Thesis

Degree Name

Master of Science in Dentistry

Department

Dentistry

First Advisor

Rafael Siqueira

Second Advisor

Iya Ghassib

Third Advisor

Caroline Carrico

Fourth Advisor

Alexandra Howell

Fifth Advisor

Gustavo Mendonca

Abstract

Objective: To compare patient reported outcome measures (PROMs) when different palatal protection techniques were used after autogenous gingival grafting (AGG) harvest. Secondary objectives were to evaluate healing of palatal tissues via photographic images and clinician preferences among techniques utilized.

Methods: Thirty-three patients who required AGG were assigned into four groups based on the palatal wound protection technique: vacuum-formed retainer (VFR), 3D-printed acrylic stent (3DS), flowable resin composite (FRC), or chairside polymer stent (CPS). Patients were followed for 2 weeks, 4 weeks, and 3 months. Healing outcomes for postoperative pain, bleeding, swelling and willingness to retreat were evaluated via visual analog scales. Wound analysis was performed using standardized palatal images. Participant demographics were compared across the groups using Fisher’s exact test. Graft dimensions were compared using ANOVA models. Repeated measures ANOVA models were used to test for differences in PROMs across groups and time. All post hoc analyses were adjusted for multiple comparisons.

Results: Thirty patients received one of four stents and attended all follow-up appointments: 3DS (n=8, 26.67%), CPS (n=5, 16.67%), FCR (n=8, 26.67%), or VFR (n=9, 30%). There were statistically significant differences in pain and swelling between groups, with the FRC group exhibiting lower levels for both outcomes (adjusted p=0.0360, adjusted p< 0.002. respectively.). There were no significant differences between groups in analgesic consumption or willingness to undergo retreatment. The average willingness to undergo retreatment across all time points and stents was 7.5 and ranged from 6.9 at 7 days post-surgery to 8.1 at 90 days post-surgery. Wound reepithelialization was not significantly different among groups (p=0.5570), with most patients reaching >99% reepithelialization by 30 days. There was 100% agreement by clinicians that they would utilize these stents in their daily clinical practice. CPS had the highest efficiency rating, however there was no statistical significance after multiple comparisons were made.

Conclusion: All four mechanical barrier stent designs evaluated in this study were associated with overall low levels of postoperative pain and high patient willingness to undergo retreatment. The use of a palatal stent following AGG appears to minimize postoperative discomfort and increase patient acceptance of future treatment and is considered by clinicians to be an efficient method for protecting the palatal wound.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

5-6-2026

Available for download on Friday, May 05, 2028

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