Evaluation of the effect of tissue thickness on the donor area and the effect of smoking on wound healing after harvesting A connective tissue graft

Evaluation of the effect of tissue thickness on the donor area and the effect of smoking on wound healing after harvesting a connective tissue graft Mucogingival problems arise when the healthy relationship between gingival and alveolar mucosa is impaired. Autogenous connective tissue grafts are frequently used in the treatment of gingival recession, which is one of the most common mucogingival problems that causes aesthetic concerns in the patient. The most commonly preferred donor site is the palate in obtaining the autogenous connective tissue graft. Wound healing is new tissue formation as a result of cellular and biochemical events that begin following trauma. Smoking is an important environmental factor adversely affecting wound healing through various mechanisms. Smoking negatively affects healing of the wound site after periodontal surgery. The aim of our study is to evaluate the effects of baseline tissue thickness and also the residual thickness after connective tissue graft harvesting from the palate, on epithelization rate and tissue filling comparatively in smoker and non-smoker patients. In total 20 patients were included in the study in the smoker and non-smoker groups. During the surgery, the baseline palatal mucosa thickness, the thickness of the elevated flap and the thickness of the tissue under the flap were measured at three points on the palate. On the 7th, 14th, 21st, 28th days postoperatively, complete epithelization of the palate was evaluated dichotomously either as present or absent. In the 2nd and 3rd months, palate thickness measurements were made at the same three points. Time for occurrence of complete epithelization in the palate was similar in the smoker and non-smoker study groups. A positive correlation was observed between the baseline palatal thickness and the thickness of the palate at 2nd and 3rd months. There was an increase in the thickness of the palate at 2nd and 3rd months with the increase in the baseline palatal thickness. In the smoking group, the change in the thickness of the palate at the mesial measuring point was significantly greater at the 3rd month compared to that of the difference in the non-smoker group. Moreover, the thickness of the palate in the smoker group at the postoperative third month was significantly less than the baseline palatal thickness. The thickness of the tissue under the flap positively correlated with the palatal thickness measured at the 2nd and 3rd months in both groups. The results of our study suggest no significant detrimental effect of smoking on the epithelization of the palate after harvesting a connective tissue graft, but tissue filling seems to be delayed. Keywords: Autografts; transplant donor site; smoking; adverse effects; wound healing