The effect of smoking on donor- site healing after free gingival graft surgery

Aim: In this study, we aimed to define, was to evaluate the effect of smoking on wound healing in the palate donor area after free gingival graft surgery, to determine the effect of smoking on postoperative healing and complete epithelialization time, and to examine patient comfort. Material and method: A total of 20 volunteer patients with Miller I and II gingival recession were included in the study. Control Group (Group 1): consists of 10 non-smokers, while Test Group (Group 2): consists of 10 individuals who smoke at least 10 cigarettes per day. After the plaque index, gingival index, bleeding on probing and pocket depth measurements of the individuals whose initial periodontal treatments were completed, SDG operation was performed. Periodontology examinations of the patients were performed on the 3rd, 7th, 14th, 21st and 42nd days after the operation. In the postoperative examination, the degree of epithelialization in the donor area was determined using hydrogen peroxide, and the color match of the newly formed tissue was examined with the photographs of the palate area taken from the patient. In addition, a visual anonymous scale (VAS scale) 0 (no pain/no burning sensation) to 10 (severe pain/burning sensation) was applied to the patients and they were asked to rate the sensitivity and burning sensation they experienced after the surgery. The study was terminated after the 42nd day data were collected. Results: This study was applied to 20 systemically healthy individuals in need of free gingival graft. While 50% (n:10) of the participants smoke, 50% (n:10) do not smoke. The COppm value of each individual was determined with a smokerlyzer monitor. Postoperative bleeding did not occur in any of the individuals after the operation, and each individual was considered on the 3rd, 7th, 14th, 21st and 42nd days. It is seen that the COppm and %COHb values of the test group are statistically significantly higher than the control group. It was determined that the measurement of pain, tenderness and burning sensation on the 1st, 3rd, 7th and 14th days of the test group and the amount of change in the eating-drinking habits on the 3rd, 7th and 14th days were statistically significantly higher than the control group. Again, the feeling of discomfort on the 7th and 14th days of the test group was found to be significantly higher than the control group, but it was concluded that the epithelialization level on the 7th, 14th, and 21st days was significantly lower than the control group. Considering the amount of painkiller use, the test group was significantly higher than the control group in all postoperative evaluations. In the examinations performed in the smoking group, the mean COppm value was taken as 10. Individuals with a COppm value of >10 had significantly higher levels of pain on the 3rd day and tenderness on the 14th day, while the amount of epithelialization was found to be significantly lower on the 21st day. No significant difference was found when the feeling of discomfort, changes in eating-drinking habits and the amount of painkiller use were compared in the within-group evaluation of the test. Conclusion: Smoking delays the wound healing and epithelialization process in the donor area after the SDG operation. It was determined that postoperative pain, burning, tenderness and discomfort, the amount of change in eating and drinking habits and the number of painkiller use were statistically significantly higher in smokers compared to non-smokers. In addition, when the group consisting of smokers is examined within itself, it has been concluded that individuals with a high amount of cigarette consumption have a statistically significantly lower level of epithelization, and a higher level of sensitivity and pain than individuals with less cigarette consumption. The reason for this is thought to be the cumulative effect of smoking on the body, depending on the amount and duration of smoking