AccScience Publishing / GTM / Volume 3 / Issue 2 / DOI: 10.36922/gtm.2693

Recombinant human platelet-derived growth factor-BB-soaked gelatin sponge reduces patient pain in palatal graft donor sites

David Meister1 Muhammad H.A. Saleh2 Hussein Basma3 Fatemah Samavatijame2 Hom-Lay Wang2*
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1 Periodontal and Implant Associates of Middle Tennessee, Franklin, Tennessee, United States of America
2 Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
3 Department of Periodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
Global Translational Medicine 2024, 3(2), 2693
Submitted: 10 January 2024 | Accepted: 29 March 2024 | Published: 10 June 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

The free gingival graft (FGG) remains a gold standard for treating mucogingival defects and increasing the width of keratinized tissue. However, patients receiving FGG surgery report substantial post-operative discomfort, bleeding, and swelling, more so than those receiving connective tissue grafts, for example, and some of these post-operative sequelae can be difficult to manage. Various techniques are utilized in achieving hemostasis, but no current techniques effectively reduce the pain and discomfort to the patient. Ten FGGs were harvested from the palates of 10 patients to treat mucogingival deficiencies elsewhere in each patient. Immediately (<1 min) after harvesting the FGG, a gelatin sponge soaked in recombinant human platelet-derived growth factor-BB (rhPDGF-BB) was placed into the wound site and sutured in place with absorbable sutures. Patients were followed up on days 3, 7, and 14 for assessing pain levels utilizing patient-reported outcome measures (PROMs), which incorporate the visual analog scale and the quantification of analgesics consumed. Clinically, the rhPDGF-BB/gelatin sponge-treated FGG palatal donor sites began to heal by day 3 of follow-up, and the healing was completed during the visit on day 14. No adverse effects, including swelling or bleeding, were observed at any of the post-surgical time points. According to the visual pain score, patients experienced minor discomfort, but no dissatisfaction was reported. Patients whose palatal FGG donor site was treated with a gelatin sponge soaked in rhPDGF-BB reported little or no post-surgery discomfort and low morbidity at the donor site within 2 weeks. These findings are in sharp contrast to the well-known substantial discomfort most patients experience following the harvesting of a palatal FGG. The data suggest that treating FGG palatal donor sites with rhPDGF-BB-soaked gelatin sponge can improve patient experience.

Tissue adhesives
Wound healing
  1. Kim DM, Neiva R. Periodontal soft tissue non-root coverage procedures: A systematic review from the AAP Regeneration Workshop. J Periodontol. 2015;86(2 Suppl):S56-S72. doi: 10.1902/jop.2015.130684


  1. Griffin TJ, Cheung WS, Zavras AI, Damoulis PD. Postoperative complications following gingival augmentation procedures. J Periodontol. 2006;77(12):2070-2079. doi: 10.1902/jop.2006.050296


  1. Ehab K, Abouldahab O, Hassan A, Fawzy El-Sayed KM. Alvogyl and absorbable gelatin sponge as palatal wound dressings following epithelialized free gingival graft harvest: A randomized clinical trial. Clin Oral Investig. 2020;24(4):1517-1525. doi: 10.1007/s00784-020-03254-z


  1. Tavelli L, Ravidà A, Saleh MHA, et al. Pain perception following epithelialized gingival graft harvesting: A randomized clinical trial. Clin Oral Investig. 2019;23(1):459-468. doi: 10.1007/s00784-018-2455-5


  1. Stavropoulou C, Atout RN, Brownlee M, Schroth RJ, Kelekis- Cholakis A. A randomized clinical trial of cyanoacrylate tissue adhesives in donor site of connective tissue grafts. J Periodontol. 2019;90(6):608-615. doi: 10.1002/JPER.18-0475


  1. Fujioka-Kobayashi M, Miron RJ, Moraschini V, Zhang Y, Gruber R, Wang HL. Efficacy of platelet-rich fibrin on bone formation, part 2: Guided bone regeneration, sinus elevation and implant therapy. Int J Oral Implantol (Berl). 2021;14(3):285-302.


  1. Miron RJ, Moraschini V, Fujioka-Kobayashi M, et al. Use of platelet-rich fibrin for the treatment of periodontal intrabony defects: A systematic review and meta-analysis. Clin Oral Investig. 2021;25(5):2461-2478. doi: 10.1007/s00784-021-03825-8


  1. Bahammam MA. Effect of platelet-rich fibrin palatal bandage on pain scores and wound healing after free gingival graft: A randomized controlled clinical trial. Clin Oral Investig. 2018;22(9):3179-3188. doi: 10.1007/s00784-018-2397-y


  1. Sullivan HC, Atkins JH. Free autogenous gingival grafts. I. Principles of successful grafting. Periodontics. 1968;6(3):121-129.


  1. Tavelli L, Ravidà A, Barootchi S, Chambrone L, Giannobile WV. Recombinant human platelet-derived growth factor: A systematic review of clinical findings in oral regenerative procedures. JDR Clin Trans Res. 2021;6(2):161-173. doi: 10.1177/2380084420921353


  1. Meza-Mauricio J, Furquim CP, Geldres A, et al. Is the use of platelet-rich fibrin effective in the healing, control of pain, and postoperative bleeding in the palatal area after free gingival graft harvesting? A systematic review of randomized clinical studies. Clin Oral Investig. 2021;25(7):4239-4249. doi: 10.1007/s00784-021-03933-5


  1. Solchaga LA, Hee CK, Roach S, Snel LB. Safety of recombinant human platelet-derived growth factor-BB in Augment(®) bone graft. J Tissue Eng. 2012;3(1). doi: 10.1177/2041731412442668


  1. DiGiovanni CW, Lin SS, Baumhauer JF, et al. Recombinant human platelet-derived growth factor-BB and beta-tricalcium phosphate (rhPDGF-BB/β-TCP): An alternative to autogenous bone graft. J Bone Joint Surg Am. 2013;95(13):1184-1192. doi: 10.2106/JBJS.K.01422


  1. Lee C, Straus WL, Balshaw R, Barlas S, Vogel S, Schnitzer TJ. A comparison of the efficacy and safety of nonsteroidal antiinflammatory agents versus acetaminophen in the treatment of osteoarthritis: A meta-analysis. Arthritis Rheum. 2004;51(5):746-754. doi: 10.1002/art.2069
Conflict of interest
The authors declare no conflicts of interest.
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Global Translational Medicine, Electronic ISSN: 2811-0021 Published by AccScience Publishing