Free Gingival Graft Patients' Treatment Perception and Experience

Patient Experience and Treatment Perception in Patients Undergoing Free Gingival Graft: A Retrospective Survey Study.

Free gingival graft (FGG) is a common and effective periodontal procedure used to improve gum health; however, it can involve challenges such as postoperative pain and discomfort due to the requirement of a secondary donor site. While clinical outcomes are well-documented, long-term patient perceptions and overall satisfaction levels have not been sufficiently explored. The purpose of this retrospective study is to systematically evaluate patient experiences, satisfaction levels, and the willingness to undergo the procedure again in individuals who underwent FGG surgery at least one year ago.

Background and Rationale: Free gingival graft (FGG) is a widely preferred mucogingival procedure in periodontal plastic surgery, aimed at increasing keratinized tissue width and improving gingival morphology. While FGG is highly effective for indications such as preventing gingival recession and enhancing oral hygiene maintenance, it requires a secondary surgical site (donor area), which can lead to postoperative pain, tissue morbidity, and reduced patient comfort. Current literature often focuses on short-term clinical outcomes, leaving long-term patient-reported outcome measures (PROMs) and perceptions insufficiently explored.

Objectives:The primary objective of this study is to retrospectively evaluate the postoperative experiences, satisfaction levels, and overall surgical perceptions of individuals who underwent FGG surgery. Specifically, the study aims to investigate the willingness of patients to undergo the procedure again, should it be necessary in the future.

Methodology: This is a retrospective, non-interventional, observational, and cross-sectional study conducted at Istanbul Aydin University, Faculty of Dentistry, Department of Periodontology. The study population includes patients who underwent FGG surgery between January 2014 and May 2024, with at least one year having passed since the operation.Data collection involves two stages:

1. Archive Review: Patient demographics, smoking status, systemic health, and surgical details (e.g., complications, donor site technique) are retrieved from institutional records.
2. Telephone Survey: A semi-structured survey is administered via telephone to assess patient-reported outcomes, including pain levels, satisfaction, analgesic requirements, and aesthetic perceptions.

Inclusion Criteria:

• Individuals who underwent Free Gingival Graft (FGG) surgery at Istanbul Aydin University, Faculty of Dentistry, Department of Periodontology; who accurately remember the surgical site and grant permission to use their patient records containing demographic and surgical data.
• Patients who have undergone periodontal plastic surgery due to an FGG procedure only once.
• Patients whose records contain complete information regarding the graft harvesting technique from the palatal donor site, including the date of the procedure and any complications within the first month following surgery.
• Patients who have not previously undergone any other surgical procedure in the palatal region.

Exclusion Criteria:

• Individuals who have not undergone FGG surgery.
• Patients who have undergone periodontal plastic surgery more than once.
• Patients who underwent FGG surgery but have missing or incomplete information in their medical records.
• Patients who have previously undergone any other surgical procedure in the palatal region.
• Patients who have previously received a different periodontal surgical treatment in the area where the relevant teeth are located.