Journal of Indian Society of Periodontology

LETTER TO EDITOR
Year
: 2014  |  Volume : 18  |  Issue : 6  |  Page : 684-

Palatal bandage


Ashish Kumar, Geeti Gupta 
 Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India

Correspondence Address:
Ashish Kumar
24 A, DDA Flats, Taimoor Enclave, New Friends Colony, New Delhi 110 065
India




How to cite this article:
Kumar A, Gupta G. Palatal bandage.J Indian Soc Periodontol 2014;18:684-684


How to cite this URL:
Kumar A, Gupta G. Palatal bandage. J Indian Soc Periodontol [serial online] 2014 [cited 2020 Jul 5 ];18:684-684
Available from: http://www.jisponline.com/text.asp?2014/18/6/684/147396


Full Text

Sir,

We read the article "Platelet-rich fibrin (PRF) as an adjunct to palatal wound healing after harvesting a free gingival graft (FGG): A case series" authored by Kulkarni et al . [1] with great interest.

Authors are absolutely correct in stating that there are very few studies on the role of PRF as an adjunct for wound healing in the oral cavity. A case report by Jain et al. [2] was probably the initial report to be published, which used PRF for palatal wound healing.

A case series by Aravindaksha et al. [3] in 2013 was probably the first study to advocate the use of PRF membrane for protection of the FGG donor (FGG) sites and compared healing of palatal donor sites with and without PRF. Aravindaksha et al. [3] coined the term "Palatal Bandage" for the PRF membrane as dressing for protection of the FGG donor sites. [3]

Kulkarni et al. [1] evaluated epithelialization as one of the criteria for palatal wound healing by looking at wound closure. We believe that clinical evaluation of wound healing by looking at wound closure is a very subjective criterion. One of the objective tests to evaluate epithelialization is H 2 O 2 test and was applied in the study by Aravindaksha et al. [3] with clear results. An uneventful comprehensive healing was observed at all the sites with PRF by 18 days in their study. [3] The demarcation of membranes integrated at the donor sites was visible at 18 days. [3] The same test had also been applied by Silva et al. [4] to evaluate complete epithelialization.

Kulkarni et al. [1] compared the palatal wound healing with sites where PRF was not used. There is no mention of status of healing after 14 days in the case report, especially about the non-PRF donor sites, which showed incomplete wound closure and some inflammation in the adjacent areas on the 14 th day. Comparisons between PRF and non-PRF sites would be more effective if authors had noted/mentioned the time taken by the non-PRF sites for complete healing and the results would have illustrated the difference. In an article by Aravindaksha et al., [3] all the sites with PRF healed by 18 days whereas the non-PRF donor site healed by 4 weeks.

There are varied reports on the time required by FGG donor sites to heal. [4],[5] Silva et al. [4] observed that 92% of the patients showed complete epithelialization and closure of the palatal FGG donor site at 15 days postoperatively whereas Del Pizzo et al. [5] reported that only 17% of their patients showed complete epithelialization of the palatal FGG donor sites after 15 days of graft harvesting.

References

1Kulkarni MR, Thomas BS, Varghese JM, Bhat GS. Platelet-rich fibrin as an adjunct to palatal wound healing after harvesting a free gingival graft: A case series. J Indian Soc Periodontol 2014;18:399-402.
2Jain V, Triveni MG, Kumar AB, Mehta DS. Role of platelet-rich-fibrin in enhancing palatal wound healing after free graft. Contemp Clin Dent 2012;3:S240-3.
3Aravindaksha SP, Batra P, Sood V, Kumar A , Gupta G. Use of platelet rich fibrin (PRF) membrane as palatal bandage. Clin Adv Periodontics 2014;4:246-250. DOI: 10.1902/cap.2013.130011.
4Silva CO, Ribeiro Edel P, Sallum AW, Tatakis DN. Free gingival grafts: Graft shrinkage and donor-site healing in smokers and non-smokers. J Periodontol 2010;81:692-701.
5Del Pizzo M, Modica F, Bethaz N, Priotto P, Romagnoli R. The connective tissue graft: A comparative clinical evaluation of wound healing at the palatal donor site. A preliminary study. J Clin Periodontol 2002;29:848-54.