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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Complication, Technical Pitfalls, and Strategies for Reducing Donor-Site Morbidity Following Connective Tissue Graft Harvesting: A Narrative Review

  • Agnieszka Droździk1
  • Dominika Cichońska2
  • Mariusz Lipski3
  • Aida Kusiak2
  1. 1Laboratory of Preclinical Periodontology, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
  2. 2Department of Periodontology, Medical University of Gdańsk, Marii Skłodowskiej-Curie 3C, 80-210 Gdańsk, Poland
  3. 3Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72, 70-111 Szczecin, Poland
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Abstract

Connective tissue grafts (CTGs) are widely used in periodontal and peri-implant plastic surgery, but palatal harvesting is associated with donor-site morbidity. This narrative review summarizes complications, technical pitfalls, and risk-reduction strategies related to subepithelial connective tissue grafts and de-epithelialized gingival graft harvesting. Subepithelial techniques enable primary closure but require adequate residual flap thickness and controlled dissection, whereas de-epithelized grafts provide better control of graft dimensions but leave an open palatal wound. Donor-site morbidity is influenced by patient-related factors, palatal anatomy, graft size, wound configuration, and surgical execution. Pain and bleeding are the most frequently reported early outcomes, while dehiscence, necrosis, infection, sensory disturbances, and symptomatic scarring remain poorly quantified. Risk may be reduced through careful assessment, minimal effective graft dimensions, atraumatic technique, reliable hemostasis, wound protection, and clear postoperative instructions. Standardized CTG-specific outcome measures and risk-assessment tools are needed to improve evidence comparability and clinical decision-making.

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Cite

BibTeXRIS
BibTeX
@article{drozdzik2026complication,
  title = {{Complication, Technical Pitfalls, and Strategies for Reducing Donor-Site Morbidity Following Connective Tissue Graft Harvesting: A Narrative Review}},
  author = {Agnieszka Droździk and Dominika Cichońska and Mariusz Lipski and Aida Kusiak},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218739},
  url = {https://www.mdpi.com/2077-0383/15/21/8739},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Complication, Technical Pitfalls, and Strategies for Reducing Donor-Site Morbidity Following Connective Tissue Graft Harvesting: A Narrative Review
AU  - Agnieszka Droździk
AU  - Dominika Cichońska
AU  - Mariusz Lipski
AU  - Aida Kusiak
PY  - 2026
DA  - 2026/11/09
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218739
UR  - https://www.mdpi.com/2077-0383/15/21/8739
AB  - Connective tissue grafts (CTGs) are widely used in periodontal and peri-implant plastic surgery, but palatal harvesting is associated with donor-site morbidity. This narrative review summarizes complications, technical pitfalls, and risk-reduction strategies related to subepithelial connective tissue grafts and de-epithelialized gingival graft harvesting. Subepithelial techniques enable primary closure but require adequate residual flap thickness and controlled dissection, whereas de-epithelized grafts provide better control of graft dimensions but leave an open palatal wound. Donor-site morbidity is influenced by patient-related factors, palatal anatomy, graft size, wound configuration, and surgical execution. Pain and bleeding are the most frequently reported early outcomes, while dehiscence, necrosis, infection, sensory disturbances, and symptomatic scarring remain poorly quantified. Risk may be reduced through careful assessment, minimal effective graft dimensions, atraumatic technique, reliable hemostasis, wound protection, and clear postoperative instructions. Standardized CTG-specific outcome measures and risk-assessment tools are needed to improve evidence comparability and clinical decision-making.
SN  - 2077-0383
ER  -