Is There a Difference in Postoperative Pain After Harvesting a Palatal Soft Tissue Graft Aiming for Primary Versus Secondary Intention Healing? A Systematic Review and Meta-Analysis.
8 affiliations
- 1Department of Periodontology, Faculty of Dentistry, University of the Republic, Montevideo, Uruguay.
- 2School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
- 3Private Practice, Montevideo, Uruguay.
- 4Department of Periodontology, Dental Clinic, Faculty of Medicine, Sigmund Freud University, Vienna, Austria.
- 5Department of Periodontology, Blekinge Hospital, Karlskrona, Sweden.
- 6Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.
- 7Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
- 8Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Abstract
Objectives
To evaluate the effect of surgical technique on postoperative pain at the palatal donor site after harvesting a soft tissue graft.Material and methods
A literature search with the following eligibility criteria was conducted: English language; (randomized) controlled clinical trials (RCT/CT); assessment of pain (including morbidity and discomfort), either directly or via surrogate measures, at the palatal donor site; and comparison of two harvesting techniques (i.e., harvesting a soft tissue graft either involving primary [PIH] or secondary intention healing [SIH]).Results
Five RCTs and two CTs (sample size: 12-50 patients) providing information on a total of 200 donor sites and with a follow-up period of 1-4 weeks were included. Pain was assessed with different methods, for example, using a visual analog scale, the proportion of patients reporting pain, and/or the quantity of analgesics consumed. Secondary outcomes included complete epithelialization, stress, inability to chew, effects on eating habits, sensitivity disturbances, and burning sensation. Four out of seven studies reported significant differences regarding pain, all favoring the PIH technique. Further, four out of seven studies contributed to a meta-analysis, which did not show any significant differences in postoperative pain between the SIH and PIH groups at 3 or 7 days. Subgroup analyses including only studies without palatal wound protection also showed no significant differences (p ≥ 0.43).Conclusions
Current evidence does not confirm that measures aiming for PIH when harvesting a palatal soft tissue graft result in significantly less pain at the donor site compared to a technique involving SIH. However, this conclusion should be taken with care due to considerable heterogeneity among the included studies (e.g., different graft/wound dimensions, use/no use of palatal wound protection), the limited number of available RCT, and the observed inconsistency regarding reporting of factors that may influence postoperative pain (e.g., residual palatal tissue thickness).Trial registration
The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42023416685).
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BibTeX
@article{asquino2026there,
title = {{Is There a Difference in Postoperative Pain After Harvesting a Palatal Soft Tissue Graft Aiming for Primary Versus Secondary Intention Healing? A Systematic Review and Meta-Analysis.}},
author = {Natalia Asquino and Rafael Esteves Lima and Ernesto Andrade and Adriana Drescher and Magdalena Mayol and Kristina Bertl and Andreas Stavropoulos},
journal = {Clinical and experimental dental research},
year = {2026},
month = oct,
doi = {10.1002/cre2.70476},
url = {https://europepmc.org/article/MED/42927627},
note = {CC BY},
}
RIS
TY - JOUR
TI - Is There a Difference in Postoperative Pain After Harvesting a Palatal Soft Tissue Graft Aiming for Primary Versus Secondary Intention Healing? A Systematic Review and Meta-Analysis.
AU - Natalia Asquino
AU - Rafael Esteves Lima
AU - Ernesto Andrade
AU - Adriana Drescher
AU - Magdalena Mayol
AU - Kristina Bertl
AU - Andreas Stavropoulos
PY - 2026
DA - 2026/10/01
JO - Clinical and experimental dental research
DO - 10.1002/cre2.70476
UR - https://europepmc.org/article/MED/42927627
AB - Objectives To evaluate the effect of surgical technique on postoperative pain at the palatal donor site after harvesting a soft tissue graft.Material and methods A literature search with the following eligibility criteria was conducted: English language; (randomized) controlled clinical trials (RCT/CT); assessment of pain (including morbidity and discomfort), either directly or via surrogate measures, at the palatal donor site; and comparison of two harvesting techniques (i.e., harvesting a soft tissue graft either involving primary [PIH] or secondary intention healing [SIH]).Results Five RCTs and two CTs (sample size: 12-50 patients) providing information on a total of 200 donor sites and with a follow-up period of 1-4 weeks were included. Pain was assessed with different methods, for example, using a visual analog scale, the proportion of patients reporting pain, and/or the quantity of analgesics consumed. Secondary outcomes included complete epithelialization, stress, inability to chew, effects on eating habits, sensitivity disturbances, and burning sensation. Four out of seven studies reported significant differences regarding pain, all favoring the PIH technique. Further, four out of seven studies contributed to a meta-analysis, which did not show any significant differences in postoperative pain between the SIH and PIH groups at 3 or 7 days. Subgroup analyses including only studies without palatal wound protection also showed no significant differences (p ≥ 0.43).Conclusions Current evidence does not confirm that measures aiming for PIH when harvesting a palatal soft tissue graft result in significantly less pain at the donor site compared to a technique involving SIH. However, this conclusion should be taken with care due to considerable heterogeneity among the included studies (e.g., different graft/wound dimensions, use/no use of palatal wound protection), the limited number of available RCT, and the observed inconsistency regarding reporting of factors that may influence postoperative pain (e.g., residual palatal tissue thickness).Trial registration The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42023416685).
SN - 2057-4347
ER -