Gingival thickness: effects on gingival wound healing.

Abstract

Background: Although available evidence indicates that gingival thickness may affect periodontal surgical outcomes, there are no studies on the effect of gingival thickness on gingival excisional wound healing. This prospective study aimed to assess the effect of gingival thickness on the healing of standardized experimental gingival wounds.

Methods: Healthy non-smokers with thick or thin gingiva were recruited. Standardized circular buccal gingival excisional wounds were created. Follow-up visits were conducted on postoperative day 3 (D3), 7 (D7), and 14 (D14). Healing Score Index (HSI) and H₂O₂ test were used to assess wound healing and epithelialization, respectively. Digital photographs were obtained to assess wound surface area. Patient-centered outcomes were assessed using custom and OHIP-14 questionnaires.

Results: Twenty-six volunteers (24-36 years old) with thin/thick gingiva (n = 13 per group, age- and sex-matched) completed the study. HSI predictably increased from D3 to D14, without significant intergroup differences at any time point (p ≥ 0.99). Wound epithelialization was 0% on D3, 61-69% on D7, and 92-100% on D14, without significant intergroup differences at any time (p ≥ 0.99). Over 95% of the immediate postoperative wound area was closed by D14, without significant intergroup differences at any time (p ≥ 0.25). Although OHIP-14 scores did not differ significantly between groups (p ≥ 0.99), thin group reported more pain after the anesthesia wore off (day of the surgery; p = 0.0391).

Conclusions: Within the limitations of the present study, standardized buccal gingival wounds heal predictably within a short period of time, with no evidence that clinically determined gingival thickness has any effects on the wound healing.