Efficacy of concentrated growth factor in the surgical treatment of postanaesthetic palatal necrosis.

Background: Although uncommon, adverse local and systemic reactions to local anesthetic administration can occurred. The postanesthetic necrosis is a rare complication which usually involved the palatal region. The wound healing is a complex process regulated by a range of growth factors. Concentrated growth factor (CGF) is the latest generation of autologous platelet concentrate which has been widely used in the repair and regeneration of oral soft and hard tissue. The study aims to analyses the clinical benefit of CGF in the treatment of postanesthetic necrosis of the hard palate.

Methods: The study included all patients referred to the Department of Maxillo-Facial Surgery, Marche University General Hospital, between 2020 and 2022, for aseptic ulcer of the hard palate due to local anesthetic administration. For each patient, the surgical debridement of the necrotic tissue and a peripheral blood sample were performed. The CGF was obtained by a centrifuge device and sutured in the affected site. The greasy gauze, placed to prevent the matrix detachment, was removed seven days post-operative.

Results: Seven patients (M:F=4:3, mean age 48.6±5.1 years) were enrolled in the study. After 7 days post-operative, no infection, discomfort, or dysphagia were reported. Moreover, 4 patients (57%) showed a total re-epithelialization, while 3 patients (43%) with larger defects, displayed a partial re-epithelialization. A complete recovery occurred in all cases 15 days after surgery.

Conclusions: CFG represents a promising potential preparation for the oral mucosa wound healing able to promote the granular tissue formation and the mucosa re-epithelialization.