Volumetric Changes After Free Gingival Graft: Tuberosity vs Palatal Donor Site (VolFGG-TP)

This randomized controlled clinical trial evaluated volumetric changes at recipient and donor sites following free gingival graft (FGG) surgery, comparing two different palatal donor regions. Forty systemically healthy non-smoking adults aged 20-40 years with Miller Class I gingival recession defects at the mandibular anterior teeth (teeth 31, 32, 41, and 42) were randomly allocated using a sealed envelope method into two groups based on the donor site: (1) the anterior palatal region (from the distal of the canine to the first molar), and (2) the posterior palatal/tuberosity region (between the first molar and the tuberosity). All grafts were harvested targeting a standardized size of 8x10 mm (80 mm²). Digital intraoral scans (3Shape TRIOS 5) were obtained preoperatively and at 1, 3, and 6 months postoperatively. Volumetric changes at both recipient and donor sites were measured using STL-based superimposition in Exocad software. The aim was to compare time-dependent volumetric change patterns at both the recipient and donor sites between the two donor groups.

Inclusion Criteria: * Adults aged 20 to 40 years (both male and female) * Presence of Miller Class I gingival recession at mandibular anterior teeth (teeth 31, 32, 41, and 42) * Systemically healthy (no known systemic diseases) * Non-smokers * Adequate oral hygiene * Able and willing to provide written informed consent and attend follow-up visits Exclusion Criteria: * Pregnancy or lactation * Current or past smoking * Diagnosis of diabetes mellitus * Use of isotretinoin or similar systemic anti-acne medications * Inadequate oral hygiene * Current anticoagulant therapy * Systemic contraindications to periodontal surgery * History of previous periodontal surgery at the recipient site