Impact of α-cyanoacrylate tissue adhesive on soft tissue healing at donor sites in free gingival graft surgery: a randomized controlled clinical trial

BACKGROUND: Peri-implant soft tissue plays a vital role in both the aesthetic appearance and long-term health of implants. Free gingival grafts (FGGs) with epithelium remain the gold-standard surgical approach for obtaining keratinized tissue width. However, FGG harvest from the palatal donor site typically results in extensive wound dimensions, significantly contributing to postoperative discomfort in patients. This study aimed to investigate the efficacy of α-cyanoacrylate tissue adhesive (CTA) application in wound closure for improving soft tissue healing at donor sites. METHODS: Sixty subjects who underwent FGG procedures were recruited and randomly allocated into 3 groups. Group A (n=20) sites were treated with sutures and a gelatin sponge. Group B (n=20) sites were treated with sutures combined with a gelatin sponge and CTA. Group C (n=20) sites were treated with CTA alone. The perception of pain (assessed by the visual analog scale (VAS) at standardized intervals: 1, 2, 3, 5, 7, and 14 days), consumption of analgesic drugs (monitored over 14 days), wound closure time (measured intraoperatively), early-wound healing index (EHI, evaluated on days 5 and 14), incidence rates of complications (monitored up to day 14), and willingness to undergo reoperation (assessed on day 14) were recorded. RESULTS: VAS scores indicated lower pain levels in Group C than in Group A on postoperative days 5 and 7 (P<0.05). Healing assessments indicated better EHI scores for Group C than for Group A (P<0.05). Furthermore, the analysis revealed that patients in Group C experienced a significantly shorter wound closure time than did those in Group A and Group B (P<0.001). The consumption of analgesic drugs, willingness to undergo reoperation, and incidence rates of complications remained statistically comparable among the groups (P>0.05). CONCLUSION: These preliminary findings suggest that the application of CTA serves as a viable alternative for palatal donor site closure, offering the distinct practical advantage of significantly shortening wound closure time and improving specific early wound healing parameters, with comparable overall complication rates and patient receptiveness.