Is the postoperative discomfort after connective tissue harvesting from the palate influenced by the use of a bipolar coagulator? A randomized controlled trial.

Objectives: This study aimed to determine the effect of the use of a bipolar coagulator on postoperative pain and complications when used during connective tissue harvesting from the palate.

Material And Methods: A randomized controlled clinical trial was conducted with 57 sequential patients requiring a connective tissue graft for periodontal or implant surgery. All samples were harvested superficially and de-epithelized outside the mouth. The patients were randomly allocated to two groups: in one group, the bipolar coagulator was used before suturing to control bleeding, and in the other group, the coagulator was not used. The surgeon was unaware of the randomization until the end of the harvesting phase. Self-reported maximum pain, number of painkillers used, bleeding events, emergency visits at the clinic were recorded 7 days after surgery.

Results: Fifty patients were randomized and treated (seven were excluded for different reasons). The mean harvested area was 75.24 mm (SD, 33.96), and the mean thickness of the samples was 2.47 mm (SD, 0.75). The mean self-reported pain value on the visual analog scale was 3.37 (SD, 2.30), and the mean number of pain medications used was 7.1 (SD, 6.60). Seven patients made an emergency visit each, and 17 delayed bleeding events were reported by 15 patients. No statistically significant differences were reported in postoperative pain, postoperative bleeding, and emergency visit to the clinic between the groups that did and did not use the bipolar coagulator. When smoking habits were taken into consideration, the number of pain medications was higher among male smokers and older smokers than among male non-smokers and younger smokers. This study was not able to find a relationship between harvested sample dimension or thickness and postoperative discomfort.

Conclusions: The bipolar coagulator can be used during connective tissue harvesting from the palate to control bleeding without influencing postoperative pain.