Effect of Fixed Prosthetic Restorations on Early Patient-Reported Outcomes Following Free Gingival Graft Surgery

Abstract

Statement of problem. Fixed dental prostheses create a different pericervical environment, yet studies comparing patient-reported outcome measures (PROMs) after free gingival grafting (FGG) between restored and nonrestored teeth remain limited. Purpose. The purpose of this prospective parallel-group clinical study was to compare early postoperative PROMs, pain, and patient satisfaction after FGG in restored and nonrestored teeth. Material and methods. This study included 49 systemically healthy participants undergoing FGG at sites with keratinized tissue width (KTW) <1 mm. The participants were allocated to a restored tooth group (RTG) or a nonrestored tooth group (NTG). Clinical parameters were recorded at baseline (T0) and at 30 days (T30). Graft dimensions were recorded intraoperatively. Postoperative pain, analgesic consumption, and PROMs using the Oral Health Impact Profile (OHIP-14) were assessed at T0, T1, T7, and T30. Results. Baseline OHIP-14 scores (functional limitation and behavioral impact) were significantly higher in the RTG. Generalized estimating equation analysis showed a significant time effect for total OHIP-14 scores (Wald χ²=32.943, P<.001), with no significant group or interaction effects (group, P=.102; interaction, P=.240). Scores peaked at T1, improved by T7, and approached baseline at T30. Postoperative pain (Wald χ²=55.074, P<.001) and analgesic consumption (Wald χ²=45.056, P<.001) also showed significant time effects without group differences. Regression analysis identified mean analgesic consumption as the only predictor of patient satisfaction. Conclusions. FGG produced comparable short-term outcomes in teeth with and without fixed dental prostheses. Although restored teeth showed poorer baseline quality of life, the postoperative experience was mainly influenced by pain intensity rather than prosthetic status. (J Prosthet Dent 2026;136:1121-1132)