Postoperative complications at the palatal donor site following autologous soft tissue grafting: a systematic review

Abstract

This systematic review analyzes postoperative complications at the palatal donor site following the harvesting of autologous soft tissue grafts in periodontal surgery. Although these grafts remain the clinical reference standard due to their effectiveness, their harvesting may be associated with donor-site morbidity, including pain, bleeding, partial necrosis, and sensory disturbances. A comprehensive search was conducted in PubMed, Scopus, and Web of Science, identifying 16 clinical studies published between 2019 and April 2025. The included studies comprised randomized controlled trials, prospective and retrospective clinical studies, and case series, with sample sizes ranging from 6 to 89 participants. Due to heterogeneity in study designs, outcome measures, and follow-up protocols, a qualitative synthesis was performed and a quantitative meta-analysis was not feasible. Postoperative pain was the most frequently reported complication and was commonly assessed using the Visual Analog Scale (VAS), although other instruments such as the Numeric Rating Scale (NRS) were also used. Several adjunctive strategies, including palatal stents, hyaluronic acid, platelet-rich fibrin (PRF), mucoadhesive dressings, and low-level laser therapy (LLLT), were reported to be associated with lower postoperative discomfort and favorable healing patterns. Bleeding was reported less frequently and was generally self-limiting, particularly when local hemostatic measures were applied. Sensory disturbances were typically mild and transient, resolving during routine follow-up. No serious infections or complications compromising patient health were reported. In conclusion, while morbidity at the palatal donor site is relatively common, it is generally mild and manageable. Certain adjunctive measures may help reduce postoperative discomfort and support healing; however, the overall strength of the available evidence remains moderate. These findings may help improve postoperative recovery and inform future clinical research.