Dimitris N. Tatakis

Aims Despite the established use of palatal tissue grafts for mucogingival procedures, there are no studies on the effect of extraoral storage time on graft outcomes. This prospective split‐mouth randomized experimental clinical trial aimed to assess whether gingival graft extraoral storage time affects graft healing. Methods Standardized grafts were harvested from the palate and stored extraorally for 2 (Control) or 40 (Test) minutes before being placed at recipient beds. Intraoral scans, clinical photographs, and tissue blood perfusion were obtained preoperatively, postoperatively, and at follow‐up visits (Days 2 (PO2), 3 (PO3), 7 (PO7), and 14 (PO14)). Healing Score Index (HSI) and wound fluid (WF) biomarkers (angiogenin, IL‐6, IL‐8 (CXCL8), IL‐33, VEGF‐A, and ENA‐78 (CXCL5)) were also assessed. Results Twenty‐three participants completed all study visits. Extraoral storage time was 2.3 ± 1.1 min and 42.8 ± 3.4 min for C and T grafts, respectively ( p < .0001). Recipient beds remained open for 21.4 ± 1.7 min. No graft underwent necrosis or failed to heal by PO14. Minimal volumetric changes were observed, without significant intergroup differences ( p ≥ .11). Graft perfusion initially decreased post‐harvesting before peaking on PO7 for both C and T grafts, with no significant intergroup differences ( p ≥ .14). HSI values progressively increased, with no significant intergroup differences ( p ≥ .22). WF analysis revealed detectable levels for all biomarkers tested, without significant intergroup differences ( p ≥ .23). Conclusion Extraoral storage time of 40 min has neither statistically significant nor clinically discernible effects on autologous graft revascularization, early healing, or survival, as determined by physiological, wound healing, and molecular parameters.