Two-Step Palatal Shield Technique Using Flowable Composite Resin for Donor-Site Protection Following De-Epithelialized Free Gingival Grafting: A Case Report Illustrating a Novel Technique.

Although multiple protective techniques have been proposed for the palatal donor-site management after de-epithelialized free gingival graft (DFGG) procedures, many increase patient discomfort, require additional resources, or prolong surgical time. This case report introduces a novel two-step palatal shield (TSPS) technique using flowable composite resin, designed to simplify donor-site protection, improve patient comfort, and enhance postoperative healing. A female patient, 43 years old, underwent DFGG harvesting from the palate for immediate implant placement with esthetic tissue augmentation. A customized palatal shield was fabricated chairside using flowable composite resin to replicate the presurgical anatomy of the donor site. The shield was tooth-supported and suture-free, allowing rapid insertion and stable wound coverage. The patient was followed postoperatively, with evaluations at suture removal and extended follow-up up to 9 months. The patient reported minimal pain or discomfort at the donor site, and clinical examination showed favorable epithelialization and soft tissue healing. The TSPS technique represents a novel, practical approach for donor-site management utilizing affordable materials. Its immediate preoperative fabrication, tooth-supported stabilization, and suture-free design may simplify the clinical workflow, help reduce operative time, and potentially enhance patient comfort, whereas precise anatomical adaptation appears to promote favorable clot stabilization and healing.