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Journal of Oral and Maxillofacial... Dec 2023An oroantral communication (OAC) is an acute opening after tooth extractions in the posterior maxilla that requires immediate closure. The search for a noninvasive and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
An oroantral communication (OAC) is an acute opening after tooth extractions in the posterior maxilla that requires immediate closure. The search for a noninvasive and cost-effective OAC treatment method remains ongoing.
PURPOSE
This study assessed the effect of oral wound dressing (OWD) on acute OACs of 2-5 mm and compared it with suturing sterile gauze (SG) and plasma-rich fibrin (PRF).
STUDY DESIGN, SETTING, AND SAMPLE
A randomized, double-blind clinical trial was conducted at the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Erciyes University. The sample included patients aged >18 years, a 2-5 mm wide OAC without previous maxillary sinus pathology or surgical operation.
PREDICTOR VARIABLE
The primary predictor variable was the closure method used: OWD, SG, or PRF. OWD is a new produced and commercially available product that has been used for closure of oral wounds after periodontal or surgical interventions.
MAIN OUTCOME VARIABLE
The primary outcome variable was OAC closure on postoperative day 30. The secondary outcomes were procedure duration and the pain scores of postoperative days 1, 3, and 7.
COVARIATES
The covariates were age and sex.
ANALYSES
Quantitative variables were compared between groups using the Kruskal-Wallis test. Qualitative variables were analyzed between groups using the Pearson's χ test. Results with a P value <.05 were considered statistically significant.
RESULTS
This study included 60 patients (30 females and 30 males). Clot formation was uneventful on postoperative days 1, 3, and 7 in all patients. OAC closure was successful in all patients on postoperative day 30. The success rate of OAC closure did not differ significantly between groups (P > .05). The surgical procedure duration was significantly shorter in the OWD group (1.2 ± 0.41 min) than in the SG (5.75 ± 0.97 min) and PRF (19.65 ± 2.74 min) groups (P < .001). Verbal analog scale scores differed significantly among the OWD (1.05 ± 1.43), SG (4.35 ± 2.85), and PRF (2.5 ± 1.82) groups on postoperative day 1 (P < .001).
CONCLUSION AND RELEVANCE
OWD is a less invasive and practical method for closing OACs.
Topics: Female; Humans; Male; Bandages; Fibrin; Maxillary Sinus; Oroantral Fistula; Tooth Extraction; Treatment Outcome; Double-Blind Method
PubMed: 37802130
DOI: 10.1016/j.joms.2023.09.006 -
Biomaterials Science Oct 2023Periodontal dressing is a surgical dressing applied to oral wounds after periodontal surgery. Currently, all commercially available setting periodontal dressings are...
Periodontal dressing is a surgical dressing applied to oral wounds after periodontal surgery. Currently, all commercially available setting periodontal dressings are stiff, uncomfortable, with poor aesthetics, and need to be removed at the patient's follow-up visit, which may cause secondary damage. A periodontal dressing with soft texture, biodegradable properties, and that could balance both comfort and aesthetics is urgently desired. Hence, non-setting and degradable dressings were developed using sodium carboxymethyl cellulose, Eudragit S 100 and povidone K30, which were compared with the commercial degradable dressing Reso-pac®. The mucosal adhesion of the dressings was evaluated by lap shear tests, which indicated adequate adhesion. The swelling rates of the dressings were approximately half that of Reso-pac®, which led to less saliva adsorption and better dimensional stability. The dressings also exhibited satisfactory biocompatibility according to the results of CCK-8, Live/Dead staining, hemolysis, and subcutaneous implantation assays. Moreover, the dressing promoted the healing of full-thickness mucosal wounds in the palatal gingivae of SD rats and contributed to better therapeutic effect than Reso-pac®. Considering the multiple advantages and the pure pharmaceutical excipient formula, we anticipate that this dressing could be a promising product and may enter clinical practice in the near future.
PubMed: 37724849
DOI: 10.1039/d3bm01314f -
Australian Endodontic Journal : the... Sep 2023This study evaluated the antimicrobial efficacy of grape seed extract medicament combined with Nd:YAG laser, against Enterococcus faecalis, Staphylococcus aureus and...
This study evaluated the antimicrobial efficacy of grape seed extract medicament combined with Nd:YAG laser, against Enterococcus faecalis, Staphylococcus aureus and Candida albicans biofilms. Root canals infected with 4-week-old biofilms were divided into five groups (n = 11): calcium hydroxide, 6.5% GSE, Nd:YAG laser (1064 nm, 1.5 w, 15 Hz and 100 mj) and 6.5% GSE followed by Nd:YAG laser and normal saline (control). Dentin chips were collected using Gates-Glidden and cultured to obtain colony-forming units. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U test. GSE showed higher antibacterial activity against all species investigated compared to Ca(OH) . However, the lowest microbial count was obtained using a combination of GSE and Nd:YAG laser (p < 0.001). No significant difference in the susceptibility of tested pathogens to each of the protocols was observed (p > 0.05). Application of Nd:YAG laser following GSE medicament is efficient against endodontic biofilms; also, GSE can be considered as an alternative to Ca(OH) dressing.
Topics: Lasers, Solid-State; Grape Seed Extract; Anti-Infective Agents; Anti-Bacterial Agents; Biofilms; Enterococcus faecalis; Dental Pulp Cavity
PubMed: 36479792
DOI: 10.1111/aej.12718 -
International Endodontic Journal Oct 2023Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) and/or calcium hydroxide (Ca(OH) ) are commonly used during root canal treatment. Evaluation of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) and/or calcium hydroxide (Ca(OH) ) are commonly used during root canal treatment. Evaluation of their effectiveness regarding clinical and patient-related outcomes requires further understanding.
OBJECTIVES
To assess the effectiveness of root canal irrigation and dressing for the treatment of teeth with apical periodontitis (AP).
METHODS
A search was conducted in the PubMed-MEDLINE, Scopus, EMBASE, Google scholar databases and available repositories, followed by hand searches, until July 2021. Eligibility criteria followed the a priori formulated Population, Intervention, Comparator, Outcomes, Timing, and Study design (PICOTS) framework. Clinical studies restricted to English language were included. The revised Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess the quality of included studies. Meta-analyses were performed using the fixed-effect model to obtain Risk Ratio (RR) and 95% Confidence Interval (CI), with sensitivity analysis. Overall quality of evidence of meta-analyses was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool.
RESULTS
The search identified 1357 records of which six fulfilled the inclusion criteria, providing data for 'irrigation' from 212 teeth and for 'dressings' from 438 teeth. Two studies reported no significant difference regarding the outcome 'pain at 7 days' using 2% chlorhexidine vs. 5.25% NaOCl and EDTA or after using different concentrations of NaOCl (1% vs. 5%). No significant difference was detected between different NaOCl concentrations regarding the reduction of AP. A meta-analysis was possible for the comparison of single-visit (SV) versus multiple-visits including the use of Ca(OH) demonstrating a significant effect in favour of SV (RR: 1.10; 95% CI: 1.03-1.19; p = .007; I = 0). RoB of included studies was moderate to low.
DISCUSSION
The use of Ca(OH) for the treatment of AP may not be beneficial. There is scarce or no evidence fulfilling the proposed PICOTS regarding irrigants and dressings.
CONCLUSIONS
There is moderate certainty that SV treatment is associated with better radiographic evidence of normal periodontal ligament space (strict criteria) compared with the use of Ca(OH) Reduction of AP is comparable after irrigation with 1% and 5% NaOCl, whereas postoperative pain at 7 days for the irrigants assessed is similar.
REGISTRATION
PROSPERO database CRD42021260271.
Topics: Humans; Dental Pulp Cavity; Edetic Acid; Root Canal Therapy; Periapical Periodontitis; Bandages; Root Canal Irrigants
PubMed: 35579074
DOI: 10.1111/iej.13777