-
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 -
Journal of Pharmacy & Bioallied Sciences Jul 2023Due to the primary closure of the fragile tissues, large postoperative drainage is unexpected following a periodontal medical procedure. This case study elaborately...
Due to the primary closure of the fragile tissues, large postoperative drainage is unexpected following a periodontal medical procedure. This case study elaborately illustrates the formation of a "liver coagulation" or "currant jam clot" following a periodontal fold surgical operation. Contamination, internal damage, and the presence of foreign particles such as bone splinters or bits of dental restorative dressing can all increase the risk of an incident happening.
PubMed: 37694041
DOI: 10.4103/jpbs.jpbs_94_23 -
Journal of Advanced Periodontology &... 2023Polylactic-co-glycolic acid and zinc oxide (PLGA-ZnO) nanocomposite has been investigated for its antibacterial properties, which could be beneficial for adding to wound...
BACKGROUND
Polylactic-co-glycolic acid and zinc oxide (PLGA-ZnO) nanocomposite has been investigated for its antibacterial properties, which could be beneficial for adding to wound dressings after periodontal surgery. However, its cytotoxicity against human gingival fibroblasts (HGFs) remains unclear and should be evaluated.
METHODS
ZnO nanoparticles were synthesized using the hydrothermal method. These metallic nanoparticles were incorporated into the PLGA matrix by the solvent/non-solvent process. The nanomaterial was evaluated by field emission scanning electron microscopy (FESEM), Fourier transform infrared (FTIR), thermogravimetric analysis (TGA), and x-ray diffraction (XRD) analyses. HGF cells were acquired from the National Cell Bank and categorized into four groups: ZnO, PLGA, ZnO-PLGA, and control. The cells were exposed to different ZnO (1, 20, 40, 60, 80, and 100 µg/mL) and PLGA (0.2, 4, 8, 12, 16, and 20 µg/mL) concentrations for 24 and 48 hours. The cytotoxicity was tested using the MTT assay. The data were analyzed using SPSS 25, and <0.05 was considered statistically significant.
RESULTS
ZnO nanoparticles exhibited significant toxicity at≥40 µg/mL concentrations after 24 hours. Cell viability decreased significantly at all the tested concentrations after 48 hours of exposure. PLGA-ZnO cell viability in 24 hours was similar to the control group for all the concentrations up to 80 µg/mL.
CONCLUSION
ZnO nanoparticles could be toxic against HGF in high concentrations and with prolonged exposure. Therefore, incorporating ZnO nanoparticles into a biocompatible polymer such as PLGA could be a beneficial strategy for reducing their toxicity.
PubMed: 37645553
DOI: 10.34172/japid.2023.010 -
Contemporary Clinical Dentistry 2023Periodontitis causes the destruction of soft and hard tissues. Stem cells have immense potential in regenerative cellular therapy. This clinical trial aimed to evaluate...
BACKGROUND
Periodontitis causes the destruction of soft and hard tissues. Stem cells have immense potential in regenerative cellular therapy. This clinical trial aimed to evaluate clinically and radiographically the effectiveness of the local application of Edelweiss stem cells as a nonsurgical treatment for stage III periodontitis.
MATERIALS AND METHODS
The trial included 40 periodontal pockets in participants who have stage III periodontitis with probing pocket depth (PPD) ≥5 mm and clinical attachment loss (CAL) ≥5 mm. Pockets were randomly divided into two groups Group 1: was given oral hygiene instruction, scaling, root planing, and subgingival application of plant stem cells on gel foam carrier after that a periodontal dressing was applied. The procedures were repeated after 2 weeks. Group 2: was treated only by scaling and root planing. Gingival index, CAL, and PPD were measured at baseline and 3 months' posttherapy. The radiographical evaluation was done by digital long-cone parallel periapical radiographs at baseline and 6 months posttherapy.
RESULTS
Clinical parameters for both groups showed a statistically significant improvement. Regarding radiographic evaluation, there was a significant increase in bone density in favor of the study group.
CONCLUSIONS
Locally applied Edelweiss stem cells can be considered a promising nonsurgical treatment modality for periodontal regeneration.
PubMed: 37547428
DOI: 10.4103/ccd.ccd_183_22 -
Journal of Controlled Release :... Jul 2023Scaffolds are implants commonly used to deliver cells, drugs, and genes into the body. Their regular porous structure ensures the proper support for cell attachment,... (Review)
Review
Scaffolds are implants commonly used to deliver cells, drugs, and genes into the body. Their regular porous structure ensures the proper support for cell attachment, proliferation, differentiated function, and migration. Techniques to fabricate a scaffold include leaching, freeze-drying, supercritical fluid technology, thermally induced phase separation, rapid prototyping, powder compaction, sol-gel, and melt molding. Gene delivery from the scaffold represents a versatile approach to influence the environment for managing cell function. Scaffolds can be used for various tissue engineering purposes, e.g. bone formation, periodontal regeneration, cartilage development, artificial corneas, heart valves, tendon repair, or ligament replacement. Moreover, they are also instrumental in cancer therapy, inflammation, diabetes, heart disease, and wound dressings. Scaffolds provide a platform to extend the delivery of drugs and genetic materials at a controlled timeframe, besides potentially being used to prevent infection upon surgery and other chronic diseases, provided that they can be formulated with specific medicines. This review discusses the need to design advanced functional scaffolds with the potential for modified drug delivery and tissue engineering in a synergistic approach. Special attention is given to works published in 2023 to generate the bibliometric map.
Topics: Tissue Engineering; Tissue Scaffolds; Drug Delivery Systems; Gene Transfer Techniques; Osteogenesis
PubMed: 37286137
DOI: 10.1016/j.jconrel.2023.05.042 -
Journal of Dental Sciences Apr 2023A challenge that arises with periodontal regeneration surgery has been associated with the future development of periodontal regeneration membrane to prevent gingiva and...
BACKGROUND/PURPOSE
A challenge that arises with periodontal regeneration surgery has been associated with the future development of periodontal regeneration membrane to prevent gingiva and fibroblasts invade the wound and allow alveolar bone successfully regenerated.
MATERIALS AND METHODS
Chitosan (CS) has the advantages of non-toxicity, biodegradation, biocompatibility, and has been widely used in wound dressings. A flexible film was made using polyvinyl alcohol (PVA) blending CS based thermosensitive hydrogel.
RESULTS
The proposed 2% PVA/CS hydrogel has the highest swelling ratio about 720% after 60 min incubation and keeps its area after 10 min incubation for surgery suture. The elastic modulus of 0%, 1%, 2%, and 4% PVA/CS hydrogel were 7.75 ± 1.96, 0.91 ± 0.16, 0.75 ± 0.21, and 0.37 ± 0.06 MPa, respectively. The maximum strain of 2% PVA/CS hydrogel was 101.00 ± 28.03 (%). After 8 weeks biodegradation, the remain weight of 2% PVA/CS hydrogel was 71.36 ± 0.79 (%).
CONCLUSION
cytotoxicity tests were performed and demonstrated PVA/CS hydrogel significantly improving cell proliferation. This study realized a promising flexible film for periodontal regeneration membrane that can prevent the rapid growth of fibroblasts to invade the wound and be used for periodontal regeneration surgery.
PubMed: 37021246
DOI: 10.1016/j.jds.2023.01.007 -
International Journal of Clinical... 2022This study aims to evaluate, over 12 months of clinical and radiographic follow-ups, the performance and outcomes of Biodentine™ pulpotomy in stage I primary molars.
AIM
This study aims to evaluate, over 12 months of clinical and radiographic follow-ups, the performance and outcomes of Biodentine™ pulpotomy in stage I primary molars.
MATERIALS AND METHODS
A total number of 20 stage I primary molars requiring pulpotomy were selected from eight healthy patients aged between 34 and 45 months. Patients presenting a negative attitude toward dental treatment on the dental chair were scheduled for dental treatments under general anesthesia.Pulpotomy with Biodentine™ as a pulp-dressing material was performed on all selected molars. The patients were called back at 1 and 3 months for clinical follow-ups, then at 6 and 12 months for clinical and radiographic follow-ups. Data were tabulated according to follow-up intervals and occurrence of any changes in root maturation, pulp canal obliteration (PCO), periodontal ligament space (PLS), and bone or root lesion.
RESULTS
No statistically significant differences were recorded at 1, 3, 6, and 12 months. There was a statistically significant increase in number of roots with closed apices from six roots at 6 months to 50 roots at 12 months ( < 0.0005) and the PCO was present in all 50 roots at 12 months, after it was present in 36 roots only at 6 months ( = 0.0001).
CONCLUSION
This is the first randomized clinical trial that evaluates the performance of Biodentine™ as a pulp-dressing agent in stage I primary molar pulpotomy over 12 months of follow-up. Contrary to previous studies, the present work highlights the continued root formation and apical closure (AC) in pulpotomized immature primary molars.
HOW TO CITE THIS ARTICLE
Nasrallah H, Noueiri BE. Biodentine™ Pulpotomy in Stage I primary Molars: A 12-month Follow-up. Int J Clin Pediatr Dent 2022;15(6):660-666.
PubMed: 36866133
DOI: 10.5005/jp-journals-10005-2400 -
Journal of Dental Research, Dental... 2022After periodontal surgery, in most cases, the surgical area is covered with a surgical pack. It has been suggested that these packs might minimize complications. This...
Comparison of the effects of Diplen LX membrane and Coe-Pak on pain, wound healing, and patient preference after the periodontal flap surgery in patients with moderate to severe chronic periodontitis.
After periodontal surgery, in most cases, the surgical area is covered with a surgical pack. It has been suggested that these packs might minimize complications. This study aimed to compare the effects of Diplen LX membrane and Coe-Pak on pain, wound healing, and patient preference after a periodontal flap surgery in patients with moderate to severe chronic periodontitis. In this randomized clinical trial, 26 patients were evaluated. Pain scores were assessed using visual analog scale (VAS) on the 3rd and 7th days postoperatively and compared between the two dressings. On the 7th and 14th days after both flap surgeries, surgical site healing was evaluated using the wound healing index (WHI). The mean age of the patients was 31. It was observed that the severity of pain in the studied patients on the 3rd and 7th days postoperatively was significantly lower in the intervention group than in the control group. It was also observed that the value of WHI in the studied patients on the 7th and 14th days postoperatively was significantly higher in the intervention group than in the control group. The pain was less severe in both groups using periodontal dressing and also lower in the Diplen LX membrane group. In addition, based on WHI, wound healing score in patients was also higher and more favorable in the Diplex LX membrane group. Due to the above factors, the majority of patients preferred the use of the Diplen LX membrane.
PubMed: 36561388
DOI: 10.34172/joddd.2022.023 -
Journal of Functional Biomaterials Dec 2022Multiple-pathogen periodontal disease necessitates a local release and concentration of antibacterial medication to control inflammation in a particular location of the...
Multiple-pathogen periodontal disease necessitates a local release and concentration of antibacterial medication to control inflammation in a particular location of the mouth cavity. Therefore, it is necessary to effectively load and deliver medicine/antibiotics to treat numerous complex bacterial infections. This study developed chlorhexidine (CHX)/polycaprolactone (PCL) nanofiber membranes with controlled release properties as periodontal dressings to prevent or treat oral disorders. Electrostatic spinning was adopted to endow the nanofiber membranes with a high porosity, hydrophilicity, and CHX loading capability. The release of CHX occurred in a concentration-dependent manner. The CHX/PCL nanofiber membranes exhibited good biocompatibility with human periodontal ligament stem cells, with cell viability over 85% in each group via CCK-8 assay and LIVE/DEAD staining; moreover, the good attachment of the membrane was illustrated by scanning electron microscopy imaging. Through the agar diffusion assay, the nanofiber membranes with only 0.075 wt% CHX exhibited high antibacterial activity against three typical oral infection-causing bacteria: , , and . The results indicated that the CHX/PCL nanofiber holds great potential as a periodontal dressing for the prevention and treatment periodontal disorders associated with bacteria.
PubMed: 36547540
DOI: 10.3390/jfb13040280