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Progress in Biomaterials Dec 2020Materials based on carbohydrate polymers may be used for biomedical application. However, materials based on natural polymers have weak physicochemical properties....
Materials based on carbohydrate polymers may be used for biomedical application. However, materials based on natural polymers have weak physicochemical properties. Thereby, there is a challenge to improve their properties without initiation of toxicity. The alternative method compared to toxic chemical agents' addition is the use of metal complexation method. In this study, chitosan/tannic acid mixtures modified by Fe(III) complexation are proposed and tested for potential applications as wound dressings. Thereby, surface properties, blood compatibility as well as platelet adhesion was tested. In addition, the periodontal ligament stromal cells compatibility studies were carried out. The results showed that the iron(III) addition to chitosan/tannic acid mixture improves properties due to a decrease in the surface free energy and exhibited a reduction in the hemolysis rate (below 5%). Moreover, cells cultured on the surface of films with Fe(III) showed higher metabolic activity. The current findings allow for the medical application of the proposed materials as wound dressings.
PubMed: 33222037
DOI: 10.1007/s40204-020-00146-z -
Acta Neurochirurgica Feb 2021Standard microscopic lumbar discectomy (MLD) is a short operation with minimal blood loss, and a low rate of peri- and intraoperative complications. The objective of...
BACKGROUND
Standard microscopic lumbar discectomy (MLD) is a short operation with minimal blood loss, and a low rate of peri- and intraoperative complications. The objective of this study was to evaluate intraoperative findings, complications, and early postoperative neurological outcome (< 105 days) in patients undergoing MLD with or without implantation of an annular closure device (ACD).
METHODS
This study is based on data analysis of a post-marketing, prospective, multicenter RCT in Europe including patients undergoing standard MLD with or without implantation of an ACD (Barricaid®, Intrinsic Therapeutics, Inc., Woburn, MA). Enrollment of 554 patients in 21 centers in Europe (Germany, Switzerland, Austria, Belgium, The Netherlands, and France) started in 2010 and was completed in October 2014, with 276 patients randomized to the ACD group and 278 to the control group.
RESULTS
Mean operation time was 70 min in the ACD group and 52 min in the control group (p < 0.0001). Intraoperative fluoroscopy time was 24 s in the ACD group and 7 s in the control group (p < 0.0001). Average blood loss was 94.2 ml in the ACD group and 64.7 ml in the control group (p = 0.0001). Serious device- or procedure-related adverse events occurred in 3.7% (10/272) of the ACD group and 7.9% (22/278) of the control group. Dural injuries occurred in 13 (4.8%) patients in the ACD group and 7 (2.5%) in the control group. There was one device-related nerve root injury resulting in a nerve root amputation. Surgical complications included 3 hematomas in the ACD group and 4 in the control group; 3 infections occurred in both groups. Device migrations were documented in 3 patients in the ACD group. Patients in the ACD group (n = 7, 2.6%) underwent fewer reoperations compared with that in the control group (n = 16, 5.8%, OR = 2.3 (0.9-5.7)). Mean VAS leg pain at 3 months was 11.9 in the ACD and 15.1 in the control group, respectively.
CONCLUSION
Short-term outcome after MLD with or without implantation of ACD was similar in both groups. Patients included in the ACD group underwent fewer reoperations in the first 3 months after surgery. Nevertheless, longer operation time, higher amount of blood loss, and risk of nerve root lesion during device implantation should be considered additional risks in patients undergoing ACD implantation after MLD.
Topics: Adult; Aged; Diskectomy; Europe; Female; Humans; Intervertebral Disc Displacement; Intraoperative Complications; Lumbar Vertebrae; Male; Middle Aged; Multicenter Studies as Topic; Pain; Pain Measurement; Periodontal Dressings; Postoperative Complications; Prospective Studies; Randomized Controlled Trials as Topic; Reoperation; Resins, Synthetic; Treatment Outcome; Wound Closure Techniques; Young Adult
PubMed: 33070235
DOI: 10.1007/s00701-020-04612-2 -
Journal of Dental Sciences Jun 2020The connective tissue graft from hard palate is a reliable graft technique that has been used for achieving root coverage, increasing keratinized tissue width and...
BACKGROUND/ PURPOSE
The connective tissue graft from hard palate is a reliable graft technique that has been used for achieving root coverage, increasing keratinized tissue width and thickness in periodontal plastic surgeries. Donor site morbidities, including complications from postoperative bleeding, pain during healing phase, difficulties in eating and speaking and unexpecting healing patterns, are always a concern for both doctors and patients. The aim of this study was to investigate a novel design of palatal stent to reduce these complications and provide patient with a smooth healing experience after soft tissue harvesting from hard palate.
MATERIALS AND METHODS
Eight patients requiring connective tissue graft from palatal site were included in the study. The palatal stents made with light-curing hybrid composite resin were fabricated and tried in for patients prior to the periodontal plastic surgeries. Stent was delivered immediately without other dressing material or suture after the graft harvesting procedure for blood clot stabilization. Bleeding tendency was evaluated at the completion of the procedure. Patients came back for follow up in 1 week, 2 weeks and 1 month after the surgery. In the consecutive clinical cases, all patients reported minimal postoperative pain and discomfort (score ranged between 0 and 2). Both chewing and swallowing were not affected when wearing the stent, while four patients reported speaking inconvenience influenced by the stent.
RESULTS
In the consecutive clinical cases, all patient reported minimal postoperative pain and discomfort (Score ranged between 0 and 2). Both chewing and swallowing were not affected when wearing the stent while four patients reported speaking influenced by the stent.
CONCLUSION
The novel design of palatal stent reduces donor site morbidity and provides patient with a good healing experience after soft tissue harvesting from hard palate.
PubMed: 32595892
DOI: 10.1016/j.jds.2020.03.014 -
Journal of Indian Society of... 2020The study was designed taking into consideration the drawbacks of periodontal dressing and healing properties of curcumin. The aim was to assess and compare the effect...
Comparison of effect of curcumin gel and noneugenol periodontal dressing in tissue response, early wound healing, and pain assessment following periodontal flap surgery in chronic periodontitis patients.
BACKGROUND
The study was designed taking into consideration the drawbacks of periodontal dressing and healing properties of curcumin. The aim was to assess and compare the effect of Curcumin gel (Curenext) and noneugenol periodontal dressing (Coe pak) on tissue response, wound healing in the early stages, and pain post periodontal flap surgery in patients diagnosed with chronic periodontitis.
MATERIALS AND METHODS
Twenty patients requiring periodontal flap surgery were allotted to two groups at random, one receiving periodontal dressing and the other receiving curcumin for this cross over split-mouth study. Flap surgeries were performed on 2 quadrants with 3 weeks' interval. After suture removal, postoperative sites were assessed for tissue response (tissue color [TC] and tissue edema [TE]) and early wound healing as primary outcomes of the study. The secondary outcome was pain assessment and the number of analgesics taken by the individuals.
RESULTS
The two groups showed no significant differences with respect to tissue response, early wound healing, and pain perception. Curcumin group consumed lesser number of analgesics as compared to the one with periodontal dressing.
CONCLUSION
It was confirmed that periodontal dressing and curcumin are effective in reducing the TE, normalizing the TC, enhancing the wound healing and reducing the pain perception. Curcumin can thus be used as an alternative to periodontal dressing.
PubMed: 31983846
DOI: 10.4103/jisp.jisp_105_19 -
International Journal of Molecular... Dec 2019Metronidazole (MD) is known as a periodontitis medicine and has been widely used in antibiotics for resistance to anaerobic bacteria, periodontal disease, and other...
Metronidazole (MD) is known as a periodontitis medicine and has been widely used in antibiotics for resistance to anaerobic bacteria, periodontal disease, and other threats. To treat diseases, drug delivery carriers are needed with a high bioadhesive property and enhanced drug penetration. Poly (acrylic acid) (PAA) hydrogel films have a good bioadhesive property and are able to localize the absorption site and increase the drug residence time. In this study, we fabricated a MD loaded PAA hydrogel with different MD content (0.1, 0.25, 0.5, and 1 wt%) using varying doses (25, 50, and 75 kGy) and the radiation doses (25, 50, or 75 kGy) in a one-step gamma-ray irradiation process. The chemical and physical structure were determined through a Fourier transformed infrared spectroscopy, X-ray photoelectron spectroscopy, gel content, and compressive strength. In addition, MD loaded PAA hydrogels were performed to MD release behaviors and cytotoxicity. Finally, we conducted antibacterial activity to demonstrate the prevention of growth of bacteria as a therapeutic dressing. The basic chemical structure analysis of MD was changed greatly at radiation doses of 50 and 75 kGy due to degradation by gamma-ray irradiation. However, when the absorbed dose was 25 kGy, the chemical structure analysis of MD did not change significantly, and the gel content and compressive strength of MD/PAA hydrogel were approximately 80% and 130 kPa, respectively. The MD/PAA hydrogels exhibited no cytotoxicity and good antibacterial activity against , , and . These results provide good evidence that MD/PAA hydrogel prepared by gamma-ray irradiation has potential as a competitive candidate for the therapeutic dressing.
Topics: Acrylic Resins; Anti-Bacterial Agents; Drug Delivery Systems; Escherichia coli; Gamma Rays; Hydrogels; Metronidazole; Molecular Structure; Staphylococcus aureus; Streptococcus mutans
PubMed: 31888070
DOI: 10.3390/ijms21010187 -
Journal of Indian Society of... 2019Periodontal plastic surgery often involves palatal donor site, thereby creating an open wound that is prone to postoperative complications such as bleeding, pain, and...
Periodontal plastic surgery often involves palatal donor site, thereby creating an open wound that is prone to postoperative complications such as bleeding, pain, and slow healing process. To prevent the same, platelet-rich fibrin (PRF) and gelatin sponge (GS) were utilized equally at the donor site in six patients. Patients were monitored at the 1, 2, 3, and 4 weeks after surgery for postoperative discomfort (D), consumption of analgesics during first postoperative week, alteration of sensitivity (AS), change in feeding habits (CFH), complete wound epithelialization (CWE), and healing index (Landry 1998). Two patients in the GS group showed significantly early CWE, higher healing index score, and less D, AS, and CFH postoperatively in comparison to the PRF group. It was suggested that GS can also be considered as an effective, economical, and biocompatible dressing material of choice to enhance wound healing and to minimize postoperative complications associated with the donor site.
PubMed: 31849408
DOI: 10.4103/jisp.jisp_165_19 -
The Journal of Contemporary Dental... Aug 2019The present study aims to assess the efficacy of different periodontal dressing materials on wound healing clinically. (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
The present study aims to assess the efficacy of different periodontal dressing materials on wound healing clinically.
MATERIALS AND METHODS
A total of 45 patients between the age group of 30-45 years, with chronic generalized periodontitis with loss of attachment of 3-6 mm, who require periodontal flap surgery, were screened to include in the study. Out of 45 subjects, 24 were males and 21 were females. The subjects were randomized into 3 groups as 15 in each. Group I: a collagen dressing, group II: light-cure dressing, and group III: non-eugenol-based dressing. The clinical parameters such as plaque index, vertical probing depth, pain, gingival index, and patient satisfaction were documented for all the three groups on the 7th and the 14th day. Visual analog scale (VAS) was used to score the pain severity. The SPSS 20 software was used to analyze the data. The significance level was set at 5%.
RESULTS
The mean gingival index score reduced from 1.40 ± 0.14 to 1.10 ± 0.30 in group I, from 1.48 ± 0.01 to 1.26 ± 0.22 in group II, and from 1.58 ± 0.16 to 1.33 ± 0.10 in group III. The mean plaque index score reduced from 1.48 ± 0.56 to 1.18 ± 0.40 in group I, from 1.46 ± 0.01 to 1.24 ± 0.48 in group II, and from 1.42 ± 0.12 to 1.20 ± 0.20 in group III. There was a statistical difference found in all the three groups and between the groups from the plaque and gingival index scores. The probing depth comparison shows a significant difference in group I. Patient satisfaction was almost similar in all the groups. The pain index showed the reduction in the pain severity from the 7th day to the 14th day in all the subjects from all the three groups.
CONCLUSION
It can be concluded that the periodontal wound covered with a collagen dressing material showed significant evidence to provide symptomatic relief and better healing to the patients compared to that of light-cure and non-eugenol periodontal dressing material.
Topics: Adult; Dental Plaque Index; Female; Humans; Male; Middle Aged; Periodontal Attachment Loss; Periodontal Dressings; Periodontal Index; Treatment Outcome; Wound Healing
PubMed: 31797844
DOI: No ID Found -
Clinics and Practice Aug 2019Pyogenic granuloma is a non-neoplastic, exuberant, reactive lesion seen in response to local irritation or trauma caused by dental calculus, bacterial plaque, caries and...
Pyogenic granuloma is a non-neoplastic, exuberant, reactive lesion seen in response to local irritation or trauma caused by dental calculus, bacterial plaque, caries and restorations, with a strong predilection for the gingiva. It is among the frequently encountered oral lesions, occurring at a challenging oral site, the gingiva. Herein, we report a 71-year-old medically compromised Caucasian female who presented with a relatively large lobulated pyogenic granuloma on the buccal gingiva of the maxillary molar-premolar region. Total surgical excision was performed with an 840nm diode laser followed by the placement of hyaluronate gel and relevant periodontal dressing. Two weeks after surgical excision, complete healing was observed, but patient denied replacement of dental restoration. After 4 months of follow-up, an overall reduction of associated teeth mobility was also observed, with a minor recurrence in gingival inflammation. The objective of this report is to briefly review clinical, radiographic and histological findings of pyogenic granuloma along with a detailed discussion on its management through a diode laser.
PubMed: 31579498
DOI: 10.4081/cp.2019.1179 -
Brazilian Oral Research 2019This study evaluated the effect of antimicrobial photodynamic therapy (aPDT) on the endodontic treatment of apical periodontitis (AP). AP was induced in 48 premolars of...
This study evaluated the effect of antimicrobial photodynamic therapy (aPDT) on the endodontic treatment of apical periodontitis (AP). AP was induced in 48 premolars of 6 dogs. After biomechanical preparation, the teeth were divided into 4 groups: Calcium-Hydroxide (CH)/120d and CH/180d: root canals filled with CH-based dressing for 15 days before obturation; aPDT/120d and aPDT/180d: conditioning with phenothiazine photosensitizer (10 mg/mL) for 1 minute and irradiation with diode laser in the same session as obturation. Root filling was performed with AH Plus sealer. After the experimental periods, animals were euthanized and teeth were submitted for histology. HE staining was performed for descriptive analysis of the periapical region, measurement of apical periodontitis and for inflammatory cells, and blood vessels count. Immunohistochemistry was performed for osteopontin (OPN) and alkaline phosphatase (ALP). Data were analyzed statistically by two-way ANOVA and chi-square test (α = 5%). Teeth in Group CH/120d presented only a slightly enlarged periodontal ligament (PL) with advanced repair. Group aPDT/120d presented the PL moderately enlarged, with moderate inflammatory infiltrate and few collagen fibers. The same pattern was observed at 180 days. AP lesions in CH-treated groups were smaller than those in aPDT-treated groups (p < 0.001) with more blood vessels (p < 0.0001), regardless of the evaluation period, without significant differences in the number of inflammatory cells (p > 0.05). CH-treated groups showed significantly more intense immunostaining for ALP and OPN (p < 0.001) in both periods. Although aPDT stimulated angiogenesis and expression of bone formation markers, the two-session endodontic treatment with CH-based dressing promoted better apical periodontitis repair.
Topics: Animals; Blood Vessels; Bone Cements; Bone Regeneration; Calcium Hydroxide; Immunohistochemistry; Neovascularization, Physiologic; Periapical Periodontitis; Photochemotherapy; Reproducibility of Results; Root Canal Therapy; Time Factors; Treatment Outcome
PubMed: 31576904
DOI: 10.1590/1807-3107bor-2019.vol33.0092 -
Biomaterials Science Oct 2019Oxidative damage generated by various biochemical pathways can disrupt the oxidant/antioxidant balance in cells, causing slow wound healing and tissue regeneration; in...
Oxidative damage generated by various biochemical pathways can disrupt the oxidant/antioxidant balance in cells, causing slow wound healing and tissue regeneration; in this regard, a hydrogel dressing with antioxidant properties can promote wound healing; however, its design is still a challenge. Herein, a polydopamine/puerarin (PDA/PUE) nanoparticle-incorporated polyethylene glycol diacrylate hybrid hydrogel (PEG-DA/PDA/PUE) with antioxidant properties was prepared and used as a wound-healing material. Experimental observations indicated that the PEG-DA/PDA/PUE hydrogel possessed excellent swelling capacity and mechanical property. Moreover, the antioxidant capability was enhanced with an increase in the concentration of polydopamine/puerarin nanoparticles in the hydrogel. The hydrogel presented good cell proliferation and antioxidant activity, including a decrease in ROS and increase in the superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity under oxidative stress conditions. Furthermore, the full-thickness skin-defect-regeneration process could be accelerated via the antioxidant hydrogel treatment. This study validated the potential applications of an antioxidant hydrogel for wound healing.
Topics: Animals; Antioxidants; Biocompatible Materials; Cell Proliferation; Cells, Cultured; Dental Pulp; Hydrogels; Indoles; Isoflavones; Male; Nanoparticles; Periodontal Ligament; Polymers; Rats, Sprague-Dawley; Reactive Oxygen Species; Stem Cells; Wound Healing
PubMed: 31393463
DOI: 10.1039/c9bm00991d