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Journal of Materials Science. Materials... Aug 2021To analyze the hemostatic, Dsurgical wounds in donor and recipient areas of free gingival grafts (FGG). Five databases (PubMed, Scopus, Science Direct, Cochrane and Web... (Comparative Study)
Comparative Study
Comparative analysis of the hemostatic, analgesic and healing effects of cyanoacrylate on free gingival graft surgical wounds in donor and recipient areas: a systematic review.
UNLABELLED
To analyze the hemostatic, Dsurgical wounds in donor and recipient areas of free gingival grafts (FGG). Five databases (PubMed, Scopus, Science Direct, Cochrane and Web of Science) were searched up to March 2021 (PROSPERO CRD42019134497). The focus of the study (cyanoacrylate) was combined with the condition (periodontal surgery OR free gingival graft OR free soft tissue graft OR autografts), and outcome (healing OR epithelialization OR pain OR analgesia OR bleeding OR hemostasis OR hemostatic). Studies reporting cyanoacrylate isolated or associated with another substance in FGG stabilization and closure were investigated and assessed for the quality and risk of bias through the Cochrane Manual. Six studies with 323 participants were included. Evaluation of the quality and risk of bias highlighted a low risk for four articles, intermediate for one and unclear for another. The use of cyanoacrylate associated or not with the hemostatic sponge or the platelet-rich fibrin was more effective in healing (three studies), analgesia (four studies), and hemostasis in one study (p < 0.05). However, groups with the association in cyanoacrylate showed superior healing, and analgesic action to the isolated cyanoacrylate group. In addition, two studies demonstrated that cyanoacrylate use reduces surgery duration, one study showed that it reduces postoperative sensibility, and another present hemostatic effect (p < 0.05). There is scarce literature for the use of cyanoacrylate in FGG wounds indicates that it can promote a minor inflammatory response, reduce operation time, does not interfere with healing, relieves postoperative discomfort, and suggests the possibility immediate hemostasis. Its use presents an alternative to suturing in FGG surgeries. But, the limited number of cases and the relative heterogeneity of the included studies suggest caution in generalizing the indication.
CLINICAL RELEVANCE
Cyanoacrylate seems to present analgesic effects and less pain when applied to wound closure and covering donor and recipient areas reducing the need for postoperative analgesic medication; and has a healing effect in the closure of the donor area on the palate. In addition, it can reduce bleeding time after surgery, and prevents late bleeding during the first postsurgical week. Scientific justification: To evaluate the hemostatic, analgesic and healing actions of cyanoacrylate compared to the suture thread and other agents when used to close surgical wounds from periodontal free gingival graft surgical wounds in both the donor and recipient areas of the graft.
MAIN FINDINGS
The use of cyanoacrylate individually or in association with wound dressing agents presents analgesic effects because the patient reports less pain experienced when cyanoacrylate is applied to the wound closure and covering, thereby reducing the need for postoperative analgesic medication. In addition, a healing effect is observed in the closure of the donor area on the palate; as well as it seems to present hemostatic effects, reducing the bleeding time after surgery, and preventing late bleeding during the first postsurgical week.
PRACTICAL IMPLICATIONS
Dentists may cautiously apply cyanoacrylate after periodontal surgeries for free gingival graft in both the donor and recipient areas of the graft. However, they must consider the limitations of the surgery, tension-free positioning, the patient's dyscrasia and postoperative care, constituting a set of predictors for adequate clinical decision-making. Widespread use of such material for all patients and surgical configurations may not be recommended.
Topics: Analgesics; Bandages; Bias; Cyanoacrylates; Gingiva; Hemostasis; Hemostatics; Humans; Palate; Platelet-Rich Fibrin; Re-Epithelialization; Plastic Surgery Procedures; Risk; Surgical Wound; Wound Healing
PubMed: 34406492
DOI: 10.1007/s10856-021-06573-z -
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 Oral & Maxillofacial Research 2017The purpose of the present study was to compare the cytotoxicity of Reso-Pac and Coe-Pak periodontal dressing.
OBJECTIVES
The purpose of the present study was to compare the cytotoxicity of Reso-Pac and Coe-Pak periodontal dressing.
MATERIAL AND METHODS
According to ISO-10993-12:2012, 1-, 3- and 7-day extracts of the two periodontal dressings were prepared in cell culture medium and exposed to the two cultured cell lines. Cell viability and proliferation at 24 h and 72 h following exposure were evaluated using quantitative MTT assay.
RESULTS
The results showed a significant (P < 0.05) reduction in the viability of cells exposed to the 3- and 7-day Coe-Pak extracts at 24 h and 72 h compared to the control group (no exposure to the extract). Reso-Pac extracts slightly decreased cell viability compared to the control group. Understudy materials showed greater cytotoxicity against human osteoblast-like compared to the human gingival fibroblast cells. No significant (P > 0.05) difference was found in the viability of cells exposed to undiluted (100%) one-day extract and diluted (50%) extract of both understudy materials at 24 h and 72 h after exposure.
CONCLUSIONS
Based on the results, Reso-Pac periodontal dressing has less cytotoxicity than Coe-Pak.
PubMed: 28496963
DOI: 10.5037/jomr.2017.8103 -
Nanomaterials (Basel, Switzerland) Sep 2022A biodegradable micro/nano-structured porous hemostatic gelatin-based sponge as a dentistry surgery foam was prepared using a freeze-drying method. In vitro function...
A biodegradable micro/nano-structured porous hemostatic gelatin-based sponge as a dentistry surgery foam was prepared using a freeze-drying method. In vitro function evaluation tests were performed to ensure its hemostatic effect. Biocompatibility tests were also performed to show the compatibility of the sponge on human fetal foreskin fibroblasts (HFFF2) cells and red blood cells (RBCs). Then, 10 patients who required the extraction of two teeth were selected, and after teeth extraction, for dressing, the produced sponge was placed in one of the extracavities while a commercial sponge was placed in the cavity in the other tooth as a control. The total weight of the absorbed blood in each group was compared. The results showed a porous structure with micrometric and nanometric pores, flexibility, a two-week range for degradation, and an ability to absorb blood 35 times its weight in vitro. The prepared sponge showed lower blood clotting times (BCTs) (243.33 ± 2.35 s) and a lower blood clotting index (BCI) (10.67 ± 0.004%) compared to two commercial sponges that displayed its ability for faster coagulation and good hemostatic function. It also had no toxic effects on the HFFF2 cells and RBCs. The clinical assessment showed a better ability of blood absorption for the produced sponge (-value = 0.0015). The sponge is recommended for use in dental surgeries because of its outstanding abilities.
PubMed: 36234564
DOI: 10.3390/nano12193436 -
Journal of Indian Society of... Nov 2013Periodontal dressings have been used for several years as a protection over injured tissue to shield the area from further insult. Several dressings are commercially...
BACKGROUND
Periodontal dressings have been used for several years as a protection over injured tissue to shield the area from further insult. Several dressings are commercially available. A recently introduced light-cured resin, claimed to be more biocompatible and esthetic, needs critical evaluation.
AIM
To compare this dressing with most widely used non-eugenol pack in the perspective of esthetics, acceptance, and healing following periodontal flap surgery.
MATERIALS AND METHODS
Twenty patients suffering from generalized chronic periodontitis, requiring periodontal flap surgery on contralateral sides of the arch, were selected and divided randomly into Group I (control) and Group II (test). In Group I, a non-eugenol dressing and in Group II light-cured dressing were applied after flap surgery. Pain and discomfort scores were recorded on day 1, 2, and 3 while plaque scores, gingival index, and bleeding index were recorded on day 7. Patient's subjective evaluation and preference for the dressing material were recorded. The data was collected and statistically analyzed.
RESULTS
Group II showed better results than Group I when plaque scores, bleeding scores, modified gingival index scores, and pain and discomfort scores were compared though the differences were not statistically significant. Subjects found no unpleasant taste/smell and perceived the light-cured dressing to be better. A significantly higher number of patients preferred light-cured resin as a post-surgical dressing over Coe-pak.
CONCLUSION
The light-cured dressing showed better patient acceptability and proves to be a better alternative to Coe-pak as a dressing material.
PubMed: 24554885
DOI: 10.4103/0972-124X.124494 -
Journal of Indian Society of... 2021Periodontal dressings are used for wound protection and patient comfort. Nano-silver particles have the ability to promote wound healing through anti-inflammatory...
BACKGROUND
Periodontal dressings are used for wound protection and patient comfort. Nano-silver particles have the ability to promote wound healing through anti-inflammatory properties. Hence, the present study aims to evaluate early wound healing parameters following periodontal surgery using nano-crystalline silver membrane as periodontal dressing.
MATERIALS AND METHODS
Forty-two systemically healthy patients diagnosed with chronic periodontitis indicated for periodontal flap surgery were enrolled for the present study. Post surgery, the patients were randomly allocated to either a nano-crystalline silver dressing (Acticoat™) group (test group) or only the noneugenol dressing group (control group). Plaque index (PI) and wound healing index were recorded at the 7- and 14-day postsurgery. The microbiological analysis and vascular endothelial growth factor (VEGF) levels were evaluated at baseline and 7-day postsurgery.
RESULTS
The healing index was significantly higher in the test group as compared to the control group at days 7 and 14 ( < 0.001; < 0.001). The colony-forming units/ml count of bacteria were significantly reduced postsurgery in the test group ( = 0.019). VEGF levels increased significantly 7-day postsurgery in the test group ( = 0.001). There was no statistically significant difference in the PI on the 7-day postsurgery between the two groups ( = 0.173).
CONCLUSION
The results of the study revealed that silver can be used as a potent periodontal dressing ingredient that can decrease the microbial colonization beneath the pack and promote faster healing postsurgery due to its antimicrobial activity.
PubMed: 34898916
DOI: 10.4103/jisp.jisp_17_21 -
Journal of Indian Society of... 2023Platelet-rich fibrin (PRF) accelerates wound healing by promoting faster cicatricial tissue remodeling and excellent neovascularization. Hyaluronic acid (HA) being...
INTRODUCTION
Platelet-rich fibrin (PRF) accelerates wound healing by promoting faster cicatricial tissue remodeling and excellent neovascularization. Hyaluronic acid (HA) being biocompatible, anti-inflammatory, and proangiogenic leads to improvement in the rate of wound healing.
AIM
The aim of this study was to compare the effect of PRF membrane and 0.2% HA gel on wounds after gingival depigmentation surgery.
MATERIALS AND METHODS
This study was carried out on 30 systemically healthy individuals recruited from the pool of patients who visited the department of periodontology. After depigmentation procedure in every patient, the sites were divided into three even groups. Group A received PRF membrane and periodontal dressing, Group B received 0.2% HA gel application and periodontal dressing, and Group C served as a control group in which only periodontal dressing was placed. The individuals were evaluated for the healing index (HI) and Numerical Rating Scale (NRS) on the 3 and 5 day. Epithelialization test (ET) was performed on the 5 day. Gingival biotype was reassessed and compared to preoperative value after 3 months. The clinical trial was expressed in terms of mean and standard deviation. Intra-group comparison and inter-group comparison were done through the Kruskal-Wallis ANOVA test. All statistical tests were performed through SPSS version 25.0 (IBM).
RESULTS
The inter-group statistical analysis concerning NRS, HI, and ET showed statistically significant results in Groups A and B compared to Group C ( < 0.05), while gingival biotype showed statistically significant results in Group A compared to Groups B and C.
CONCLUSION
The use of PRF membrane and HA gel to protect the raw wound site of depigmented gingiva proved to be an effective approach, resulting in faster healing.
PubMed: 38434500
DOI: 10.4103/jisp.jisp_291_22 -
Journal of Indian Society of... Oct 2010Free gingival grafts have been used extensively for gingival augmentation procedures, but are associated with postoperative morbidity because of the open palatal wound....
BACKGROUND
Free gingival grafts have been used extensively for gingival augmentation procedures, but are associated with postoperative morbidity because of the open palatal wound. This study compares the clinical efficiency of two dressing materials, a non-eugenol-based dressing (Coe-Pak™) and a collagen dressing (Colla Cote(®)) on palatal wound healing.
MATERIALS AND METHODS
Thirty-two patients in the age group of 25-50 years, who required gingival augmentation, were selected. Free gingival graft was harvested from the palatal mucosa and the wound was then protected using Coe-pak(®) in control group and Colla Cote(®) in test group. The subjective parameters pain and burning sensation were recorded on the 2(nd) and 7(th) day and the objective parameters colour and consistency were recorded on the 7(th) and 42(nd) day, using a visual analog scale. Thickness of the mucosa was measured using K file at baseline and 42(nd) day. Histological examination was done on 42(nd) day.
RESULTS
The subjective and objective parameters showed significant improvement in the test group when compared to control group. Histologically, there was a greater evidence of collagen formation and turn over in the test group than control group.
CONCLUSIONS
Collagen-based dressing may thus offer significantly greater advantages over the traditional non-eugenol dressings.
PubMed: 21731250
DOI: 10.4103/0972-124X.76929 -
Journal of Indian Society of... 2018The platelet concentrate is a windfall in the field of regenerative therapy in periodontology. It accelerates wound healing by excellent neovascularization and promoting...
BACKGROUND
The platelet concentrate is a windfall in the field of regenerative therapy in periodontology. It accelerates wound healing by excellent neovascularization and promoting fast cicatricle tissue remodeling.
AIM
This study aims to evaluate clinically and histologically accelerated effect of platelet-rich fibrin (PRF) membrane and PRF matrix (PRFM) following depigmentation procedure.
MATERIALS AND METHODS
Eleven individuals were divided into three groups after depigmentation procedure. PRF membrane and PRFM gel were prepared as per standard protocol. Group A and B received PRF membrane and PRFM gel followed by periodontal dressing, respectively, and the only periodontal dressing was placed in Group C. The individuals were evaluated for visual analog scale (VAS) and healing index (HI) on 3 and 5 day. Epithelization test and histologic analysis from punch biopsy were done on the 5 day. At 3 month, reevaluation was performed.
RESULTS
The intergroup statistical analysis in respect to VAS, HI, epithelization test, and histologic analysis showed a statistically significant results with < 0.001 in Groups A and B compared to Group C. Clinical evaluation of epithelization test and histologic analysis revealed better-wound healing and moderate to no inflammatory cell infiltrate in Groups A and B, respectively, as compared to Group C, which appeared more erythematous with dense inflammatory cells.
CONCLUSION
Thus, the application of PRF membrane and PRFM gel has shown a successful approach to protect the raw wound area of depigmented sites with better patient comfort and faster healing.
PubMed: 29769770
DOI: 10.4103/jisp.jisp_342_17 -
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