El-Sayed, M., Hommos, A., Kotry, G., Labib, G. (2021). THE EFFECT OF A CALENDULA BASED TOPICAL FORMULA VERSUS OXIDIZED REGENERATED CELLULOSE ON PALATAL WOUND HEALING: A RANDOMIZED CONTROLLED CLINICAL TRIAL. Alexandria Dental Journal, 46(Issue 2), 45-53. doi: 10.21608/adjalexu.2021.185219
Moustafa K. El-Sayed; Ahmed M. Hommos; Gehan S. Kotry; Gihan S. Labib. "THE EFFECT OF A CALENDULA BASED TOPICAL FORMULA VERSUS OXIDIZED REGENERATED CELLULOSE ON PALATAL WOUND HEALING: A RANDOMIZED CONTROLLED CLINICAL TRIAL". Alexandria Dental Journal, 46, Issue 2, 2021, 45-53. doi: 10.21608/adjalexu.2021.185219
El-Sayed, M., Hommos, A., Kotry, G., Labib, G. (2021). 'THE EFFECT OF A CALENDULA BASED TOPICAL FORMULA VERSUS OXIDIZED REGENERATED CELLULOSE ON PALATAL WOUND HEALING: A RANDOMIZED CONTROLLED CLINICAL TRIAL', Alexandria Dental Journal, 46(Issue 2), pp. 45-53. doi: 10.21608/adjalexu.2021.185219
El-Sayed, M., Hommos, A., Kotry, G., Labib, G. THE EFFECT OF A CALENDULA BASED TOPICAL FORMULA VERSUS OXIDIZED REGENERATED CELLULOSE ON PALATAL WOUND HEALING: A RANDOMIZED CONTROLLED CLINICAL TRIAL. Alexandria Dental Journal, 2021; 46(Issue 2): 45-53. doi: 10.21608/adjalexu.2021.185219
THE EFFECT OF A CALENDULA BASED TOPICAL FORMULA VERSUS OXIDIZED REGENERATED CELLULOSE ON PALATAL WOUND HEALING: A RANDOMIZED CONTROLLED CLINICAL TRIAL
1Postgraduate candidate, Faculty of Dentistry, Alexandria University
2Professor of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University
3Assistant professor of Pharmaceutics, Faculty of Pharmacy and Drug Manufacturing, Pharos University in Alexandria
Abstract
INTRODUCTION:Free palatal and sub-epithelial connective tissue grafts are the most commonly used grafts in periodontal plastic surgeries. The surgical technique of free palatal grafting requires harvesting of soft tissue from the palatal donor site and transplantation to an intraoral recipient one. Post-surgical complications and atypical healing processes have been described in the literature. In order to reduce the morbidity associated with mucogingival surgery, there are several ways to manage the donor site after soft tissue harvesting. Various topically applied formulas and hemostatic agents have been employed to manage post-operative healing at the donor site. OBJECTIVES: to assess the effects of Calendula based topical formula on palatal wound healing after free palatal graft surgery in comparison to oxidized regenerated cellulose. MATERIAL AND METHODS This randomized, controlled trial included twenty-four surgical sites for palatal graft procurement, divided equally into two groups, managed by the topical application of either a Calendula based formula (Group-I) or oxidized regenerated cellulose (Group-II). Palatal wound healing was assessed using photo-digital planimetry on the day of the surgery and; at seven and fourteen days, post-surgical. Pain was assessed by visual analogue scale (VAS) one, four and seven days post-surgical. RESULTS: The VAS score results showed no significant difference at days one, four and seven when comparing group I and II. For the percentages of remaining wound area, there was no significant difference in the percentages of remaining wound area. However, at day seven, there was a significant decrease in the percentage of remaining wound area in group II when compared to group I. Comparing the percentages of remaining wound area at day seven and fourteen in group I, there was a significant decrease of the percentages of remaining wound area at day fourteen. The same was found in group II. For group I, there was no significant difference between any of the recording periods. However, for group II, there was a significant decrease in the VAS scores between day one and seven, and also between day four and seven. CONCLUSION: Both materials were beneficial in improving palatal wound healing. However, oxidized regenerated cellulose exhibited better pain reduction following palatal graft procedures as reported by the study subjects when compared to the topical Calendula group < /p>
1. Takei H, Azzi R, Han T. Periodontal plastic and esthetic surgery. Carranza's Clinical Periodontology 10ma ed St Louis Missouri: Saunders Elsevier. 2006:1005-26.
2. Zuhr O, Bäumer D, Hürzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. Journal of clinical periodontology. 2014;41(s15).
3. Ibarrola JL, Bjorenson JE, Austin BP, Gerstein H. Osseous reactions to three hemostatic agents. Journal of endodontics. 1985;11(2):75-83.
4. Finn MD, Schow SR, Schneiderman ED. Osseous regeneration in the presence of four common hemostatic agents. Journal of oral and maxillofacial surgery. 1992;50(6):608-12.
5. Matthew I, Browne R, Frame J, Millar B. Tissue response to a haemostatic alginate wound dressing in tooth extraction sockets. British Journal of Oral and Maxillofacial Surgery. 1993;31(3):165-9.
6. Rossmann JA, Rees TD. A comparative evaluation of hemostatic agents in the management of soft tissue graft donor site bleeding. J Periodontol. 1999;70(11):1369-75.
7. Faria RL, Cardoso LML, Akisue G, Pereira CA, Junqueira JC, Jorge AOC, et al. Antimicrobial activity of Calendula officinalis, Camellia sinensis and chlorhexidine against the adherence of microorganisms to sutures after extraction of unerupted third molars. Journal of Applied Oral Science. 2011;19(5):476-82.
8. Magee K, Loiacono C. A review of common herbs and potential interactions. International journal of dental hygiene. 2004;2(3):111.
9. Fronza M, Heinzmann B, Hamburger M, Laufer S, Merfort I. Determination of the wound healing effect of Calendula extracts using the scratch assay with 3T3 fibroblasts. Journal of ethnopharmacology. 2009;126(3):463-7.
10. World Medical A. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4.
11. Pannucci CJ, Wilkins EG. Identifying and avoiding bias in research. Plastic and reconstructive surgery. 2010;126(2):619.
12. Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 2007;39(2):175-91.
14. Reynolds JE. Martindale: the extra pharmacopoeia: London, UK; The Pharmaceutical Press; 1982.
15. Mutimer MN, Riffkin C, Hill JA, Cyr GN. Modern Ointment Base Technology I.: Properties of Hydrocarbon Gels. Journal of the American Pharmaceutical Association (Scientific ed). 1956;45(2):101-5.
16. Labib GS, Aldawsari H. Innovation of natural essential oil-loaded Orabase for local treatment of oral candidiasis. Drug design, Development and therapy. 2015;9:3349.
17. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC medicine. 2010;8(1):18.
18. O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972;43(1):38-.
19. Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol. 1967;38(6 Part II):610-6.
20. Bozkurt Doğan Ş, Öngöz Dede F, Ballı U, Atalay EN, Durmuşlar MC. Concentrated growth factor in the treatment of adjacent multiple gingival recessions: a split‐mouth randomized clinical trial. Journal of clinical periodontology. 2015;42(9):868-75.
21. Sullivan H, Atkins J. The role of free gingival grafts in periodontal therapy. Dental Clinics of North America. 1969;13(1):133-48.
22. Sullivan HC. Free autogenous gingival grafts. I. Principles of successfull grafting. Periodontics. 1968;6:121-9.
23. Sullivan HC, Atkins JH. Free autogenous gingival grafts. 3. Utilization of grafts in the treatment of gingival recession. Periodontics. 1968;6(4):152-60.
24. Thoma DS, Sancho‐Puchades M, Ettlin DA, Hämmerle CH, Jung RE. Impact of a collagen matrix on early healing, aesthetics and patient morbidity in oral mucosal wounds–a randomized study in humans. Journal of clinical periodontology. 2012;39(2):157-65.
25. Huskisson EC, Jones J, Scott PJ. Application of visual-analogue scales to the measurement of functional capacity. Rheumatol Rehabil. 1976;15(3):185-7.
26. Passeron T, Zakaria W, Ostovari N, Mantoux F, Lacour JP, Ortonne JP. Treatment of erosive oral lichen planus by the 308 nm excimer laser. Lasers in surgery and medicine. 2004;34(3):205.
27. Bushra R, Aslam N. An overview of clinical pharmacology of ibuprofen. Oman Medical Journal. 2010;25(3):155.
28. Shanmugam M, Kumar T, Arun K, Arun R, Karthik SJ. Clinical and histological evaluation of two dressing materials in the healing of palatal wounds. Journal of Indian Society of Periodontology. 2010;14(4):241.
29. Saroff SA, Chasens AI, Eisen SF, Levey SH. Free soft tissue autografts. Hemostasis and protection of the palatal donor site with a microfibrillar collagen preparation. J Periodontol. 1982;53(7):425-8.
30. Stein MD, Salkin LM, Freedman AL, Glushko V. Collagen sponge as a topical hemostatic agent in mucogingival surgery. J Periodontol. 1985;56(1):35-8.
31. Faria RL, Cardoso LM, Akisue G, Pereira CA, Junqueira JC, Jorge AO, et al. Antimicrobial activity of Calendula officinalis, Camellia sinensis and chlorhexidine against the adherence of microorganisms to sutures after extraction of unerupted third molars. Journal of applied oral science : revista FOB. 2011;19(5):476-82.
32. Bissett DL. Common cosmeceuticals. Clinics in dermatology. 2009;27(5):435-45.
33. Ebner F, Heller A, Rippke F, Tausch I. Topical Use of Dexpanthenol in Skin Disorders. American journal of clinical dermatology. 2002;3(6):427-33.
34. Engeland CG, Bosch JA, Cacioppo JT, Marucha PT. Mucosal Wound Healing: The Roles of Age and Sex. JAMA Surgery. 2006;141(12):1193-7.
35. Bernimoulin JP, Luscher B, Muhlemann HR. Coronally repositioned periodontal flap. Clinical evaluation after one year. J Clin Periodontol. 1975;2(1):1-13.
36. Nicolaus C, Junghanns S, Hartmann A, Murillo R, Ganzera M, Merfort I. In vitro studies to evaluate the wound healing properties of Calendula officinalis extracts. J Ethnopharmacol. 2017;196:94-103.
37. Kozlovsky A, Artzi Z, Hirshberg A, Israeli-Tobias C, Reich L. Effect of local antimicrobial agents on excisional palatal wound healing: a clinical and histomorphometric study in rats. J Clin Periodontol. 2007;34(2):164-71.
38. Pollack RP, Bouwsma OJ. Applications of oxidized regenerated cellulose in periodontal therapy: Part 1. Compendium. 1992;13(10):888, 90, 92 passim.
39. Thoma DS, Sancho-Puchades M, Ettlin DA, Hammerle CH, Jung RE. Impact of a collagen matrix on early healing, aesthetics and patient morbidity in oral mucosal wounds - a randomized study in humans. J Clin Periodontol. 2012;39(2):157-65.
40. Morone NE, Weiner DK. Pain as the fifth vital sign: exposing the vital need for pain education. Clinical therapeutics. 2013;35(11):1728-32.
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