Evaluation Of the Effects of Antioxidant Gel on The Palatal Graft Donor Site - A Randomised Controlled Clinical Trial
Main Article Content
Keywords
Evaluation, Clinical, study, conventional
Abstract
Background: FGG is the most effective way to increase the attached gingiva. However, the donor site morbidity is a serious issue following it. Hence to decrease donor site morbidity and promote faster healing a novel antioxidant blue®m gel was used.
Aim: To compare the in vivo effects of the blue®m gel with slow release of oxygen on the healing of donor site.
Materials And Methods: 60 patients undergoing free gingival surgery were included and randomly divided into 2 groups, group 1 (control group) - palatal donor site was covered with AbGelTM alone and, in group 2 (test group)- blue®m gel was applied to the palatal donor site and covered with AbGelTM. Postoperative pain and Wound healing index were calculated at one week and one month.
Results: Immediately After 2 h (immediately after the effect of anesthesia was resolved), no significant difference was found between both groups (p > 0.05). The pain was significantly reduced in both the groups from baseline to 1 week and 1 month (p < 0.05). At one week and After 1 month, there was a significant difference between both groups (p < 0.05). Values from one week to one month (within the groups) in group 1 and group 2 showed a significant difference (p < 0.05). At the 1-week follow-up, there was a statistically significant difference between the groups (p < 0.05). Even at 1 month, a significant difference was found between the groups (p < 0.05).
Conclusion: According to the findings of the present study, using the blue®m oxygen gel as an adjunct to an AbGelTM improves wound healing, stimulates rapid re-epithelization, and relieves postoperative pain compared with the conventional dressing with AbGelTM alone.
References
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8. Cunha EJ, Auersvald CM, Deliberador TM, Gonzaga CC, Esteban Florez FL, Correr GM, et al. Effects of Active Oxygen Toothpaste in Supragingival Biofilm Reduction: A Randomized Controlled Clinical Trial. Int J Dent. 2019 Jul 1;2019:3938214.
9. Sridharan G, Ramani P, Patankar S, Vijayaraghavan R. Evaluation of salivary metabolomics in oral leukoplakia and oral squamous cell carcinoma. J Oral Pathol Med. 2019 Apr;48(4):299–306.
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11. Vijayakumar Jain S, Muthusekhar MR, Baig MF, Senthilnathan P, Loganathan S, Abdul Wahab PU, et al. Evaluation of Three-Dimensional Changes in Pharyngeal Airway Following Isolated Lefort One Osteotomy for the Correction of Vertical Maxillary Excess: AProspective Study. J Maxillofac Oral Surg. 2019 Mar;18(1):139–46.
12. Prabakar J, John J, Arumugham IM, Kumar RP, Sakthi DS. Comparing the Effectiveness of Probiotic, Green Tea, and Chlorhexidine- and Fluoride-containing Dentifrices on Oral Microbial Flora: A Double-blind, Randomized Clinical Trial. Contemp Clin Dent. 2018 Oct-Dec;9(4):560–9.
13. Kaarthikeyan G, Jayakumar ND, Sivakumar D. Comparative Evaluation of Bone Formation between PRF and Blood Clot Alone as the Sole Sinus-Filling Material in Maxillary Sinus Augmentation with the Implant as a Tent Pole: A Randomized Split-Mouth Study. J Long Term Eff Med Implants. 2019;29(2):105–11.
14. Ramesh A, Varghese S, Jayakumar ND, Malaiappan S. Comparative estimation of sulfiredoxin levels between chronic periodontitis and healthy patients - A case-control study. J Periodontol. 2018 Oct;89(10):1241–8.
15. Murthykumar K, Arjunkumar R, Jayaseelan VP. Association of vitamin D receptor gene polymorphism (rs10735810) and chronic periodontitis. J Investig Clin Dent. 2019 Nov;10(4):e12440.
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17. Lambris JD, Mastellos DC, Reis ES. Therapeutic Modulation of the Complement System: Clinical Indications and Emerging Drug Leads. Frontiers Media SA; 2020. 185 p.
18. Rajasekar A, Varghese SS. Bacterial Profile Associated with Peri-Implantitis: A Systematic Review. J Long Term Eff Med Implants. 2023;33(3):9–20.
19. Website [Internet]. Available from: doi: http://dx.doi.org/10.19070/2377-8075-21000779
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21. Govindarasu M, Prathap L, Govindasamy R. Histone deacetylase inhibitors regulate the oral cancer via PI3K/AKT signaling pathway. Oral Oncol. 2022 Dec;135:106221.
22. Jabin Z, Jain G, Jaiswal M, Vishnu Priya V. Top 100 cited articles on Silver diamine fluoride-A bibliometric analysis. J Oral Biol Craniofac Res. 2022 May 18;12(4):413–20.
23. Devi SS, Dinesh S, Sivakumar A, Nivethigaa B, Alshehri A, Awadh W, et al. Reliability of Frankfort Horizontal Plane with True Horizontal Plane in Cephalometric Measurements. J Contemp Dent Pract. 2022 Sep 23;23(6):601–5.
24. Garapati B, Ramamurthy J, Shanmugam R. Formulation, development, and evaluation of anti-inflammatory and antimicrobial effects of a novel polyherbal mouthwash-An study. J Popul Ther Clin Pharmacol. 2022 Aug 15;29(3):e94–103.
25. Garapati B, Malaiappan S, Rajeshkumar S, Murthykumar K. Cytotoxicity of lycopene-mediated silver nanoparticles in the embryonic development of zebrafish-An animal study. J Biochem Mol Toxicol. 2022 Oct;36(10):e23173.
26. Yang P, Huang H, Xie X. Removal of antibiotic resistant bacteria in wastewater by aggregation-induced emission photosensitizer. Environ Pollut. 2023 Apr 28;121738.
27. Neuman TS, Thom SR. Physiology and Medicine of Hyperbaric Oxygen Therapy. Elsevier Health Sciences; 2008. 637 p.
28. Juliana H, Tarek S. Comparative study of the effect of BlueM active oxygen gel and coe-pack dressing on postoperative surgical depigmentation healing. Saudi Dent J. 2022 May;34(4):328–34.
29. Patel PV, Kumar V, Kumar S, Gd V, Patel A. Therapeutic effect of topical ozonated oil on the epithelial healing of palatal wound sites: a planimetrical and cytological study. J Investig Clin Dent. 2011 Nov;2(4):248–58.
30. Batool F, Stutz C, Petit C, Benkirane-Jessel N, Delpy E, Zal F, et al. A therapeutic oxygen carrier isolated from Arenicola marina decreased P. gingivalis induced inflammation and tissue destruction. Sci Rep. 2020 Sep 8;10(1):14745.
31. Taniguchi N, Osaki M, Onuma K, Ishikawa M, Ryoke K, Kodani I, et al. Bisphosphonate-induced reactive oxygen species inhibit proliferation and migration of oral fibroblasts: A pathogenesis of bisphosphonate-related osteonecrosis of the jaw. J Periodontol. 2020 Jul;91(7):947–55.
32. Taşdemir Z, Alkan BA, Albayrak H. Effects of Ozone Therapy on the Early Healing Period of Deepithelialized Gingival Grafts: A Randomized Placebo-Controlled Clinical Trial. J Periodontol. 2016 Jun;87(6):663–71.
33. Zucchelli G, Mounssif I. Periodontal plastic surgery. Periodontol 2000. 2015 Jun;68(1):333–68.
34. Zucchelli G, Mele M, Stefanini M, Mazzotti C, Marzadori M, Montebugnoli L, et al. Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative randomized-controlled clinical trial. J Clin Periodontol. 2010 Aug 1;37(8):728–38.
35. Knighton DR, Hunt TK, Scheuenstuhl H, Halliday BJ, Werb Z, Banda MJ. Oxygen tension regulates the expression of angiogenesis factor by macrophages. Science. 1983 Sep 23;221(4617):1283–5.
36. Eisenbud DE. Oxygen in wound healing: nutrient, antibiotic, signaling molecule, and therapeutic agent. Clin Plast Surg. 2012 Jul;39(3):293–310.
37. Santos VCED, Maquera-Huacho PM, Imbriani MJM, Minhaco VMTR, Spolidorio DMP. Effects of BlueM® against Streptococcus mutans biofilm and its virulence gene expression. Braz Dent J. 2023 Jan-Feb;34(1):19–28.
38. O’Neil TC. Antibacterial properties of periodontal dressings. J Periodontol. 1975 Aug;46(8):469.
39. Jorkjend L, Skoglund LA. Effect of non-eugenol- and eugenol-containing periodontal dressings on the incidence and severity of pain after periodontal soft tissue surgery. J Clin Periodontol. 1990 Jul;17(6):341–4.
40. Han SK. Innovations and Advances in Wound Healing. Springer; 2015. 287 p.
41. Han YH, Kim HS, Kim JM, Kim SK, Yu DY, Moon EY. Inhibitory role of peroxiredoxin II (Prx II) on cellular senescence. FEBS Lett. 2005 Aug 29;579(21):4897–902.
42. Lektemur Alpan A, Torumtay Cin G. PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial. Clin Oral Investig. 2020 Jan;24(1):425–36.
43. Nezwek RA, Caffesse RG, Bergenholtz A, Nasjleti CE. Connective Tissue Response to Periodontal Dressings. J Periodontol. 1980 Sep;51(9):521–9.
44. Grant DA, Bernick S, Levy BM, Dreizen S. A comparative study of periodontal ligament development in teeth with and without predecessors in marmosets. J Periodontol. 1972 Mar;43(3):162–9.
2. Silva CO, Ribeiro EDP, Sallum AW, Tatakis DN. Free gingival grafts: graft shrinkage and donor-site healing in smokers and non-smokers. J Periodontol. 2010 May;81(5):692–701.
3. Bosco AF, Bosco JMD. An alternative technique to the harvesting of a connective tissue graft from a thin palate: enhanced wound healing. Int J Periodontics Restorative Dent. 2007 Apr;27(2):133–9.
4. Scheyer ET, Sanz M, Dibart S, Greenwell H, John V, Kim DM, et al. Periodontal soft tissue non-root coverage procedures: a consensus report from the AAP Regeneration Workshop. J Periodontol. 2015 Feb;86(2 Suppl):S73–6.
5. Farsaei S, Khalili H, Farboud ES. Potential role of statins on wound healing: review of the literature. Int Wound J. 2012 Jun;9(3):238–47.
6. Huang JF, Tsai AYM, Liu CM, Yang YL, Hou LT. Double laterally-rotated bilayer flap operation for treatment of gingival recession. J Formos Med Assoc. 2004 Jul;103(7):562–7.
7. Wyrębek B, Górski B, Górska R. Patient morbidity at the palatal donor site depending on gingival graft dimension. Dent Med Probl. 2018 Apr-Jun;55(2):153–9.
8. Cunha EJ, Auersvald CM, Deliberador TM, Gonzaga CC, Esteban Florez FL, Correr GM, et al. Effects of Active Oxygen Toothpaste in Supragingival Biofilm Reduction: A Randomized Controlled Clinical Trial. Int J Dent. 2019 Jul 1;2019:3938214.
9. Sridharan G, Ramani P, Patankar S, Vijayaraghavan R. Evaluation of salivary metabolomics in oral leukoplakia and oral squamous cell carcinoma. J Oral Pathol Med. 2019 Apr;48(4):299–306.
10. Duraisamy R, Krishnan CS, Ramasubramanian H, Sampathkumar J, Mariappan S, Navarasampatti Sivaprakasam A. Compatibility of Nonoriginal Abutments With Implants: Evaluation of Microgap at the Implant-Abutment Interface, With Original and Nonoriginal Abutments. Implant Dent. 2019 Jun;28(3):289–95.
11. Vijayakumar Jain S, Muthusekhar MR, Baig MF, Senthilnathan P, Loganathan S, Abdul Wahab PU, et al. Evaluation of Three-Dimensional Changes in Pharyngeal Airway Following Isolated Lefort One Osteotomy for the Correction of Vertical Maxillary Excess: AProspective Study. J Maxillofac Oral Surg. 2019 Mar;18(1):139–46.
12. Prabakar J, John J, Arumugham IM, Kumar RP, Sakthi DS. Comparing the Effectiveness of Probiotic, Green Tea, and Chlorhexidine- and Fluoride-containing Dentifrices on Oral Microbial Flora: A Double-blind, Randomized Clinical Trial. Contemp Clin Dent. 2018 Oct-Dec;9(4):560–9.
13. Kaarthikeyan G, Jayakumar ND, Sivakumar D. Comparative Evaluation of Bone Formation between PRF and Blood Clot Alone as the Sole Sinus-Filling Material in Maxillary Sinus Augmentation with the Implant as a Tent Pole: A Randomized Split-Mouth Study. J Long Term Eff Med Implants. 2019;29(2):105–11.
14. Ramesh A, Varghese S, Jayakumar ND, Malaiappan S. Comparative estimation of sulfiredoxin levels between chronic periodontitis and healthy patients - A case-control study. J Periodontol. 2018 Oct;89(10):1241–8.
15. Murthykumar K, Arjunkumar R, Jayaseelan VP. Association of vitamin D receptor gene polymorphism (rs10735810) and chronic periodontitis. J Investig Clin Dent. 2019 Nov;10(4):e12440.
16. Gajendran PL, Parthasarathy H, Tadepalli A. Comparative evaluation of cathepsin K levels in gingival crevicular fluid among smoking and nonsmoking patients with chronic periodontitis. Indian J Dent Res. 2018 Sep-Oct;29(5):588–93.
17. Lambris JD, Mastellos DC, Reis ES. Therapeutic Modulation of the Complement System: Clinical Indications and Emerging Drug Leads. Frontiers Media SA; 2020. 185 p.
18. Rajasekar A, Varghese SS. Bacterial Profile Associated with Peri-Implantitis: A Systematic Review. J Long Term Eff Med Implants. 2023;33(3):9–20.
19. Website [Internet]. Available from: doi: http://dx.doi.org/10.19070/2377-8075-21000779
20. Mony U, Priya Veeraraghavan V. “Rules” to the genetic progression of tumours deciphered: Is it time to think differently in treating oral cancer patients? Oral Oncol. 2022 Nov;134:106111.
21. Govindarasu M, Prathap L, Govindasamy R. Histone deacetylase inhibitors regulate the oral cancer via PI3K/AKT signaling pathway. Oral Oncol. 2022 Dec;135:106221.
22. Jabin Z, Jain G, Jaiswal M, Vishnu Priya V. Top 100 cited articles on Silver diamine fluoride-A bibliometric analysis. J Oral Biol Craniofac Res. 2022 May 18;12(4):413–20.
23. Devi SS, Dinesh S, Sivakumar A, Nivethigaa B, Alshehri A, Awadh W, et al. Reliability of Frankfort Horizontal Plane with True Horizontal Plane in Cephalometric Measurements. J Contemp Dent Pract. 2022 Sep 23;23(6):601–5.
24. Garapati B, Ramamurthy J, Shanmugam R. Formulation, development, and evaluation of anti-inflammatory and antimicrobial effects of a novel polyherbal mouthwash-An study. J Popul Ther Clin Pharmacol. 2022 Aug 15;29(3):e94–103.
25. Garapati B, Malaiappan S, Rajeshkumar S, Murthykumar K. Cytotoxicity of lycopene-mediated silver nanoparticles in the embryonic development of zebrafish-An animal study. J Biochem Mol Toxicol. 2022 Oct;36(10):e23173.
26. Yang P, Huang H, Xie X. Removal of antibiotic resistant bacteria in wastewater by aggregation-induced emission photosensitizer. Environ Pollut. 2023 Apr 28;121738.
27. Neuman TS, Thom SR. Physiology and Medicine of Hyperbaric Oxygen Therapy. Elsevier Health Sciences; 2008. 637 p.
28. Juliana H, Tarek S. Comparative study of the effect of BlueM active oxygen gel and coe-pack dressing on postoperative surgical depigmentation healing. Saudi Dent J. 2022 May;34(4):328–34.
29. Patel PV, Kumar V, Kumar S, Gd V, Patel A. Therapeutic effect of topical ozonated oil on the epithelial healing of palatal wound sites: a planimetrical and cytological study. J Investig Clin Dent. 2011 Nov;2(4):248–58.
30. Batool F, Stutz C, Petit C, Benkirane-Jessel N, Delpy E, Zal F, et al. A therapeutic oxygen carrier isolated from Arenicola marina decreased P. gingivalis induced inflammation and tissue destruction. Sci Rep. 2020 Sep 8;10(1):14745.
31. Taniguchi N, Osaki M, Onuma K, Ishikawa M, Ryoke K, Kodani I, et al. Bisphosphonate-induced reactive oxygen species inhibit proliferation and migration of oral fibroblasts: A pathogenesis of bisphosphonate-related osteonecrosis of the jaw. J Periodontol. 2020 Jul;91(7):947–55.
32. Taşdemir Z, Alkan BA, Albayrak H. Effects of Ozone Therapy on the Early Healing Period of Deepithelialized Gingival Grafts: A Randomized Placebo-Controlled Clinical Trial. J Periodontol. 2016 Jun;87(6):663–71.
33. Zucchelli G, Mounssif I. Periodontal plastic surgery. Periodontol 2000. 2015 Jun;68(1):333–68.
34. Zucchelli G, Mele M, Stefanini M, Mazzotti C, Marzadori M, Montebugnoli L, et al. Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative randomized-controlled clinical trial. J Clin Periodontol. 2010 Aug 1;37(8):728–38.
35. Knighton DR, Hunt TK, Scheuenstuhl H, Halliday BJ, Werb Z, Banda MJ. Oxygen tension regulates the expression of angiogenesis factor by macrophages. Science. 1983 Sep 23;221(4617):1283–5.
36. Eisenbud DE. Oxygen in wound healing: nutrient, antibiotic, signaling molecule, and therapeutic agent. Clin Plast Surg. 2012 Jul;39(3):293–310.
37. Santos VCED, Maquera-Huacho PM, Imbriani MJM, Minhaco VMTR, Spolidorio DMP. Effects of BlueM® against Streptococcus mutans biofilm and its virulence gene expression. Braz Dent J. 2023 Jan-Feb;34(1):19–28.
38. O’Neil TC. Antibacterial properties of periodontal dressings. J Periodontol. 1975 Aug;46(8):469.
39. Jorkjend L, Skoglund LA. Effect of non-eugenol- and eugenol-containing periodontal dressings on the incidence and severity of pain after periodontal soft tissue surgery. J Clin Periodontol. 1990 Jul;17(6):341–4.
40. Han SK. Innovations and Advances in Wound Healing. Springer; 2015. 287 p.
41. Han YH, Kim HS, Kim JM, Kim SK, Yu DY, Moon EY. Inhibitory role of peroxiredoxin II (Prx II) on cellular senescence. FEBS Lett. 2005 Aug 29;579(21):4897–902.
42. Lektemur Alpan A, Torumtay Cin G. PRF improves wound healing and postoperative discomfort after harvesting subepithelial connective tissue graft from palate: a randomized controlled trial. Clin Oral Investig. 2020 Jan;24(1):425–36.
43. Nezwek RA, Caffesse RG, Bergenholtz A, Nasjleti CE. Connective Tissue Response to Periodontal Dressings. J Periodontol. 1980 Sep;51(9):521–9.
44. Grant DA, Bernick S, Levy BM, Dreizen S. A comparative study of periodontal ligament development in teeth with and without predecessors in marmosets. J Periodontol. 1972 Mar;43(3):162–9.
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May 13, 2023
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Bhavana Garapati, Jaiganesh Ramamurthy, & Paladugu Devi Navya. (2023). Evaluation Of the Effects of Antioxidant Gel on The Palatal Graft Donor Site - A Randomised Controlled Clinical Trial. Journal of Population Therapeutics and Clinical Pharmacology, 30(10), 433–441. https://doi.org/10.47750/jptcp.2023.30.10.048
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