The Effectiveness of 0.2% Chlorhexidine Gel on Early Wound Healing after Tooth Extraction: A Randomized Controlled Trial

Objective This study aimed to evaluate the effect of 0.2% chlorhexidine (CHX) gel on wound healing after tooth extraction. Materials and Methods A single blind, randomized controlled trial was performed recruiting 32 participants who underwent dental extractions. Patients were randomly allocated for CHX group or placebo group. The primary outcomes were wound closure measured with calipers and healings were assessed by Landry et al index after 7 days of topical application of allocated gels on extraction sites. Results The wound closures were greater in CHX group compared with placebo group and healing scores were correlated with the use of CHX gel (p-value < 0.05). Conclusion In a population of healthy nonsmoker adults, application of 0.2% CHX gel twice a day for 7 days after tooth extraction has a beneficial effect on wound healing.

ГЕЛЬ «МІРАДОНТ» – НАПРЯМ У ПРАКТИЧНОМУ ЗАГОЄННІ РАНОВОГО ПРОЦЕСУ В ПІСЛЯОПЕРАЦІЙНИЙ ПЕРІОД НА ТКАНИНАХ ПАРОДОНТУ

Мета дослідження – обґрунтування можливості та визначення ефективності застосування гелю «Мірадонт»» зі стандартизованою схемою лікування генералізованого пародонтиту. Методи дослідження. На базі Стоматологічного медичного центру Львівського національного медичного університету імені Данила Галицького проведено оперативне лікування 136 хворих із генералізованими захворюваннями тканин пародонту з використанням медикаментозної терапії в комбінації з гелем «Мірадонт»» або без нього. 82 хворим (60,3% (p˂0,05)) застосовувався гель «Мірадонт» із комплексною терапією (основна група), серед них 34 чоловіки (25% (p˂0,05)) та 48 жінок (35,3% (p˂0,05)); 54 хворим (39,7% (p˂0,05)) не застосовувався гель «Мірадонт» із комплексною терапією (контрольна група), серед них 19 чоловіків (14% (p˂0,05)) та 35 жінок (25,7% (p˂0,05)) Для об’єктивної оцінки були використані параметри EHS (оцінка раннього загоєння ран), індекс раннього загоєння рани (early wound healing index, EHI) та у відстрочені терміни загоєння на 15 та 30 добу в післяопераційний період, результати яких оброблені за допомогою програмного пакета «Statistica 6.0». Наукова новизна. Уперше систематизовано результати та визначено ефективність застосування гелю «Мірадонт» із медикаментозною терапією на клінічному рівні при оперативних втручаннях на тканинах пародонту. Клінічно доведено вплив на процеси перекисного окиснення ліпідів (далі – ПОЛ), які негативно впливають на перебіг загоєння ран. Висновки. Підсумком отриманих результатів стало те, що у хворих (контрольна група), яким не призначили гель «Мірадонт», збагачений флавоноїдами, в комплексі з медикаментозною терапією, негативна тенденція при тотальному загоєнні триває з 24 годин до 30 діб у післяопераційний період порівняно з хворими основної групи, що об’єктивно оцінено відповідними показниками, хоч і з позитивною динамікою. Однією із суттєвих особливостей флавоноїдів, що входять до складу компонентів гелю «Мірадонт», є антиоксидантна дія, яка виявляється завдяки тому, що фенольна структура (завдяки вільним -ОН-групам) дає можливість молекулі взаємодіяти з вільними радикалами, зменшуючи інтенсивність перекисного окиснення ліпідів.

Effectiveness of platelet rich fibrin versus demineralized bone xenograft in periodontally accelerated osteogenic orthodontics: A pilot comparative clinical study

ABSTRACT Objectives To compare the rate of extraction space closure between periodontally accelerated osteogenic orthodontics (PAOO) using platelet-rich fibrin (PRF) (Group 1) and PAOO using demineralized bone xenograft (DMBM) (Group 2) and to compare the level of wound healing between the PRF group vs the DMBM group after PAOO. Materials and Methods A two-arm prospective single blind pilot study with a split-mouth design was used in which 14 patients requiring premolar extraction were divided into two groups: PRF and DMBM. En-masse space closure was carried out with using mini implants after the PAOO procedure. The amount of space closure was measured at five time points with 2-week intervals within 2 months. The gingival healing levels were assessed using early wound healing scores on the first postoperative day. Results The rate of extraction space closure was faster in the experimental quadrant at all time points (T1-T4) in the PRF group and at time points (T3, T4) in the DMBM group. Comparison between experimental quadrants showed a significant increase in the rate of space closure in the PRF group T1 to T3 (P &lt; .05). The PRF group showed higher total early healing scores than the DMBM group. Conclusions PRF, when used in the PAOO procedure, produces a faster rate of space closure with better early wound healing than DMBM.

Drain or no drain in Rhomboid excision and Limberg rotational flap for pilonidal sinus

Background: Healing in Rhomboid flap for pilonidal sinus is always a problem. Different measures are applied to reduce the rate of wound infection with variable results. Objectives: To determine the effect of routine use of drain on the rate of early wound complications and additional interventions after Rhomboid flap. Methods: A retrospective chart review of all cases that underwent Rhomboid flap in five years in two tertiary care centres was done. Complication rates such as wound infection, wound disruption, and flap necrosis were evaluated. Results: A total of 38 cases of Rhomboid flap are included for analysis. Out of all cases 37 cases were done for Pilonidal sinus and one case for presacral dermoid cyst. In the first eight cases, flap was made without drain and subsequent 30 cases were done with two suction drains for five days. The rate of superficial wound infection in the group without drain was found to be significantly higher compared with flap with drain 5 (in 8) versus 2 (in 30) (62.5% versus 6.66%, p <0.5). Conclusion: Drain placement after Rhomboid flap is a good intervention to reduce wound infection.

Augmentation Stability of Guided Bone Regeneration for Peri-Implant Dehiscence Defects with L-shaped Porcine-Derived Block Bone Substitute

Block bone substitutes have better augmentation stability for guided bone regeneration (GBR) than particulate bone substitutes. This study sought to determine whether GBR with an L-shaped porcine block bone (DPBM-C) differs from GBR with an L-shaped bovine block bone (DBBM-C) based on clinical, radiographic, and volumetric outcomes for peri-implant dehiscence defects. A total of 42 peri-implant defects were grafted with 20 L-shaped DPBM-C and 22 DBBM-C groups. The horizontal and vertical thicknesses of the augmented hard tissue were measured using sagittal cone-beam computed tomography, and the volumetric tissue change was evaluated by stereolithography image superimposition. Postoperative discomfort, early wound healing outcomes, and implant stability were also assessed. Among the clinical (subjective pain and swelling, wound dehiscence, membrane exposure, and periotest values), radiographic (changes in horizontal and vertical hard tissue thickness), and volumetric parameters of the L-shaped DPBM-C and DBBM-C groups during the healing period, only the periotest values showed a statistically significant difference (0.67 ± 1.19, p = 0.042). Within the limitations of this study, an L-shaped DPBM-C is not inferior to an L-shaped DBBM-C based on their clinical, radiographic, and volumetric outcomes for GBR of peri-implant dehiscence defects.

Biological dressing is a paradigm shift in children’s scald burn: our experience

Background: Burn injury has multiple causes but scald burn is the most common type of burn in children. Prototype of scald burn is hot water burn. Change of burn dressing in children is challenging. Biological collagen dressing has totally changed the management of scald burn or it is a paradigm shift in the management of scald burn in children. Aim of this study was to achieve early wound healing with less complication and to prevent change of frequent dressings in children.Methods: A prospective study was done in 30 patients of scald burn under 12 years of age between November 2020 to July 2021. Meticulous debridement and deroofing of all blisters and removal of dead skin were performed. Bovine meshed wet collagen dressing was thoroughly rinsed with normal saline three times to remove the preservative isopropyl alcohol. After that collagen dressing applied over the raw area. Paraffin with chlorhexidine impregnated gauze dressing applied over the collagen. First dressing was changed at post operative day five.Results: All burn wounds healed well between 10-14 days without any complications. In follow up no hypertrophy of skin and almost same skin color had noted.Conclusions: We conclude that collagen dressing is a paradigm shift in the management of scald burn. It is cost effective, pain less, requires less frequent change of dressing with good match of skin color.