Healing Of Extraction Wounds Research Articles

Differential effects of clopidogrel and/or aspirin on the healing of tooth extraction wound bone tissue.

A multitude of variables influence the healing of tooth extraction wounds, and delayed or non-healing extraction wounds might complicate later prosthodontic therapy. In this research, we analyzed the effects of systemic clopidogrel and aspirin alone or in combination on the healing of tooth extraction wounds in mice in order to provide experimental evidence for the healing of extraction wounds in patients who are clinically treated with the two medicines. 7-week-old ICR mice were randomly divided into four groups: control group (CON), clopidogrel group (CLOP), aspirin group (ASP), and clopidogrel combined with aspirin group (CLOP + ASP); left upper first molar was extracted, after which mice in 1week of adaptive feeding, CLOP/ASP/CLOP + ASP groups were respectively administered with clopidogrel (10mg/kg/d), aspirin (15mg/kg/d), clopidogrel (10mg/kg/d)+aspirin (15mg/kg/d), and the control group was given an equal amount of 0.9% saline by gavage. Mice in each group were euthanized at 14 and 28days postoperatively, and the maxilla was extracted. The tissues in the extraction sockets were examined using MicroCT and sectioned for HE staining, Masson staining, and TRAP staining, and immunohistochemistry staining (for TRAP, RANKL and osteoprotegerin). MicroCT analysis showed that at day 14, BS/BV was significantly lower in CLOP and CLOP + ASP groups compared to control and ASP groups, while BV/TV, Tb.Th was significantly higher. At day 28, BV/TV was significantly higher in the CLOP + ASP group compared to the CLOP group, with p < 0.05 for all results. HE staining and Masson trichrome staining findings revealed that at day 28, the mesenchyme in the bone was further decreased compared to that at day 14, accompanied with tightly arranged and interconnected bone trabeculae. In the quantitative analysis of Masson, the fraction of newly formed collagen was significantly higher in the CLOP group in comparison with that in the CON group (p < 0.05). At day 14, the ASP group had substantially more TRAP-positive cells than the CLOP and CLOP + ASP groups (p < 0.05). In immunohistochemical staining, RANKL expression was found to be significantly higher in the ASP group than those in the other three groups at day 28 (p < 0.05); OPG expression was significantly higher in the CLOP group and the CLOP + ASP group compared with that at day 14, and was higher than that in the ASP group at day 14 and day 28. OPG/RANKL was significantly higher in the CLOP and the CLOP + ASP groups than in the ASP group (p < 0.05). Clopidogrel alone promotes osteogenesis in the extraction wound, whereas aspirin alone inhibits alveolar bone healing. When the two drugs were combined, the healing effect of the extraction wound was more similar to that of the clopidogrel alone group. These results indicated that clopidogrel could promote the healing of the tooth extraction wound, and neutralize the adverse effect of ASP on osteogenesis when the two drugs were used in combination.

A multifunctional thermosensitive hydrogel based on phototherapy for promoting the healing of dental extraction wounds.

Post-extraction wound infections are a common complication of dental extractions. More specifically, infection in the alveolar socket after tooth extraction accelerates the resorption and destruction of the alveolar bone, and ultimately affects the final restoration results. Currently, the main clinical treatment approaches applied to the socket after tooth extraction include mechanical wound debridement, chemical rinses (e.g., chlorhexidine), filling of the extraction socket with absorbent gelatin sponges, and the systemic application of antibiotics. However, these traditional treatment modalities have some limitations and their therapeutic effects are unsatisfactory. In this study, a phototherapeutic temperature-sensitive hydrogel material was constructed for injection using a tea polyphenol (TP)-modified poly-N-isopropylacrylamide (PNIPAM) hydrogel skeleton loaded with the photosensitiser indocyanine green (ICG). The resulting PNIPAM-TP/ICG system exhibited an excellent injectability and temperature-sensitive properties. In addition, it stopped haemorrhaging and acted as a wound astringent. The hydrogel steadily released ICG into the oral environment to exert photothermal/photodynamic effects along with synergistic antibacterial and anti-inflammatory properties when combined with tea polyphenols. In vivo experiments demonstrated that the application of PNIPAM-TP/ICG to infected dental extraction wounds in rats rapidly stopped the bleeding and accelerated wound healing. Overall, this study describes a drug-loaded, temperature-sensitive hydrogel for the treatment of open wound infections, and shows promise as a reference for the treatment of tooth extraction wounds.

Effects of platelet‐rich fibrin on post‐extraction wound healing and wound pain: A meta‐analysis

AbstractWe conducted a meta‐analysis to assess the effect of platelet‐rich fibrin (PRF) on post‐extraction wound healing and pain, with a view to providing a reliable basis for the selection of treatment options in clinical practice. A computerised search of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for studies on the effect of PRF on post‐extraction wound healing and pain compared with natural healing (control group) was performed from the time of creation of the respective databases to July 2023. Literature screening, data extraction and quality assessment were done independently by two authors. Meta‐analysis was performed using RevMan 5.4 software. Fourteen studies with a total of 508 patients were finally included. Meta‐analysis showed that the use of PRF relieved patients' wound pain (standardised mean differences [SMDs]: −1.78, 95% confidence intervals [CIs]: −2.61 to −0.94, p &lt; 0.001), promoted soft tissue healing of extraction wounds (SMD: 1.09, 95% CIs: 0.26–1.91, p = 0.010) and also reduced the incidence of alveolar osteitis (AO) in patients after tooth extraction (2.42% vs. 10.14%, odds ratio: 0.27, 95% CIs: 0.11–0.65, p = 0.004). Current clinical evidence suggests that the use of PRFs can reduce patients' postoperative wound pain, promote soft tissue healing of extraction wounds and reduce the incidence of postoperative AO compared with natural healing. However, due to limitations in the number and quality of studies, large‐scale randomised controlled trials are still needed to validate the results of this study in the future.

Effectiveness of Snakehead Fish Extract on Tooth Extraction Wound Healing

Tooth extraction can cause open wound in the oral cavity, if not handled properly it can cause complications such as bleeding, infection and delayed wound healing. Wound healing is a biological process associated with tissue growth and regeneration. The wound healing process can be accelerated by administering chemicals that can affect the inflammatory, proliferative and remodeling phases. One of them is by giving snakehead fish extract. The extract contains albumin, copper and zinc which play an important role in the wound healing phase. The purpose of writing this review article is to explain the mechanism of snakehead fish extract in accelerating the healing of tooth extraction wounds. Several studies have revealed that snakehead fish extract affects pro-inflammatory cytokines in helping the wound healing process and significantly helps increase the number of fibroblast cells in tooth socket wounds, so that the healing process can take place more quickly. Based on this, it can be concluded that snakehead fish extract has the potential to accelerate the healing of tooth extraction wounds.

Inflammation Can Be a High-Risk Factor for Mucosal Nonunion of MRONJ by Regulating SIRT1 Signaling When Treated with an Oncologic Dose of Zoledronate.

Zoledronate (ZA) stands as a highly effective antiresorptive agent known to trigger medication-related osteonecrosis of the jaw (MRONJ). Its clinical dosages primarily encompass those used for oncologic and osteoporosis treatments. While inflammation is recognized as a potential disruptor of mucosal healing processes associated with ZA, prior research has overlooked the influence of varying ZA dosages on tissue adaptability. Therefore, a deeper understanding of the specific mechanisms by which inflammation exacerbates ZA-induced MRONJ, particularly when inflammation acts as a risk factor, remains crucial. Cell proliferation and migration of human oral keratinocytes (HOK) was analyzed after treatment with different doses of ZA and/or lipopolysaccharide (LPS) to assess their possible effect on mucosal healing of extraction wounds. Mouse periodontitis models were established using LPS, and histological changes in extraction wounds were observed after the administration of oncologic dose ZA. Hematoxylin and eosin (HE) staining and immunofluorescence were used to evaluate mucosal healing. In vitro, LPS did not exacerbate the effects of osteoporosis therapeutic dose of ZA on the proliferation and migration of HOK cells, while aggravated these with the oncologic dose of ZA treatment by inducing mitochondrial dysfunction and oxidative stress via regulating SIRT1 expression. Furthermore, SIRT1 overexpression can alleviate this process. In vivo, local injection of LPS increased the nonunion of mucous membranes in MRONJ and decreased the expression of SIRT1, PGC-1α, and MnSOD. Inflammation aggravates oncologic dose of ZA-induced mitochondrial dysfunction and oxidative stress via a SIRT1-dependent pathway, enhancing the risk of impaired mucosal healing in MRONJ. Our study implies that inflammation becomes a critical risk factor for MRONJ development at higher ZA concentrations. Elucidating the mechanisms of inflammation as a risk factor for mucosal non-healing in MRONJ could inform the development of SIRT1-targeted therapies.

To evaluate the effects of Low-level laser therapy (LLLT) on wound healing of extraction socket: A systematic review

Background: Low power laser therapy or low-level laser therapy (LLLT) is relatively novel and has demonstrated tremendous advantages in dentistry which includes reduction in post-surgical pain as well as swelling and also accelerates wound healing and helps in bone regeneration etc. Objective: This systematic review aimed to find out whether low-level laser therapy promotes tooth extraction wound healing. Materials and Methods: Literature was searched from January 2010 till 31 December 2020 using PubMed, Scopus, and Web of science. Further findings were done from gray literature google scholar, and Research Gate using Low-level laser therapy, photobiomodulation, wound healing, extraction socket healing, cold laser, biostimulation, low-level laser irradiation, and phototherapy. Any article that reported effects of low-level laser therapy on wound healing was included. 19 studies fulfilled the criteria and were included for this systematic review. Quality assessment was done for each article using Joanna Briggs Institute (JBI) checklist for analytical cross-sectional studies. Results and Discussion: Throughout the search, approximately 22,808 relevant articles were found. Out of which 50 articles fulfilled the selection criteria. 31 articles were excluded because that did not fulfill inclusion criteria. 19 articles were included for this systematic review that compared the effects of low level-laser therapy on wound healing after extraction of a tooth. Conclusion: Overall, this systematic review concluded that low-level laser therapy enhanced the process of wound healing after extraction of teeth but most of the research was conducted on animals. Further research is needed to investigate the biostimulatory effects of low-level irradiation on wound healing after extraction of a tooth Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 585-597

The effect of Mahogany seeds extract (Swietenia mahagoni) on the quantity of macrophages in the Post-tooth extraction wound healing phase of Wistar Rats (Rattus norvegicus)

Tooth extraction often cause tissue damage and wound. After tooth extraction, the wound healing process becomes a major concern because of many complications and makes patients feel the pain suffered. Lande et al. (2015) showed the prevalence of tooth extraction complications, including crown fracture (31.82%), root fracture (13.6%), dry socket (4%), swelling (2.27%), and bleeding (1.6%). Macrophages are a common inflammatory cell in wounds, and the local macrophage population shifts from pro-inflammatory (M1-like phenotypes) to anti-inflammatory (M2-like phenotypes), indicating to the start of the next healing phase. Various alternative materials can help the healing process of wounds, one of which is mahogany seeds. Flavonoids found in Mahagony seeds can influence cell function by boosting the synthesis of PDGF, VEGF, pro-inflammatory cytokines, activating monocytes, and raising the number of macrophages involved in the wound healing. Proving mahogany seed extract (Swietenia mahagoni) affects the number of macrophages in the wound healing process after extracting Wistar rat (Rattus norvegicus) teeth. 20 Wistar rats were divided into four groups there were one control group (K) performed tooth extraction without any treatment, and three treatment groups (P1, P2, P3) performed tooth extraction and topically induced with three different doses of mahogany seeds extract (50 mg/200g rbw, 100mg/200g rbw, 200mg/200g rbw) in the post-extraction socket. Wistar rats were sacrificed on the 3rd day. Observations were made by reading histologic preparations using Hematoksilin Eosin (HE) 400x light microscope magnification. The quantity of macrophages in each group differed significantly between 4 groups (p = 0.003), namely between K1 and P1 (p = 0.008), P1 and P3 (p = 0.001), P2 and P3 (p = 0.006). Mahogany seeds extract affects the wound healing process, with 50mg/200g rbw as the optimal dose

Efektivitas Gel Ekstrak Etanol 70% Daun Anggrek Oncidium (Oncidium Aliceara alice) terhadap Penyembuhan Luka Kulit Dorsum Tikus Sprague Dawley

Wounds are tissue damage that is generally caused by physical contact. Wound healing is a complex mechanism involving biochemical and biocellular processes. Various therapies can be done to speed up the wound healing process, one of which is treatment using natural ingredients. One of the plants that have the potential to heal wounds is Oncidium Aliceara alice. The purpose of this study was to determine the phytochemical content of Oncidium Aliceara alice and its activity in wound healing when it is formulated in a gel form. This research is experimental research with extraction stages, phytochemical assay, gel formulations, quality test, and wound healing activity tests in animals. The gel formulation was made with various concentrations of Oncidium Aliceara alice extract 2.5%, 5% and 10%. Male Sprague Dawley rats were given an incision wound on the dorsum of the longitudinal axis along 3 cm. Wound care by administering topical Bioplacenton as a positive control, base gel as a negative control, and gel extract concentration variants according to each treatment group. Based on the research, the results of qualitative phytochemical tests showed that the 70% ethanol extract of Oncidium Aliceara alice contains flavonoids (catechins), tannins, steroids, and saponins. The best results were seen on the 7th day of observation for the 10% gel extract treatment group with more perfect signs of wound closure than the bioplacenton treatment.

Extraction Optimization, Antioxidant, Cosmeceutical and Wound Healing Potential of Echinacea purpurea Glycerolic Extracts.

Echinacea purpurea is a plant with immunomodulating properties, often used in topical preparations for treatment of small superficial wounds. In the presented study, the best conditions for ultrasound-assisted extraction of caffeic acid derivatives (caftaric and cichoric acid) (TPA-opt extract), as well as the conditions best suited for preparation of the extract with high radical scavenging activity (RSA-opt extract), from E. purpurea aerial parts were determined. A Box-Behnken design based on glycerol content (%, w/w), temperature (°C), ultrasonication power (W) and time (min) as independent variables was performed. Antioxidant, antiaging and wound healing effects of the two prepared extracts were evaluated. The results demonstrate that glycerol extraction is a fast and efficient method for preparation of the extracts with excellent radical scavenging, Fe2+ chelating and antioxidant abilities. Furthermore, the extracts demonstrated notable collagenase, elastase and tyrosinase inhibitory activity, indicating their antiaging properties. Well-pronounced hyaluronidase-inhibitory activities, with IC50 values lower than 30 μL extract/mL, as well as the ability to promote scratch closure in HaCaT keratinocyte monolayers, even in concentrations as low as 2.5 μL extract/mL (for RSA-opt), demonstrate promising wound healing effects of E. purpurea. The fact that the investigated extracts were prepared using glycerol, a non-toxic and environmentally friendly solvent, widely used in cosmetics, makes them suitable for direct use in specialized cosmeceutical formulations.

The evaluation of the effects of natural zeolite (Clinoptilolite) in diabetic rats on bone healing in dental extracting socket.

The fact that clinoptilolite reserves are abundant and economical in the world, its toxic effects are not observed in clinical studies in humans and animals, and it has superior physical properties suggests that clinoptilolite may be an easily accessible product for the healing of tooth extraction wounds. The aim of the study was to evaluate the effects of cliniotilolite on bone tissue healing and bone formation in the extraction socket in experimentally diabetic rats by micro-CT analysis. 36 male Wistar Albino rats were divided into 3 main groups as Healthy Control, Diabetes Control and Diabetes+Clinoptilolite. Afterwards, these groups were divided into 2 subgroups to be sacrificed on the 14th and 28th days, and each subgroup had 6 rats (n=6). At the 14th and 28th days, the rats were sacrificed and the effects of clinoptilolite on bone tissue healing and bone formation in the alveolar socket were evaluated by micro-CT analysis. According to the statistical analysis results, the difference between the groups in terms of bone volume, bone surface to bone volume, trabecular thickness and hounsfield units values, which are the parameters of the 14th day groups, was statistically significant (p<0.05). Among the parameters of the 28th day groups, only the hounsfield units value was statistically significant (p<0.05). The results of the study show that clinoptilolite can contribute to the healing of extraction wounds and bone formation.

Fluorescent risedronate analogue 800CW-pRIS improves tooth extraction-associated abnormal wound healing in zoledronate-treated mice

BackgroundBisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare but serious side effect of nitrogen-containing bisphosphonate drugs (N-BPs) frequently prescribed to reduce skeletal-related events in bone malignancies and osteoporosis. BRONJ is associated with abnormal oral wound healing after dentoalveolar surgery and tooth extraction. We previously found that N-BP chemisorbed to bone mineral hydroxyapatite was dissociated by secondary applied N-BP. This study investigated the effect of the surface equilibrium-based removal of N-BP from jawbone on tooth extraction wound healing of zoledronate (ZOL)-treated mice.MethodsA pharmacologically inactive N-BP derivative (the 4-pyridyl isomer of risedronate equipped with a near-infrared 800CW fluorescent imaging dye, 800CW-pRIS) was designed and synthesized. 800CW-pRIS was intra-orally injected or topically applied in a deformable nano-scale vesicle formulation (DNV) to the palatal tissue of mice pretreated with ZOL, a potent N-BP. The female C56BL6/J mice were subjected to maxillary molar extraction and oral wound healing was compared for 800CW-pRIS/ZOL, ZOL and untreated control groups.Results800CW-pRIS is confirmed to be inactive in inhibiting prenylation in cultured osteoclasts while retaining high affinity for hydroxyapatite. ZOL-injected mice exhibit delayed tooth extraction wound healing with osteonecrosis relative to the untreated controls. 800CW-pRIS applied topically to the jaw one week before tooth extraction significantly reduces gingival oral barrier inflammation, improves extraction socket bone regeneration, and prevents development of osteonecrosis in ZOL-injected mice.ConclusionsTopical pre-treatment with 800CW-RIS in DNV is a promising approach to prevent the complication of abnormal oral wound healing associated with BRONJ while retaining the anti-resorptive benefit of legacy N-BP in appendicular or vertebrate bones.

Efficacy of hyaluronic acid gel and spray in healing of extraction wound: a randomized controlled study.

To evaluate the efficacy of 0.2% hyaluronic acid gel and 0.01% hyaluronic acid (HA) spray in the healing of extraction wounds using the ruler and digital planimetry method. 30 systemically healthy female participants aged between 20-60 years requiring extraction were selected. Extraction sockets receiving 0.2% HA gel Gengigel®, 0.01% HA spray Gengigel®, and where hyaluronic acid was excluded were allocated into three groups as test group A (HA gel group), test group B (HA spray group) and control group (without HA). Socket wound closure was measured post-operative on the day of extraction and 1-week post extraction using digital planimetry and ruler method. Patient satisfaction rate was evaluated for both the gel and spray. The wound closure with the ruler method was 43.01% for the control group, 67.01%, and 65.82% for the gel group and spray group respectively. The wound closure with the digital planimetry method was 47.97% for the control group, 69.08% for the gel group, and 66.94% for the spray group. The gel showed better results of wound closure as compared to the spray. However, the results were not statistically significant. Hyaluronic acid offers a beneficial effect in early post-operative healing after extraction.

Taking 200 mg Vitamin C Three Times per Day Improved Extraction Socket Wound Healing Parameters: A Randomized Clinical Trial.

Vitamin C is essential for wound healing. However, there are no reports concerning the effect of a different dose of vitamin C on extraction wound size clinically. Therefore, the aim of this study was to investigate the effect of different oral vitamin C doses on extraction wound healing. A split-mouth, double-blind randomized clinical trial was performed in 42 patients who underwent symmetric bilateral noninfected premolar extraction. The patients were randomly divided into 3 groups, namely, P/600, P/1,500, and 600/1,500 (14 patients for each group); P/600: placebo vs. 600 mg vitamin C/d, P/1,500: placebo vs. 1,500 mg vitamin C/d, and 600/1,500: 600 mg vitamin C/d vs. 1,500 mg vitamin C/d. Patients were prescribed placebo or/and vitamin C three times a day for 10 days after each tooth extraction. Extraction wound size and pain score were evaluated. The wound assessment was performed on day 0, 7, and 21; and then the tooth on the other side was extracted using the same protocol. Pain score was recorded on the first three days after extraction. The reduced size of mesiodistal extraction wound in percentage reduction between day 0 and 7 of teeth receiving vitamin C 600 mg/d was more than that in placebo (P < 0.05). Pain scores on day 1–3 of teeth receiving vitamin C 600 mg/d were significantly lower than the placebo side (P < 0.05). Taking oral vitamin C 600 mg/d over three doses for 10 days after tooth extraction enhances extraction wound healing by reducing mesiodistal extraction wound and reduces postoperative pain.

Effect of Resorbable Collagen Plug (RCP) on Extraction Wound Healing

Abstract: Ideal tooth extraction is removal of complete tooth structure from the alveolar bone with minimal trauma and without causing any pain. It leaves a wound in the form of an open tooth socket. Efforts to reduce the problem of wound healing can be done inter alia by forming new tissue engineering that replaces the damaged tissue with collagen which is easily absorbed biologically and has good biocompatibility. One of the wound covering materials containing collagen is resorbable collagen plug (RCP). It serves to accelerate wound healing, control bleeding due to its intrinsic hemostatic property, and accelerate the wound healing process. This was a literature review study using databases namely PubMed, Embase, Wiley Online Library, and National Center for Biotechnology. The keywords were tooth extraction, wound healing, collagen, and resorbable collagen plug. The results showed that the RCP could accelerate wound healing because it contained collagen which had the ability to stabilize blood clotting and to protect wounds. In conclusion, the use of resorbable collagen plug can accelerate wound healing after tooth extraction due to its collagen content.Keywords: dental extraction; wound healing process; resorbable collagen plug (RCP) Abstrak: Pencabutan gigi ideal adalah pengangkatan struktur gigi secara utuh dari tulang alveolar tanpa menimbulkan rasa sakit dengan trauma minimal. Tindakan pencabutan meninggalkan luka berupa soket gigi terbuka. Tujuan penyembuhan luka yaitu memperbaiki kerusakan jaringan dan fungsi organ. Upaya untuk mengurangi masalah penyembuhan luka dapat dilakukan, salah satunya dengan membentuk rekayasa jaringan baru yang menggantikan jaringan rusak yaitu dengan kolagen. Kolagen merupakan protein yang memiliki sifat mudah diserap secara biologis serta memiliki biokompatibilitas yang baik. Salah satu bahan penutup luka yang mengandung kolagen ialah resorbable collagen plug (RCP) yang berfungsi membantu mempercepat penyembuhan luka, mengontrol pendarahan oleh karena sifat hemostatik instrinsik, dan mempercepat proses penyembuhan luka. Penelitian ini merupakan suatu literatur review menggunakan database dari PubMed, Embase, Wiley Online Library, dan National Center for Biotechnology dengan kata kunci yang meliputi pencabutan gigi, penyembuhan luka, kolagen, Resorbable Collagen Plug. Hasil penelitian menunjukkan bahwa RCP dapat membantu mempercepat penyembuhan luka karena mengandung kolagen yang memiliki kemampuan untuk menstabilkan pembekuan darah dan dapat melindungi luka. Simpulan penelitian ini ialah penggunaan resorbable collagen plug dapat membantu mempercepat penyembuhan luka setelah pencabutan gigi oleh karena adanya kandungan kolagen.Kata kunci: pencabutan gigi; penyembuhan luka; resorbable collagen plug (RCP)

Topical Medicine Potency of Musa paradisiaca var. sapientum (L.) kuntze as Oral Gel for Wound Healing: An In Vitro, In Vivo Study.

Topical application of ambonese banana (Musa paradisiaca var. sapientum (L.) kuntze) stem sap gel (GEGPA) on the socket wound area showed an increase in the expression of platelet-derived growth factor-BB, while decrease in the expression of matrix metalloproteinase-2 and 9. The aim of this study is to achieve standard formulation of GEGPA through stability, viscosity, distribution area, and drugs release for oral gel wound healing. This is an in vitro and in vivo study with the randomized posttest only control group design. The gel was formulated according to the composition of each group by adding hydroxypropyl methylcellulose (HPMC), Lexgard, propylene glycol, and cold water to obtain 100 g of gel. Observations were made through the following tests: stability, viscosity, distribution area, drug release, and histopathological analysis of tooth extraction wound healing. Data were analyzed using a one-way analysis of variance (α = 0.05) with GraphPad Prism-8 statistical software. The study showed that the GEGPA formulation was stable against changes in consistency, color, smell, homogeneity, and pH value. There is a significant difference between groups with respect to viscosity (p = 0.0001), adhesion (p = 0.004), dispersion (p = 0.000), and fibroblast cell numbers on days 3 and 5 (p = 0.007 and p = 0.001). There is no interaction between the active ingredients and the gel base of all formulations. Formulation 3 had better properties in terms of viscosity, broad distribution, and drug release compared with other groups. Application of GEGPA to tooth extraction wounds showed a significant proliferation of fibroblast cells on days 3 and 5. The formulation of M. paradisiaca var. sapientum (L.) kuntze extract with HPMC and propylene glycol obtained a gel preparation, GEGPA, that was organoleptically stable and met the topical gel standard for wounds in the oral cavity.

Curcumin nanoliposomes mitigate wound tissue inflammatory response caused by tooth extraction

Curcumin is a plant-derived compound with polypharmacological properties that are hampered by its poor solubility, fast degradation, etc. Wound closure complications that follow tooth extraction are numerous, and relatively frequently additional treatment is needed to prevent unwanted process chronification. The present study aims to compare the effects of free and the nanoliposome-encapsulated curcumin on tooth extraction wound closure. The experiments were performed on Wistar rats where both forms of curcumin were applied topically on a tooth extraction wound for seven days. Changes in tissue oxidative stress (malondialdehyde and oxidized proteins concentrations, and catalase activity) and inflammation (nitric oxide levels and myeloperoxidase activity) related parameters were studied three and seven days following the tooth extraction. Also, the extent of pathohistological changes and osteopontin immunohistochemical expression were studied. The obtained results indicate that both forms of curcumin prevent an increase in oxidative stress and inflammation-related parameters in the studied samples at 3-and 7-day time points. Additionally, we found that curcumin diminished tissue inflammatory response and osteopontin expression, while at the same time it caused faster granulation tissue maturation. The encapsulation of curcumin in nanoliposomes proved to be better in improving the extraction wound healing process than the free curcumin, giving this formulation a potential in the pharmaceutical industry.

An in-vivo study of photobiomodulation using 403\xa0nm and 649\xa0nm diode lasers for molar tooth extraction wound healing in wistar rats

PurposeThis study aims to examine the effects of red 649 nm 4 J/cm2 and blue 403 nm 8 J/cm2 diode laser treatment for post-extraction wounded healing in rats through histopathological and immunohistochemical analysis.MethodsSamples of 54 Wistar rats were divided into six groups: C- control group without treatment; C + wounded group without treatment; TB wound group with Povidone-iodine treatment; TD wounded group with doxycycline treatment; TLB wounded group with 403 nm diode laser treatment; and TLR wounded group with 649 nm diode laser treatment. Mandibular samples were observed for the number of lymphocytes and fibroblasts cells, new blood vessels formation, Interleukin 1β, and Collagen 1α expression level.ResultsBased on the histopathological test results, red laser diode treatment significantly increased the number of lymphocyte, fibroblast cells and the formation of new blood vessels. Meanwhile, immunohistochemical tests showed an increase in the expression of the Colagen-1α protein which plays a role in the formation of collagen for new tissues formation after damage, as well as a decrease in Interleukin-1β expression level. Blue laser is also able to show a positive effect on wound healing even though its penetration level into the tissue is lower compared to red laser.ConclusionThe red diode laser 649 nm has been shown to accelerate the process of proliferation in wound healing post molar extraction based on histopathological and immunohistochemical test results.

Salivary VEGF and post-extraction wound healing in type 2 diabetic immediate denture wearers

Objective Oral wound healing in healthy could be promoted by VEGF in saliva, and immediate denture wearing, but data in type 2 diabetes are lacking. Aims were to investigate the timeline of extraction wound healing in diabetic participants wearing immediate dentures and its correlation to salivary VEGF, as well as to examine the impact of the palatal plate on tissue VEGF during palatal wound healing in rat diabetic model. Material and methods Healthy (42) and type 2 diabetic (36) denture wearers, candidates for teeth extractions were included. Extraction wound healing was followed via measurements of socket closure, gingival hyperaemia, pain and presence of necrosis on 3rd, 7th, 14th and on 21st-day post-extraction. Salivary VEGF was measured before and on the 3rd and 21st day after the extraction. In streptozotocin-induced diabetic (30) as well as non-diabetic rats (30), tissue VEGF was measured in palatal wounds healing under or without a palatal plate. Results Type 2 diabetic prosthetic patients exhibit delayed socket closure, with pronounced hyperaemia, pain and necrosis. Salivary VEGF is increased in diabetes and positively correlates to socket closure while negatively with pain on 21st day after the extraction. Palatal incision induced VEGF increase in non-diabetic and diabetic, but less pronounced in diabetic rats. Wound healing under the palatal plate exhibit higher tissue VEGF. Conclusion Type 2 diabetes-induced increase in salivary VEGF may mitigate diabetes-induced detrimental effects on extraction wound healing. Lack of adequate tissue VEGF response to injury may underly dysregulation of diabetic oral wound healing.

Effectiveness of Honey and Aloe Vera on the Post Extraction Healing Among Young Adults: A Randomized Clinical Trial

INTRODUCTION: "Dry socket" was first described by Crawford in literature in 1896. When people are recognizing that current medicine is not the soul cure for diseases, we look back to the past for potential remedies with the least possible side-effectiveness. So the objective of this study was to evaluate the effectiveness of honey and aloevera on healing of post extraction wounds. MATERIAL AND METHODS: Honey and aloe-vera were prepared by mixing with sterilized cotton. The socket involved was separated by dry autoclaved cotton rolls from the rest of the oral cavity, then honey/aloe-vera was inserted into the respective groups. All patients were advised to avoid solid and liquid diets for 30 minutes after the treatment. Dressings were changed on 3rd day and on 7th day and sockets were evaluated. RESULTS: When the intra-group comparison of honey (p-value=0.003) and aloe-vera (p-value=0.000) was done, both were found to be statistically significant in the healing of dry socket. When the inter-group comparison was done between honey and aloe-vera, Aloe-vera had high healing capacity and was found to be highly statistically significant (p-value=0.001). DISCUSSION: When the intra-group comparison of honey and aloe-vera was done, both were found to be statistically significant in the reduction of dry socket. When the inter-group comparison was done between honey and aloe-vera, Aloe-vera had high healing capacity and was found to be highly statistically significant (p-value=0.00). CONCLUSION: From the analysis, it can be inferred that aloe vera and honey are healthy, natural and user-friendly substitute adjuncts that might be feasible to promote healing of extraction sockets.

Comparative evaluation of the synbiotics, antibiotics and analgesics in post extraction healing of tooth sockets- A randomized control trial

The emergence of antibiotic resistance and its side effects have restricted their use in array of prophylactic options in present scenario. Indeed, some new strategies and alternative therapies like herbal medicines and laser therapies have already minimised the use of antibiotic prevent/cure health related issues or oral diseases. Nowadays many authors are trying to prove influence of synbiotics in oral health maintenance so this study was done to check the usage of synbiotics and its benefits in the post extraction tooth socket. The aim of this research is to study the effect of synbiotics supplements on post-surgical complications and oral wound healing after extraction of tooth. To determine the clinical effectiveness and cost-effectiveness of synbiotics over antibiotics and analgesics in post extraction of tooth socket. This study is a randomized controlled trial, parallel group, multicentre trial comparing the efficacy of synbiotics in healing of post extraction sockets that was conducted in three centres of Lucknow city-India including BBD dental college of dental sciences. Three groups were made with 80 patients in each group. The primary outcome measures were observed in each group on 3rd day, 5th day and 7th day. We could find significant difference between the 3 groups regarding the evaluated parameters. In age and gender distribution was observed. Wound related complications like bleeding, swelling and gut flora disturbance at the surgical site was present more in group 2 and group 3 as compared to group 1 which is found statistically significant with p value 0.02, 0.01 and 0.01. In the cost analysis during the treatment among the study subjects was noted where statistical significant results were obtained between groups 1 vs group 2; group 1 vs group 3 and group 2 vs group 3 at p ≤ 0.01. Since this was a novel approach in comparing the post extraction wound healing and as the results showed a definite positive effect by synbiotics. Further studies with a larger sample and different formulation would be recommended to be put into clinical use.