Palatal Wound Healing Research Articles

Effect of Hyaluronic Acid Mucoadhesives on Palatal Wound Healing and Postoperative Discomfort in Free Gingival Graft Surgery: A Clinical Trial

Objectives: This study aimed to assess the effect of hyaluronic acid (HA) mucoadhesives with two different concentrations on palatal epithelial wound healing and postoperative discomfort following free gingival graft (FGG) surgery. Materials and Methods: In this triple-blind, randomized, controlled clinical trial, 39 patients undergoing FGG surgery were randomly allocated to three groups (N=13). Following palatal graft harvesting, the two experimental groups received mucoadhesives containing 0.8% and 0.2% HA, while the control group received mucoadhesives without HA. In all groups, the donor site was protected with periodontal dressing. Epithelization, color match, contour, and distortion were assessed at 3, 7, 14, 21, and 42 days, postoperatively using the Landry's healing index and modified Manchester Scar Proforma (mMSP) index. Pain level and response to thermal stimuli were evaluated after 3, 7, 14, and 21 days using a visual analog scale (VAS). Data were analyzed by the Chi-square, Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon signed-rank tests (alpha=0.05). Results: Significant differences were observed in the mMSP index scores among the groups at 3, 7, 14, and 42 days, favoring HA groups (P<0.05). The Landry's healing index score was significantly higher in 0.8% HA group on day 21 (P=0.023), compared to the control group. No significant differences were found in pain score or thermal stimulus responses among the groups (P>0.05). Conclusion: Mucoadhesives containing HA were found to enhance palatal wound healing, leading to improved outcomes in terms of epithelization, color match, contour, and distortion reduction.

Comparison of the effect of A-PRF and L-PRF application to palatal donor sites on quality of life and wound healing after free gingival graft surgery.

This study compared the effects of leukocyte platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) on patients' quality of life and the healing of palatal wounds after free gingival graft harvesting. After free gingival graft harvesting, palatal donor sites of 36 patients were assigned to one of three groups: L-PRF group, A-PRF group, or palatal stent + periodontal pack group (control group). Wound healing was evaluated by H2O2 test. Pain was evaluated by visual analog scale and number of analgesics consumed. For patient quality of life, the Oral Health Impact Profile-14 (OHIP-14) questionnaire was utilized. Complete epithelialization was higher in the control group on day 7 than in the test groups (P < .05). Complete epithelialization was achieved in all groups 14 days postoperatively. Visual analog scale scores for pain and the number of analgesic tablets consumed were similar in all groups (P > .05). OHIP-14 total scores were similar in all study groups at 7 days postoperatively (P > .05). OHIP-14 total and physical pain score was lower in the L-PRF group than the A-PRF group at 14 days postoperatively (P < .05). Aside from the slight superiority of L-PRF over A-PRF, it can be concluded that both PRF procedures have similar effects on palatal wound healing and quality of life.

Palatal Graft Harvesting Site Healing and Pain Management: What Is the Best Choice? An Umbrella Review

The use of free gingival graft (FGG) and connective tissue graft (CTG) from the palate are among the most predictable periodontal and peri-implant plastic surgery procedures. However, palatal harvesting causes severe discomfort in the palatal area in patients undergoing harvesting. The aim of this umbrella review is to evaluate which products or techniques can result in fewer side effects and less morbidity in patients. Systematic reviews, with meta-analysis or not, about postoperative pain and wound healing in patients undergoing surgery to remove a free gingival graft or connective tissue graft from the palatal region, published only in the English language, were electronically searched for on BioMed Central, Scopus, MEDLINE/PubMed, the Cochrane library databases, and PROSPERO register. Of 1153 titles, only 7 articles were included in this review. The reviews included suggest that the more effective interventions for patient-reported outcomes, particularly for pain management, are cyanoacrylate adhesives, platelet-rich fibrin, hyaluronic acid, and the use of palatal stents. Low-level laser therapy also demonstrated good results in palatal wound healing speed after FGG procedures. Also, topical agents were also described. Future studies and more high-quality randomized clinical trials are needed to provide clear descriptions and standardized procedures of interventions to obtain clear results.

Donor site wound healing following free gingival graft surgery using platelet rich fibrin: A randomized controlled trial.

The primary purpose of this two-arm, parallel design, randomized controlled study is to compare healing of the palatal tissue donor site when platelet-rich fibrin (PRF) is used as a wound dressing compared to the use of a hemostatic agent. Secondary outcomes of patient pain perception and analgesic intake were also evaluated. Seventy-four patients receiving free gingival grafts were randomized to receive either PRF (test) or hemostatic agent (control) as a palatal wound dressing by patients selecting a sealed envelope containing their group assignment (initially 37 envelopes for PRF group and 37 for hemostatic agent group). Patient pain assessment and analgesic consumption were documented using a 21-point numerical scale (NMRS-21) at 24, 48, and 72hours post-surgery. At 1-, 2-, 3-, and 4-week follow-up appointments palatal early healing index (PEHI) scores including wound color, epithelialization, presence or absence of swelling, granulation tissue, and bleeding on gentle palpation were generated by direct intraoral examination by a blinded examiner unaware of the patients' treatment group. NMRS-21 pain scores showed a significant reduction in pain over time in both groups, with no significant difference between groups at any time point. No significant between-group difference was found in the amount of analgesics taken by patients at 24, 48, and 72hours. There was significant improvement in PEHI scores over the 4-week time period in both groups, but there was no significant difference in PEHI score at each time point (1, 2, 3, 4weeks) between groups. CONCLUSIONS: Study findings suggest that there is no difference in early palatal wound healing, patient pain perception, or analgesic consumption between use of PRF or a hemostatic agent as donor-site wound dressings.

Performance of multiple therapeutic approaches for palatal wound healing after soft tissue graft removal - an overview of systematic reviews.

To overview the literature to answer the following question: "What is the performance of different therapies on wound healing and postoperative discomfort after palatal ASTG removal?" SRs that evaluated the wound healing (WH), postoperative pain, bleeding, and analgesic consumption of patients submitted to de-epithelialized/free gingival grafts (FGG) or subepithelial connective tissue grafts (SCTG) removed from the palate were included. The searches were conducted on six white and two gray databases up to December 2023. Methodological quality was evaluated through AMSTAR 2. The synthesis of results was described as a narrative analysis. Ten SRs (involving 25 randomized clinical trials) related to low-level laser therapy (LLLT) (3), platelet-rich fibrin (PRF) (4), cyanoacrylate tissue adhesives (CTA) (2), and ozone therapy (OT) (1) were included in this overview. All techniques demonstrated improvements in WH. LLT, PRF, and CTA reduced pain and analgesic consumption. PRF and CTA reduced bleeding. Regarding methodological quality, the SRs were classified as critically low (2), low (5), moderate (2), or high quality (1). In SRs related to LLLT, PRF, CTA, and OT, the use of different therapies after palatal ASTG removal improved WH and postoperative discomfort. Due to the studies' low methodological quality and high heterogeneity, data should be interpreted with caution. The present overview compiles the evidence of SRs related to different therapies for WH and patients' postoperative experience and reveals that different treatments can significantly improve the clinical outcomes of patients who require ASTG removal for periodontal or peri-implant surgeries. PROSPERO registration number: CRD42022301257.

Efficacy of a Novel Melatonin-Loaded Gelatin Sponge in Palatal Wound Healing

ObjectivesThe aim of this research was to assess both clinically and histologically the effect of a topically applied melatonin-loaded gelatin sponge on palatal wound healing after graft harvesting. MethodsTwenty-six patients for whom free palatal graft procurement was indicated were divided equally into 2 groups. In the test group, the donor site was covered by a melatonin-loaded gelatin sponge, and in the control group the site was covered by a placebo-loaded gelatin sponge. Wound healing was evaluated on the day of surgery and at 7 and 14 days postsurgery using photo-digital planimetry. Histologic specimens were taken to verify healing type and rate. Pain was assessed via Visual Analogue Scale (VAS) for 7 days from the day of the surgery. ResultsAt the 7-day interval, photo-digital planimetry showed a significant decrease in the traced raw area (P = .04) in the test group compared with the control group and a significant increase in the mean area of immature epithelia (P = .04). At the 14-day interval, there was no statistically significant difference in any area of interest. Histologically, the application of melatonin was associated with accelerated healing and superior maturation at all follow-up time points. No significant differences were noted in VAS scores between the 2 groups. ConclusionsMelatonin-treated tissue showed marked clinical improvement in the first week postsurgery, indicating an increased rate of healing. Similarly, histologic analysis revealed significant maturation at both time intervals. A melatonin-loaded gelatin sponge is a novel palatal wound dressing that can be used to improve wound healing outcomes and reduce patient morbidity.

Clinical effectiveness of orange peel polymethoxy-flavonoids rich fraction as a palatal dressing material compared to Alveogyl: randomized clinical trial

This study assessed the clinical effectiveness of orange peel polymethoxy-flavonoids rich fraction (OPMF) solid dispersion as a palatal dressing material, compared with Alveogyl, in a randomized clinical trial. After harvesting free gingival grafts for 18 patients in three groups, the donor site in group I received OPMF; group II received Alveogyl; and group III received placebo dough material. The visual analog scale (VAS) pain score in group I showed the lowest value in week one without a significant difference. In week 2, there was a substantial decrease in pain in group I compared to group III. Week 4 showed reduced pain scores in all groups without significant differences. The results of the number of analgesic pills revealed, after 1 week, the lowest number of pills consumed in group I, with a considerable difference compared to group III. Healing process results showed that group I had the highest healing values in each interval, with a significant difference between group I and group III at 1 and 2 weeks. Color matching parameter showed slight differences between the groups’ readings in favor of group I in all intervals without a statistically significant difference. The results suggest OPMF as a palatal dressing material that facilitates hemostasis, pain relief, and palatal wound healing.

Preliminary evidence of impaired oral wound healing in e-cigarette users: a call for perioperative vaping cessation.

A prospective, parallel-arm, age- and gender-matched clinical study. To assess and compare palatal wound healing of orally and systemically healthy e-cigarette users with a matched group of non-vapers. Included were healthy adult volunteers (18-50 years), either e-cigarette users or never smokers, who agreed to use a study-specific e-cigarette device and e-liquids, and were willing to provide consent from. Exclusion criteria were: hypersensitivity to lidocaine, ASA grade >2, recent antibiotic therapy, history of periodontal surgery, active oral lesions, and carious cavities. E-cigarette users were instructed to use the device 2 times daily for more than 1 hour each, with 20 puffs per session. Bilateral 5 mm punch biopsy wounds were made palatally opposite to the 2nd premolar, and subjects were followed up at 1, 2, 4, 7, 14 and 21 days post-operatively. Throughout this period, 3 mm punch biopsies were harvested from the right and left healing wounds at 1- and 3- weeks respectively. All surgical procedures were conducted by the same operator. Pre-wounding palatal biofilms were collected by swabs for metabolomic profiling. Wound healing was evaluated by clinical assessment, metabolite profile, histology, and immunohistochemistry to quantify the following proteins: vimentin, keratin and filaggrin. A total of 16 individuals were recruited: 8 e-cigarette users and 8 non-vapers. The average age was 27 years, and there were 4 men and 4 women in each group. The e-cigarette group tended to show a slightly lower total score of healing index in all visits compared to the control subjects, but the differences were not statistically significant. No site exhibited suppuration at any point, and no differences between groups were observed in the parameters of granulation. However, statistically significant differences were observed between groups for bleeding and swelling (p < 0.0001 and p = 0.0083, respectively), but not for epithelialization and redness (p = 0.0834 and p = 0.0967, respectively). Pain on palpation and difficulty in achieving hemostasis were more prevalent in e-cigarette group. The metabolic analysis between week 1 and 3 revealed significantly elevated carbohydrate and lipid metabolism in e-cigarette users, while protein metabolism was over-represented in the control group. For immunohistochemistry, significantly lower scores of vimentin, keratin, and filaggrin were shown in the e-cigarette group compared to controls at 1 and 3 weeks (p < 0.05 and p < 0.01, respectively). E-cigarettes may significantly impair oral wound healing by impacting keratinization of epithelium and modifying the metabolic composition of the oral microbiome. Therefore, vaping cannot be regarded as safe for patients undergoing oral surgery.

Evaluation of Post-Operative Morbidity and Palatal Wound Healing after Implant Uncovering Surgical Procedure Performed with Apically Positioned Flap (APF) and Leukocyte and Platelet-Rich-Fibrin (L-PRF): An Original Technique.

Background and Objectives: Dental implants are recognized as an effective treatment in the management of edentulous patients; controversies surround the connection between the sufficiency of keratinized gingiva (KG) and peri-implant health. Maintaining an ample amount of peri-implant KG is crucial for minimizing gingival inflammation, highlighting the need for regular consideration of soft-tissue augmentation. Among the diverse periodontal plastic surgical procedures, the apically positioned flap (APF) is notable for its ability to enhance the width of keratinized tissue while minimizing patient morbidity. The aim of this study was to evaluate the effects of L-PRF on palatal wound healing and patient discomfort after surgery. Materials and Methods: Twenty patients with two adjacent submerged fixtures in the maxilla and buccal keratinized gingiva widths < 2 mm were treated with APF and L-PRF. Clinical evaluations were performed at 1, 2, 3, and 4 weeks post-surgery, focusing on parameters such as complete wound epithelialization (CWE), postoperative discomfort (D), changes in feeding habits (CFH), alteration of sensitivity (AS) around the wound area, and the consumption of analgesics. Results: Our data revealed CWE in 5 patients by the end of the second week, with the remaining 15 achieving CWE by the end of the third week. For D and CHF, a statistically significant improvement was recorded for all cases between the first and second weeks, as well as AS, although less substantial, by the third week. No significant changes were noted for AS over the initial two weeks. Conclusions: These findings suggest that L-PRF may enhance wound healing and decrease patient discomfort following APF for fixture uncovering.

Effects of melatonin and alpha-lipoic acid on collagen and VEGF expression in palatal wound healing

Effects of melatonin and alpha-lipoic acid on collagen and VEGF expression in palatal wound healing

Ultrasonographic analysis of palatal donor site healing accelerated with platelet-rich fibrin following subepithelial connective tissue harvesting.

Platelet-rich fibrin (PRF) contains a variety of growth factors and bioactive molecules that play crucial roles in wound healing and angiogenesis. We aimed to evaluate the effects of PRF on tissue thickness and vascularization of the palatal donor site by ultrasound (USG) following subepithelial connective tissue harvesting. A subepithelial connective tissue graft was harvested from the palatal region with a single incision for root coverage in 20 systemically healthy patients. In the test group (n = 10), the PRF membrane was placed at the donor site, whereas no material was applied in the control group (n=10). Palatal tissue thickness (PTT) and pulsatility index (PI) were evaluated by USG at baseline and on the 3rd, 7th, 14th, 30th, and 90th days after surgery. The early healing index (EHI) was used to evaluate donor site healing for 30 days. PTT was significantly higher in the PRF group on the 3rd and 14th days after surgery when compared to the controls. In the PRF-treated group, PI levels were significantly higher than in the controls, especially on the 14th day. PTT increased significantly 90 days after surgery compared to the test group baseline, but controls showed a significant decrease. The PRF group showed statistically significant improvements in EHI scores compared to controls on days 3, 7, and 14. This study found a negative correlation between PI values and EHI scores on postoperative days three and seven in the test group. USG is a non-invasive, objective method to radiographically evaluate the regenerative effects of PRF on palatal wound healing after soft tissue harvesting. To overcome graft inadequacy in reharvesting procedures, PRF application may enhance clinical success and reduce possible complications by increasing tissue thickness and revascularization in the donor area.

Oral Wound Healing: A Scoping Review and Proposal of a New Index for Palatal Mucosa.

The aim of this scoping review was to evaluate the wound healing indices available in literature and propose a new intra-oral wound healing index to assess the healing of palatal mucosa. A PubMed database search was conducted to identify relevant studies using the search strategy: ('Oral Wound healing') OR ('Palatal tissue healing') OR ('Healing indices in Oral and Maxillofacial Surgery') OR ('Palatal wound healing') OR ('Complications in wound healing'). A qualitative and quantitative synthesis of the results was done and data was presented following the PRISMA-ScR guidelines. The search resulted in 9 articles published between 2019 and 2022, which were eligible for inclusion in the study. The data revealed that the indices currently available for the assessment of intra-oral healing were limited and primarily concerned with the assessment of gingival and periodontal tissues. The healing indices devised for gingival and periodontal tissues cannot be applied to palatal healing due to the differences in clinical and histological aspects. Therefore, a new index to monitor the healing response specifically for the soft tissues in the palate has been proposed. This maybe particularly useful in cleft palate repair and other procedures performed over the palatal tissues.

Current insights in the preclinical study of palatal wound healing and oronasal fistula after cleft palate repair.

Poor palatal wound healing after cleft palate repair could lead to unfavorable prognosis such as oronasal fistula (ONF), which might affect the patient's velopharyngeal function as well as their quality of life. Thus, restoring poor palatal wound healing for avoiding the occurrence of ONF should be considered the key to postoperative care after cleft palate repair. This review provided current insights in the preclinical study of poor palatal wound healing after cleft palate repair. This review comprehensively introduced the animal model establishment for palatal wound healing and related ONF, including the models by mice, rats, piglets, and dogs, and then demonstrated the aspects for investigating poor palatal wound healing and related treatments, including possible signaling pathways that could be involved in the formation of poor palatal wound healing, the related microbiota changes because of the deformity of palatal structure, and the studies for potential therapeutic strategies for palatal wound healing and ONF. The purpose of this review was to show the state of the art in preclinical studies about palatal wound healing after cleft palate repair and to show the promising aspects for better management of palatal wound healing.

Clinical and histological comparison of healing by steel scalpel, diode laser, and radiofrequency in palatal wound: An animal study.

Wound healing following periodontal soft tissue procedures can differ owing to different techniques, the feasibility of which can be determined through detailed macroscopic and microscopic observations. This study aimed to clinically and histologically evaluate palatal wound healing in rats by secondary intention after excision using a steel scalpel, diode laser, and radiofrequency. An excision was made in the edentulous anterior maxilla of 42 4-month-old male Wistar rats weighing 289-428 g. Part of the connective tissue was left in the surgical area to observe the dynamics of secondary intention wound healing. Three experimental groups were established: the steel scalpel, an 810-nm diode laser at a power output of 1.5 W in continuous mode, and a monopolar radiofrequency in a fully rectified waveform at 15 W. Clinical and histological analyses were performed on days 2, 4, and 7. Hemostasis, changes in body weight, defect size, epithelial gap, and inflammatory infiltration were evaluated. The epithelial gap closed completely in all groups on day 7. Bleeding occurred significantly more in the scalpel group (P < 0.001). No significant changes were observed in body weight between the groups. Macroscopically, the mean wound area decreased over time in all groups. Wound healing was significantly slower in the laser group on day 2 and in the radiofrequency group on days 4 and 7 (P < 0.001). Microscopically, the laser created the cleanest wound area, with minimal inflammatory infiltration and no thermal injury. More damage occurred in the connective tissue of the radiofrequency group. Wound healing was observed on day 7 in all groups. Palatal wound healing with secondary intention yielded different outcomes in a rat model when different techniques were used. However, almost complete healing was observed in all wounds, which highlights the importance of the soft tissue left in the surgical area. Wound healing in periodontal soft tissue procedures is not compromised by different techniques, as long as the clinician has sufficient knowledge and experience.

EFFECT OF PROPOLIS ON WOUND HEALING: A CLINICAL AND HISTOMORPHOMETRIC STUDY IN RATS

Background: Propolis is known to have antioxidant, antiinflammatory, antibacterial, antiviral, immunostimulant and local anesthetic effects. The aim of the present study was to investigate the clinical and histomorphometric effects of propolis on the healing of excisional palatal wounds in rats. &#x0D; Materials and methods: Sixty male Wistar rats were used for the study. Six animals were sacrificed at beginning of the study as initial wound (0 day). The rats were divided into three groups: Propolis (P), Chlorhexidine (CHX) and Control (C). Subjects in all three groups were randomly selected to form nine subgroups of six rats each. Under anesthesia, circular excision wounds with a diameter of 3 mm were formed in the middle of the palate of the rats by punching. The mucoperiosteal part was removed with sharp dissection, and the area on the open bone surface was left to heal the secondary wound. Propolis was administered locally at a rate of 1 ml/day. The rats were sacrificed on days 7, 14, and 21, and pictures of the wound area were taken. Each photograph was transferred to a dedicated program to measure the defect area. Histological sections were taken and the presence of inflammatory cells, epithelialization, and degree of healing were assessed.&#x0D; Results: The average wound area between epithelial margins decreased significantly over time in all groups (p

Effect of orodispersible hyaluronic acid film on palatal mucosa wound healing.

The objective of the study was to evaluate the healing effect of hyaluronic acid films on palatal wounds. After making 5-mm diameter palatal wounds, 72 rats were randomly assigned to three groups: control, hyaluronic acid gel, and hyaluronic acid film. The animals were sacrificed at 3, 7, and 21 days after the experiment. Clinical, histological, and RT-PCR analyses were performed. Human ex vivo oral mucosa models were used. Histological analysis and pan-cytokeratin staining were performed at 5 days after wound creation. In rat model, both gels and films showed favorable healing on Days 3 and 7 compared with healing in the control (p < 0.05). Film showed remarkable VEGF and α-SMA expression than did the others (p < 0.05). Immunohistochemical analysis showed that film exhibited significantly lower CD68 and greater α-SMA and vimentin expression levels than those in the others (p < 0.05). In human model, re-epithelialization rate of film group was significantly higher than that of the others. Complete epithelial regeneration was confirmed only in film group using pan-cytokeratin staining. Within the limits of this study, hyaluronic acid film outperformed gels in terms of palatal wound healing in both models.

Wound healing dynamics, morbidity, and complications of palatal soft-tissue harvesting.

Palatal-tissue harvesting is a routinely performed procedure in periodontal and peri-implant plastic surgery. Over the years, several surgical approaches have been attempted with the aim of obtaining autogenous soft-tissue grafts while minimizing patient morbidity, which is considered the most common drawback of palatal harvesting. At the same time, treatment errors during the procedure may increase not only postoperative discomfort or pain but also the risk of developing other complications, such as injury to the greater palatine artery, prolonged bleeding, wound/flap sloughing, necrosis, infection, and inadequate graft size or quality. This chapter described treatment errors and complications of palatal harvesting techniques, together with approaches for reducing patient morbidity and accelerating donor site wound healing. The role of biologic agents, photobiomodulation therapy, local and systemic factors, and genes implicated in palatal wound healing are also discussed.

Physiological reaction of anxious patients taking sedative medications before and after periodontal surgery

Clinicians use sedatives for anxiety patients at times in daily practice, but the direct influence of the medication on the wound healing of periodontal tissues is unknown. The aim of this study was to analyze the influence of the short-term administration of diazepam to patients with dental anxiety undergoing free gingival graft (FGG) procedures. A total of 51 FGG procedures in 39 patients were included. Twenty-six anxious patients medicated with 5mg of diazepam from the night before surgery to 7 days after surgery served as the medication group, and the rest served as the control group. Direct examination, photographs and H2O2 were used to evaluate the healing of palatal wounds. Stress levels and sleep quality, and salivary melatonin levels were assessed. On Day 14, complete epithelization of the wounds was noted in 48.39% of the patients in the medication group and 35.29% of the patients in the control group. Regardless of whether they receive medication or not, groups with complete epithelialization by Day 14 had higher levels of preoperative melatonin than those without, with a P value of 0.02. The postoperative melatonin in the medication group tended to present higher levels than the control group. Higher preoperative melatonin levels can accelerate wound healing. The short-term administration of the diazepam seemed to facilitate palatal wound healing by reducing stress and maintaining postoperative melatonin levels. This is the first time the relationships between sedatives, melatonin levels and palatal wound healing has been reported.

The Impact of Corticosteroid Administration at Different Time Points on Mucosal Wound Healing in Rats: An Experimental Pilot In Vivo Study.

Simple SummaryThe objective of this pilot study was to evaluate the impact of corticosteroid (CS) administration at different time points on palatal wound healing in rats. Thirty-six young male rats were divided into three groups. The test groups were treated by CS in the early (1–4 days) and late (5–9 days) stages after palatal wounding, while the control group was left for spontaneous healing. Our findings do not support the positive impact of CS administration on palatal wound healing. While microscopically, we found no difference between the CS and control groups, CS exposure was associated with a macroscopically larger final wound area, reflecting a possible harmful effect of CS.Background: Conflicting results were found regarding the effect of corticosteroid (CS) administration upon wound healing. The objective of this pilot study was to evaluate the impact of CS administration at different time points on palatal wound healing in rats. Methods: A 4.2 mm diameter punch created a secondary healing excisional palatal defect in thirty-six (36) Wistar-derived, two-month-old male rats weighing 250–270 g. We evaluated the effect of CS by comparing wound healing between three equal groups: 12 rats who were not exposed to CS and two additional groups in which 1 mg/kg dexamethasone (1 mg/kg) was administered daily, early (1–4 days) and late (5–9 days) after injury. The dynamics of the healing process were evaluated weekly in 4 sacrificed rats from each group for three weeks. The wound area was assessed both macroscopically and microscopically; the inflammation score was assessed microscopically. Results: The initial wound area in all the rats was 13.85 mm2. At the end of the study, it decreased to 4.11 ± 0.88 mm2, 7.32 ± 2.11 mm2, and 8.87 ± 3.01 mm2 in control, early, and late CS administration groups, respectively (p = 0.075). Inflammation scores showed a tendency to decrease in the third week in all groups, with no statistical differences. Conclusions: Our findings do not support the positive impact of CS administration on palatal wound healing. While microscopically, we found no difference between the CS and control groups, CS exposure was associated with a macroscopically larger final wound area, reflecting a possible harmful effect of CS.

Observation of Palatal Wound Healing Process Following Various Degrees of Mucoperiosteal and Bone Trauma in a Young Rat Model.

Simple SummaryThe exact correlation of palatal trauma to maxillary inhibition has not been demonstrated. This paper determines the influence of different degrees of palatal trauma on maxillofacial growth and assesses whether usage of ADM can help rescue the inhibited growth during palatal wound healing. This research would help the surgeons comprehensively understand the impact of palatal trauma on maxillary growth and the therapeutic effect of the ADM.The accidental injury or surgery on soft and hard palatal tissue has an adverse impact on normal maxillary morphology. To design a single-factor experiment that excludes other interfering factors on maxillary growth, a young rat model was established to simulate the various degrees of palatal trauma. Eight maxillary parameters were measured to evaluate the impact of palatal trauma on maxillary growth. Furthermore, the acellular dermal matrix (ADM) was applied to cure the palatal trauma and alleviate the adverse impact of bone denudation on the maxillary growth. Micro-CT scanning and histology analyses were used. One-way ANOVA with least significant difference (LSD) post-test was used to evaluate the statistical significance. The palatal trauma mainly disturbed the transverse development of the maxilla. ADM promotes mucosa healing, but there is still an inhibitory effect on maxillofacial growth.