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Yadav VS, Makker K, Haidrus R, Dawar A, Gumber B. Chitosan-based dressing for management of palatal donor site: A randomized clinical trial. J Periodontal Res 2024. [PMID: 38594813 DOI: 10.1111/jre.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/29/2024] [Accepted: 03/31/2024] [Indexed: 04/11/2024]
Abstract
AIMS This study aimed to evaluate the effectiveness of a chitosan-based dressing (CD) in achieving early wound healing and hemostasis at palatal donor sites in patients undergoing free gingival graft (FGG) surgery. METHODS Thirty-two patients requiring FGG were treated in this randomized controlled clinical trial. Complete epithelialization (CE) and color match (CM) at donor sites were assessed by a blinded examiner on postoperative days 7, 14, 21, and 28. Donor sites were compressed for 2 min with wet gauze (WG) alone in control group (CG) or WG + CD in test group (TG) immediately after graft harvesting, and immediate bleeding (IB) was recorded (yes/no). Delayed bleeding (DB) (for 1 week), and number of analgesic tablets consumed, and VAS scores for pain (for 2 weeks) were recorded by patient every day. RESULTS Twenty-eight patients (14 in each group) were included in final analysis. The prevalence of CE (at weeks 2 and 3) and VAS scores for CM scores were higher in TG but the intergroup differences were statistically significant only for CM (at week 4). Number of patients exhibiting IB and DB was significantly fewer in the TG (p < .05). Although average pain scores and analgesic consumption were higher in TG up to 5 days, differences between two groups were not statistically significant at any time point. CONCLUSION Our data suggests that the application of CD increased re-epithelialization and accelerated wound healing process, although it did not reach statistical significance. Moreover, CD was found to significantly reduce bleeding complications, but it did not decrease the pain levels.
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Affiliation(s)
- Vikender Singh Yadav
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kanika Makker
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Razia Haidrus
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Anika Dawar
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Bhumika Gumber
- Herman Ostrow School of Dentistry, University of Southern California - USC, Los Angeles, California, USA
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2
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Tekin GG, Deveci B, Deveci E. Ellagic acid protected the gingival tissue via fibroblast and epidermal growth factors in rats. Acta Cir Bras 2024; 39:e391224. [PMID: 38477786 DOI: 10.1590/acb391224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/15/2023] [Indexed: 03/14/2024] Open
Abstract
PURPOSE To investigate the effect of ellagic acid (EA) in gingival tissues injury in rats. METHODS Twenty rats were categorized into two groups. In burn group, an excisional wound area was created by removing a 4-mm diameter flap from the left molar region in the mucoperiosteal region of the gingiva. In burn + ellagic acid group, 1.2 mg/mL EA was administered as irrigation for one week. Animals was sacrificed under anesthesia at the end of experiment. Malondialdehyde (MDA), myeloperoxidase (MPO) and glutathione (GSH) level were measured. Hematoxylin and eosin, fibroblast growth factor (FGF) and epidermal growth factor (EGF) immunostainings were applied to tissues. RESULTS MDA, MPO, inflammation and leukocyte infiltration were high in burn group. Degeneration epithelium, edema and inflammatory cell infiltration in connective tissue areas, and dilatation and congestion in blood vessels were observed in burn group. In burn + EA group, the gingival epithelium improved, collagen fiber production increased and organized dermis were observed. After burn injury, FGF and EGF activity was increased in EA treated groups. CONCLUSIONS We suggest that EA have the potential for better healing outcomes in oral wounds. EA seems to have promising therapeutic efficacy to enhance oral wound healing.
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Affiliation(s)
- Gülüçağ Giray Tekin
- Batman University - Faculty of Dentistry - Department of Periodontology - Batman, Turkey
| | - Buşra Deveci
- Diyarbakir Oral and Dental Health Center - Diyarbakir, Turkey
| | - Engin Deveci
- Dicle University - Medical School - Department of Histology and Embryology - Diyarbakir, Turkey
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3
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Li H, Li B, Lv D, Li W, Lu Y, Luo G. Biomaterials releasing drug responsively to promote wound healing via regulation of pathological microenvironment. Adv Drug Deliv Rev 2023; 196:114778. [PMID: 36931347 DOI: 10.1016/j.addr.2023.114778] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/06/2022] [Accepted: 03/10/2023] [Indexed: 03/17/2023]
Abstract
Wound healing is characterized by complex, orchestrated, spatiotemporal dynamic processes. Recent findings demonstrated suitable local microenvironments were necessities for wound healing. Wound microenvironments include various biological, biochemical and physical factors, which are produced and regulated by endogenous biomediators, exogenous drugs, and external environment. Successful drug delivery to wound is complicated, and need to overcome the destroyed blood supply, persistent inflammation and enzymes, spatiotemporal requirements of special supplements, and easy deactivation of drugs. Triggered by various factors from wound microenvironment itself or external elements, stimuli-responsive biomaterials have tremendous advantages of precise drug delivery and release. Here, we discuss recent advances of stimuli-responsive biomaterials to regulate local microenvironments during wound healing, emphasizing on the design and application of different biomaterials which respond to wound biological/biochemical microenvironments (ROS, pH, enzymes, glucose and glutathione), physical microenvironments (mechanical force, temperature, light, ultrasound, magnetic and electric field), and the combination modes. Moreover, several novel promising drug carriers (microbiota, metal-organic frameworks and microneedles) are also discussed.
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Affiliation(s)
- Haisheng Li
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Buying Li
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dalun Lv
- Department of Burn and Plastic Surgery, First Affiliated Hospital of Wannan Medical College, Wuhu City, China; Beijing Jayyalife Biological Technology Company, Beijing, China
| | - Wenhong Li
- Beijing Jayyalife Biological Technology Company, Beijing, China
| | - Yifei Lu
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
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4
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de Jesus G, Marques L, Vale N, Mendes RA. The Effects of Chitosan on the Healing Process of Oral Mucosa: An Observational Cohort Feasibility Split-Mouth Study. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:706. [PMID: 36839074 PMCID: PMC9963900 DOI: 10.3390/nano13040706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
The healing process is a dynamic process accompanied by some classical symptoms of inflammation such as redness, swelling, pain, and loss of function. Chitosan is a natural polymer with properties that contribute to tissue healing, with properties that could be applied in periodontal therapy, such as the wound healing of oral mucosa. This experimental split-mouth study aims to assess the possibilities of chitosan influencing the healing process of oral mucosa in eight patients, where the studied group was subjected to two oral surgeries: one with chitosan hydrogel into the socket and other without the biomaterial. A semi-quantitative analysis of the data was performed. Some classic signs of inflammation in a short period of time were observed where chitosan acted, compared to the control. An absence of bleeding was observed in the chitosan cases. According to the literature, chitosan recruits and activates neutrophils and macrophages and stimulates angiogenesis. Hemostatic and antimicrobial activity of chitosan also play an important role in wound healing. Chitosan seems to improve the postoperative quality of patients, allowing rapid wound healing with less complications.
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Affiliation(s)
- Gonçalo de Jesus
- Centro Regional das Beiras, Universidade Católica Portuguesa, Estrada da Circunvalação, 3504-505 Viseu, Portugal
| | - Lara Marques
- OncoPharma Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Nuno Vale
- OncoPharma Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
| | - Rui Amaral Mendes
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-7401, USA
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5
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Allen BN, Wang Q, Filali Y, Worthington KS, Kacmarynski DSF. Full-Thickness Oral Mucoperiosteal Defects: Challenges and Opportunities. TISSUE ENGINEERING. PART B, REVIEWS 2022; 28:813-829. [PMID: 34409870 PMCID: PMC9469748 DOI: 10.1089/ten.teb.2021.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/10/2021] [Indexed: 11/12/2022]
Abstract
Regenerative engineering strategies for the oral mucoperiosteum, as may be needed following surgeries, such as cleft palate repair and tumor resection, are underdeveloped compared with those for maxillofacial bone. However, critical-size tissue defects left to heal by secondary intention can lead to complications, such as infection, fistula formation, scarring, and midface hypoplasia. This review describes current clinical practice for replacing mucoperiosteal tissue, including autografts and allografts. Potentially paradigm-shifting experimental regenerative engineering strategies for mucoperiosteal wound healing, such as hybrid grafts and engineered matrices, are also discussed. Throughout the review, the advantages and disadvantages of each replacement or regeneration strategy are outlined in the context of clinical outcomes, quality of life for the patient, availability of materials, and cost of care. Finally, future directions for research and development in the area of mucoperiosteum repair are proposed, with an emphasis on identifying globally available and affordable solutions for promoting mucoperiosteal regeneration. Impact statement Unassisted oral mucoperiosteal wound healing can lead to severe complications such as infection, fistulae, scarring, and developmental abnormalities. Thus, strategies for promoting wound healing must be considered when mucoperiosteal defects are incident to oral surgery, as in palatoplasty or tumor resection. Emerging mucoperiosteal tissue engineering strategies, described in this study, have the potential to overcome the limitations of current standard-of-care donor tissue grafts. For example, the use of engineered mucoperiosteal biomaterials could circumvent concerns about tissue availability and immunogenicity. Moreover, employment of tissue engineering strategies may improve the equity of oral wound care by increasing global affordability and accessibility of materials.
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Affiliation(s)
- Brittany N Allen
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Qi Wang
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Yassine Filali
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Kristan S Worthington
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Deborah S F Kacmarynski
- Department of Otolaryngology - Head and Neck Surgery, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA
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6
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Schäfer S, Smeets R, Köpf M, Drinic A, Kopp A, Kröger N, Hartjen P, Assaf AT, Aavani F, Beikler T, Peters U, Fiedler I, Busse B, Stürmer EK, Vollkommer T, Gosau M, Fuest S. Antibacterial properties of functionalized silk fibroin and sericin membranes for wound healing applications in oral and maxillofacial surgery. BIOMATERIALS ADVANCES 2022; 135:212740. [PMID: 35929202 DOI: 10.1016/j.bioadv.2022.212740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/13/2022] [Accepted: 02/25/2022] [Indexed: 06/15/2023]
Abstract
Oral wounds are among the most troublesome injuries which easily affect the patients' quality of life. To date, the development of functional antibacterial dressings for oral wound healing remains a challenge. In this regard, we investigated antibacterial silk protein-based membranes for the application as wound dressings in oral and maxillofacial surgery. The present study includes five variants of casted membranes, i.e., i) membranes-silver nanoparticles (CM-Ag), ii) membranes-gentamicin (CM-G), iii) membranes-control (without functionalization) (CM-C), iv) membranes-silk sericin control (CM-SSC), and v) membranes-silk fibroin/silk sericin (CM-SF/SS), and three variants of nonwovens, i.e., i) silver nanoparticles (NW-Ag), ii) gentamicin (NW-G), iii) control (without functionalization) (NW-C). The surface structure of the samples was visualized with scanning electron microscopy. In addition, antibacterial testing was accomplished using agar diffusion assay, colony forming unit (CFU) analysis, and qrt-PCR. Following antibacterial assays, biocompatibility was evaluated by cell proliferation assay (XTT), cytotoxicity assay (LDH), and live-dead assay on L929 mouse fibroblasts. Findings indicated significantly lower bacterial colony growth and DNA counts for CM-Ag with a reduction of bacterial counts by 3log levels (99.9% reduction) in CFU and qrt-PCR assay compared to untreated control membranes (CM-C and CM-SSC) and membranes functionalized with gentamicin (CM-G and NW-G) (p < 0.001). Similarly, NW-G yielded significantly lower DNA and colony growth counts compared to NW-Ag and NW-C (p < 0.001). In conclusion, CM-Ag represented 1log level better antibacterial activity compared to NW-G, whereas NW-G showed better cytocompatibility for L929 cells. As data suggest, these two membranes have the potential of application in the field of bacteria-free oral wound healing. However, provided that loading strategy and cytocompatibility are adjusted according to the antibacterial agents' characteristic and fabrication technique of the membranes.
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Affiliation(s)
- Sogand Schäfer
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany; Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | | | | | | | - Nadja Kröger
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Cologne, 50937 Cologne, Germany
| | - Philip Hartjen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Alexandre Thomas Assaf
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Farzaneh Aavani
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Imke Fiedler
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Ewa K Stürmer
- Department of Vascular Medicine, University Heart Center, Translational Wound Research, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Tobias Vollkommer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Sandra Fuest
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany.
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7
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Toma AI, Fuller JM, Willett NJ, Goudy SL. Oral wound healing models and emerging regenerative therapies. Transl Res 2021; 236:17-34. [PMID: 34161876 PMCID: PMC8380729 DOI: 10.1016/j.trsl.2021.06.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/07/2021] [Accepted: 06/15/2021] [Indexed: 12/21/2022]
Abstract
Following injury, the oral mucosa undergoes complex sequences of biological healing processes to restore homeostasis. While general similarities exist, there are marked differences in the genomics and kinetics of wound healing between the oral cavity and cutaneous epithelium. The lack of successful therapy for oral mucosal wounds has influenced clinicians to explore alternative treatments and potential autotherapies to enhance intraoral healing. The present in-depth review discusses current gold standards for oral mucosal wound healing and compares endogenous factors that dictate the quality of tissue remodeling. We conducted a review of the literature on in vivo oral wound healing models and emerging regenerative therapies published during the past twenty years. Studies were evaluated by injury models, therapy interventions, and outcome measures. The success of therapeutic approaches was assessed, and research outcomes were compared based on current hallmarks of oral wound healing. By leveraging therapeutic advancements, particularly within in cell-based biomaterials and immunoregulation, there is great potential for translational therapy in oral tissue regeneration.
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Affiliation(s)
- Afra I Toma
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, USA.
| | - Julia M Fuller
- Department of Biology, Emory University, Atlanta, GA, USA.
| | - Nick J Willett
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, USA; Department of Orthopedics, Emory University, Atlanta, GA, USA; The Atlanta Veterans Affairs Medical Center, Atlanta, GA, USA.
| | - Steven L Goudy
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA, USA; Department of Otolaryngology, Emory University, Atlanta, GA, USA; Department of Pediatric Otolaryngology, Children's Healthcare of Atlanta, Atlanta, GA, USA.
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8
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Tort S, Demiröz FT, Coşkun Cevher Ş, Sarıbaş S, Özoğul C, Acartürk F. The effect of a new wound dressing on wound healing: Biochemical and histopathological evaluation. Burns 2020; 46:143-155. [DOI: 10.1016/j.burns.2019.02.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/02/2019] [Accepted: 02/14/2019] [Indexed: 12/14/2022]
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Surboyo MDC, Arundina I, Rahayu RP, Mansur D, Bramantoro T. Potential of Distilled Liquid Smoke Derived from Coconut (Cocos nucifera L) Shell for Traumatic Ulcer Healing in Diabetic Rats. Eur J Dent 2019; 13:271-279. [PMID: 31487751 PMCID: PMC6777171 DOI: 10.1055/s-0039-1693527] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective
Distilled liquid smoke (DLS) is a result of coconut processing by-product that not only serves as a natural food preservative but also has a promising therapeutic effect. The healing potential of DLS derived from coconut (
Cocos nucifera
L) shell was investigated on a traumatic ulcer with the diabetic rat.
Materials and Methods
DLS was analyzed the component by gas chromatograph mass spectrometry. Diabetic condition was induced by alloxan in 55 male Wistar rats. Ten mm of traumatic ulcer was made along the labial fornix incisive inferior after the diabetic condition was confirmed. Then DLS coconut shell, benzydamine hydrochloride, and sterile distilled water were applied topically for 3, 5, and 7 days. The potential healing was evaluated based on the expression of nuclear factor kappa beta (NFκB) and tumor necrosis factor alpha (TNF-α) on macrophages using immunohistochemical staining and the amount of collagen using Masson Trichome staining. The difference between each group was analyzed using one-way analysis of variance. The least significant difference test is used to determine the significant difference (
p
< 0.05).
Results
The major compounds found were phenol (36.6%), 2-methoxyphenol (guaiacol) (25.2%), furfural (17.8%), and 4-ethyl-2-methoxyphenol (3.5%) with 28 other minor constituents. The lowest NFκB and TNF-α expression on macrophage was observed by topical application of DLS derived from coconut shell for 3, 5, and 7 days of treatment. The amount of collagen was increased and indicated by the highest result of DLS compared to others.
Conclusion
The DLS derived from coconut (
Cocos nucifera
L) shell was able to improve traumatic ulcer healing in a person with diabetes.
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Affiliation(s)
- Meircurius Dwi Condro Surboyo
- Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia.,Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ira Arundina
- Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Retno Pudji Rahayu
- Department of Oral Pathology and Maxillofacial, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Dieni Mansur
- Research Center for Chemistry, Indonesian Institute of Sciences, Kawasan PUSPIPTEK-Serpong, Tangerang Selatan, Banten, Indonesia
| | - Taufan Bramantoro
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
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10
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Rahmani F, Moghadamnia AA, Kazemi S, Shirzad A, Motallebnejad M. Effect of 0.5% Chitosan mouthwash on recurrent aphthous stomatitis: a randomized double-blind crossover clinical trial. Electron Physician 2018; 10:6912-6919. [PMID: 30034658 PMCID: PMC6049970 DOI: 10.19082/6912] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 05/08/2018] [Indexed: 11/26/2022] Open
Abstract
Background Recurrent aphthous stomatitis (RAS) is one of the most common painful oral lesions of which there is no certain treatment. Objective The aim of this study was to determine the effect of Chitosan mouthwash 0.5% on RAS. Methods This randomized double-blind crossover clinical trial was conducted at a dental school in Babol, Iran, from 2015 to 2016. Twenty patients with a history of minor aphthous stomatitis were entered into this study. All patients were initially monitored in the first episode without treatment, and then were randomly treated in three other episodes with Chitosan, Triamcinolone or Biogel mouthwashes. The ulcer size and pain intensity by using visual analogous score (VAS) were recorded in each episode. Data were analyzed by ANOVA and Tukey test. We used SPSS version 20 to analyze data. Results The mean ulcer size on the fifth day (p=0.026, p=0.042, respectively) and VAS on the third and fifth days (p=0.011, p=0.013, respectively) were significantly less in Triamcinolone and Chitosan groups than Biogel and the no treatment episode. There were no significant differences between Chitosan and Triamcinolone groups in the average ulcer size and pain intensity in all the examination days. Conclusions Chitosan mouthwash is effective on pain relief and reducing ulcer size of minor aphthous stomatitis and this effect is almost the same as Triamcinolone mouthwash. Clinical trial registration The study was registered and approved by Iranian Registry of Clinical Trials (http://www.irct.ir) with IRCT ID: IRCT2015030718753N2. Funding The study was funded by Deputy of Research and Technology of Babol University of Medical Sciences (ref. no.: 9133625).
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Affiliation(s)
- Fatemeh Rahmani
- DDS of Oral and Maxillofacial Medicine, Avicenna Medical Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Akbar Moghadamnia
- Ph.D. of Pharmacology& Toxicology, Professor, Faculty of Medicine, Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sohrab Kazemi
- Ph.D. of Pharmaceutics Sciences, Faculty of Medicine, Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Atena Shirzad
- DDS of Oral and Maxillofacial Medicine, Assistant Professor, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Mina Motallebnejad
- DDS of Oral and Maxillofacial Medicine, Professor, Faculty of Dentistry, Oral Health Research Center, Babol University of Medical Sciences, Babol, Iran
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11
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Alvarez Echazú MI, Olivetti CE, Peralta I, Alonso MR, Anesini C, Perez CJ, Alvarez GS, Desimone MF. Development of pH-responsive biopolymer-silica composites loaded with Larrea divaricata Cav. extract with antioxidant activity. Colloids Surf B Biointerfaces 2018; 169:82-91. [PMID: 29751344 DOI: 10.1016/j.colsurfb.2018.05.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/04/2018] [Accepted: 05/06/2018] [Indexed: 11/16/2022]
Abstract
A detailed study of biomaterials is mandatory to comprehend their feasible biomedical applications in terms of drug delivery and tissue regeneration. Particularly, mucoadhesive biopolymers such as chitosan (chi) and carboxymethylcellulose (CMC) have become interesting biomaterials regards to their biocompatibility and non-toxicity for oral mucosal drug delivery. In this work, pH-responsive biopolymer-silica composites (Chi-SiO2, Chi-CMC-SiO2) were developed. These two types of composites presented a different swelling behavior due to the environmental pH. Moreover, the nanocomposites were loaded with aqueous Larrea divaricata Cav. extract (Ld), a South American plant which presents antioxidant properties suitable for the treatment of gingivoperiodontal diseases. Chi-CMC-SiO2 composites showed the highest incorporation and reached the 100% of extract release in almost 4 days while they preserved their antioxidant properties. In this study, thermal and swelling behavior were pointed out to show the distinct water-composite interaction and therefore to evaluate their mucoadhesivity. Furthermore, a cytotoxicity test with 3T3 fibroblasts was assessed, showing that in both composites the addition of Larrea divaricata Cav. extract increased fibroblast proliferation. Lastly, preliminary in vitro studies were performed with simulated body fluids. Indeed, SEM-EDS analysis indicated that only chi-SiO2 composite may provide an environment for possible biomineralization while the addition of CMC to the composites discouraged calcium accumulation. In conclusion, the development of bioactive composites could promote the regeneration of periodontal tissue damaged throughout periodontal disease and the presence of silica nanoparticles could provide an environment for biomineralization.
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Affiliation(s)
- María Inés Alvarez Echazú
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3° (1113), Buenos Aires, Argentina
| | - Christian Ezequiel Olivetti
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3° (1113), Buenos Aires, Argentina
| | - Ignacio Peralta
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3° (1113), Buenos Aires, Argentina
| | - Maria Rosario Alonso
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3° (1113), Buenos Aires, Argentina
| | - Claudia Anesini
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3° (1113), Buenos Aires, Argentina
| | - Claudio Javier Perez
- Instituto de Investigaciones en Ciencia y Tecnología de Materiales (INTEMA), Grupo Ciencia y Tecnología de Polímeros, Universidad Nacional de Mar del Plata, Juan B. Justo 4302, (7600) Mar del Plata, Argentina
| | - Gisela Solange Alvarez
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3° (1113), Buenos Aires, Argentina
| | - Martin Federico Desimone
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Junín 956, Piso 3° (1113), Buenos Aires, Argentina.
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Ma XY, Feng YF, Wang TS, Lei W, Li X, Zhou DP, Wen XX, Yu HL, Xiang LB, Wang L. Involvement of FAK-mediated BMP-2/Smad pathway in mediating osteoblast adhesion and differentiation on nano-HA/chitosan composite coated titanium implant under diabetic conditions. Biomater Sci 2018; 6:225-238. [PMID: 29231215 DOI: 10.1039/c7bm00652g] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Nanophase HA/CS composite coated porous titanium implant exhibited superior biological performance under diabetic conditions compared to pure Ti.
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Affiliation(s)
- Xiang-Yu Ma
- Department of Orthopedics
- General Hospital of Shenyang Military Area Command of Chinese PLA
- Shenyang
- China
- Department of Orthopedics of the 463 Hospital of PLA
| | - Ya-Fei Feng
- Department of Orthopedics
- Xijing Hospital
- Fourth Military Medical University
- Xi'an
- China
| | - Tian-Sheng Wang
- Department of Orthopedics of the 463 Hospital of PLA
- Shenyang
- China
| | - Wei Lei
- Department of Orthopedics
- Xijing Hospital
- Fourth Military Medical University
- Xi'an
- China
| | - Xiang Li
- School of Mechanical Engineering
- Shanghai Jiao Tong University
- State Key Laboratory of Mechanical System and Vibration
- Shanghai
- China
| | - Da-Peng Zhou
- Department of Orthopedics
- General Hospital of Shenyang Military Area Command of Chinese PLA
- Shenyang
- China
| | - Xin-Xin Wen
- Department of Orthopedics of the 463 Hospital of PLA
- Shenyang
- China
- Department of Orthopedics
- Xijing Hospital
| | - Hai-Long Yu
- Department of Orthopedics
- General Hospital of Shenyang Military Area Command of Chinese PLA
- Shenyang
- China
| | - Liang-Bi Xiang
- Department of Orthopedics
- General Hospital of Shenyang Military Area Command of Chinese PLA
- Shenyang
- China
| | - Lin Wang
- Department of Orthopedics
- Xijing Hospital
- Fourth Military Medical University
- Xi'an
- China
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Aslan C, Çelebi N, Değim İT, Atak A, Özer Ç. Development of Interleukin-2 Loaded Chitosan-Based Nanogels Using Artificial Neural Networks and Investigating the Effects on Wound Healing in Rats. AAPS PharmSciTech 2017; 18:1019-1030. [PMID: 27853994 DOI: 10.1208/s12249-016-0662-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/30/2016] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to develop and characterize rh- IL-2 loaded chitosan-based nanogels for the healing of wound incision in rats. Nanogels were prepared using chitosan and bovine serum albumin (BSA) by ionic gelation method and high temperature application, respectively. Particle size, zeta potential, and polydispersity index were measured for characterization of nanogels. The morphology of nanogels was examined by using SEM and AFM. The IL-2 loading capacity of nanogels was determined using ELISA method. In vitro release of IL-2 from nanogels was performed using Franz diffusion cells. Artificial neural network (ANN) models were developed using selected input parameters (stirring rate, chitosan%, BSA%, TPP%) where particle size was an output parameter for IL-2 free nanogels. Wound healing effect of IL-2 loaded chitosan-TPP nanogel was evaluated by determining the malondialdehyde (MDA) and glutathione (GSH) levels of wound tissues in rats. The particle size of IL-2 loaded chitosan-TPP nanogels was found to be larger than that of IL-2 loaded BSA-based chitosan nanogels. Drug loading capacity of nanogels was found 100% ± 0.010 for both nanogels. IL-2 was released slowly after the initial burst effect. According to SEM and AFM imaging, BSA-chitosan nanogel particles were of nanometer size and presented a swelling tendency, and chitosan-TPP nanogel particles were found to be spherical and homogenously dispersed. IL-2 loaded chitosan-TPP nanogel was found suitable for improving wound healing because it decreased the MDA levels and increased the GSH levels wound tissues comparing to control group.
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Aragão-Neto AC, Soares PA, Lima-Ribeiro MH, Carvalho EJ, Correia MT, Carneiro-da-Cunha MG. Combined therapy using low level laser and chitosan-policaju hydrogel for wound healing. Int J Biol Macromol 2017; 95:268-272. [DOI: 10.1016/j.ijbiomac.2016.11.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/03/2016] [Accepted: 11/07/2016] [Indexed: 11/16/2022]
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15
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Madrazo-Jiménez M, Rodríguez-Caballero Á, Serrera-Figallo MÁ, Garrido-Serrano R, Gutiérrez-Corrales A, Gutiérrez-Pérez JL, Torres-Lagares D. The effects of a topical gel containing chitosan, 0,2% chlorhexidine, allantoin and despanthenol on the wound healing process subsequent to impacted lower third molar extraction. Med Oral Patol Oral Cir Bucal 2016; 21:e696-e702. [PMID: 27475700 PMCID: PMC5116111 DOI: 10.4317/medoral.21281] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/29/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Despite efforts to prevent postoperative discomfort, there are still many immediate side effects associated with the surgical extraction of impacted lower third molars. Cicatrization is a physiological process through which the loss of integrity of oral mucosa is recovered and damaged tissues are repaired. Bexident Post (ISDIN, Spain) is a topical gel that contains chitosan, 0.2% chlorhexidine, allantoin and dexpanthenol. While this gel has many clinical indications, there are no published clinical trials evaluating its use in impacted mandibular third molar surgery. This study aims to clinically evaluate the efficacy of a gel containing chitosan, 0.2% chlorhexidine, allantoin and dexpanthenol on wound healing and reduction of postoperative side effects and complications after extraction of an impacted mandibular third molar. MATERIAL AND METHODS A split-mouth design study was carried out on a total of 50 bilaterally and symmetrically impacted third molar extractions, which were randomly placed into either a control group (CG=25) or an experimental group (EG=25). Patients were all informed of the purpose of the study and provided written consent. All procedures were carried out by the same dental practitioner, in accordance with standard surgical protocol. A different dental practitioner, unaware of which treatment had been applied, provided follow-up care. The EG applied 10 ml of topical gel composed of chitosan, 0.2% chlorhexidine, allantoin and dexpanthenol to the surgical wound three times a day for 10 days, patients in the CG did not apply any gel. RESULTS The groups were homogeneous insofar as potentially confounding variables. No significant findings were found regarding postoperative swelling and pain. Neither of the groups displayed poor healing or infectious complications of the wound during the postoperative period. In all the recorded follow-ups (Day 7 p=0.001, and Day 14 p=0.01), the wound's aesthetic appearance was better in the EG. Overall treatment tolerance was satisfactory and similar in both groups. CONCLUSIONS The gel composed of chitosan, 0.2% chlorhexidine, allantoin and dexpanthenol did not aid in patients' postoperative comfort; however, improved wound healing was observed.
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Affiliation(s)
- M Madrazo-Jiménez
- Facultad de Odontología de Sevilla, C/ Avicena s/n 41009, Sevilla, Spain,
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Elviri L, Bianchera A, Bergonzi C, Bettini R. Controlled local drug delivery strategies from chitosan hydrogels for wound healing. Expert Opin Drug Deliv 2016; 14:897-908. [PMID: 27732106 DOI: 10.1080/17425247.2017.1247803] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The main target of tissue engineering is the preparation and application of adequate materials for the design and production of scaffolds, that possess properties promoting cell adhesion, proliferation and differentiation. The use of natural polysaccharides, such as chitosan, to prepare hydrogels for wound healing and controlled drug delivery is a research topic of wide and increasing interest. Areas covered: This review presents the latest results and challenges in the preparation of chitosan and chitosan-based scaffold/hydrogel for wound healing applications. A detailed overview of their behavior in terms of controlled drug delivery, divided by drug categories, and efficacy was provided and critically discussed. Expert opinion: The need to establish and exploit the advantages of natural biomaterials in combination with active compounds is playing a pivotal role in the regenerative medicine fields. The challenges posed by the many variables affecting tissue repair and regeneration need to be standardized and adhere to recognized guidelines to improve the quality of evidence in the wound healing process. Currently, different methodologies are followed to prepare innovative scaffold formulations and structures. Innovative technologies such as 3D printing or bio-electrospray are promising to create chitosan-based scaffolds with finely controlled structures with customizable shape porosity and thickness. Chitosan scaffolds could be designed in combination with a variety of polysaccharides or active compounds with selected and reproducible spacial distribution, providing active wound dressing with highly tunable controlled drug delivery.
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Affiliation(s)
- Lisa Elviri
- a Department of Pharmacy , University of Parma , Parma , Italy
| | - Annalisa Bianchera
- b Interdepartmental Centre Biopharmanet-Tec , University of Parma , Parma , Italy
| | - Carlo Bergonzi
- b Interdepartmental Centre Biopharmanet-Tec , University of Parma , Parma , Italy
| | - Ruggero Bettini
- a Department of Pharmacy , University of Parma , Parma , Italy
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Sa G, Xiong X, Wu T, Yang J, He S, Zhao Y. Histological features of oral epithelium in seven animal species: As a reference for selecting animal models. Eur J Pharm Sci 2016; 81:10-7. [DOI: 10.1016/j.ejps.2015.09.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 09/22/2015] [Accepted: 09/28/2015] [Indexed: 10/23/2022]
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Li X, Ma XY, Feng YF, Ma ZS, Wang J, Ma TC, Qi W, Lei W, Wang L. Osseointegration of chitosan coated porous titanium alloy implant by reactive oxygen species-mediated activation of the PI3K/AKT pathway under diabetic conditions. Biomaterials 2015; 36:44-54. [DOI: 10.1016/j.biomaterials.2014.09.012] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/10/2014] [Indexed: 12/20/2022]
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