Biological and mechanical characterization of commercial and experimental periodontal surgical dressings

Abstract The objective of this study was to evaluate the biocompatibility and mechanical properties of two commercially available and one experimental periodontal dressing materials. The cytotoxicity of Periobond ® , Barricaid ® and one experimental periodontal dressing based on Exothane ® 8 monomer was tested on 3T3/NIH mouse fibroblast. Genotoxicity was assessed by micronuclei formation, and cell alterations were analyzed using light microscopy. Both biological assays were performed using the eluate obtained from specimens after 24, 72, or 168 hours of incubation. Mechanical characterization was assessed through the ultimate tensile strength and the water sorption and solubility tests. The significance level of α = 0.05 was used for all statistical analyses. All the materials promoted a cell viability lower than 60% in all evaluated times. In general, the cell viability was significantly reduced after 72 and 168h of specimens' incubation. Considering the factor material, there were not statistical differences in the cell viability (p = 0.156). The genotoxicity was not statistically significant among the groups in the different periods of time (p > 0.05). Differences in the ultimate tensile strength values were not statistically significant different among the groups (p = 0.125). Periobond ® showed the higher water sorption values (p < 0.001). Regarding solubility, there were no statistical differences between the groups (p = 0.098). All the periodontal dressing materials evaluated in this study exerted a cytotoxic effect against mouse fibroblasts, and their toxicity became more evident over time. Among the materials evaluated, the experimental light-cure type has shown overall similar properties to the commercial references.

Effect of propolis extract in combination with eugenol-free dressing [Coe-Pak[TM]] on pain and wound healing after crown-lengthening: a randomized clinical trial

Statement of the Problem: Researchers have long been in search of products to enhance healing and patient comfort postoperatively

Purpose: This study aimed to assess the efficacy of propolis extract in combination with Coe-Pak[TM] dressing for pain relief and wound healing after crown lengthening surgery

Materials and Method: This randomized clinical trial was performed on 36 patients who were randomly divided into two groups of Coe-Pak[TM] dressing with [trial group] and without [control group] propolis extract. Pain and burning sensation by use of visual analog scale [VAS] and number of analgesics taken were asked from patients

Gingival color and consistency, bleeding on probing [BOP] and presence of infection were studied 7 days after dressing removal

Results: Although a large number of patients in the trial group did not have burning sensation, this difference was not significant between the two groups [p> 0.05]

In both groups, the majority of patients experienced moderate and mild pain and there was no pain in the trial group after three days. No significant difference was noted between the two groups in pain score and number of analgesics taken [p> 0.05]

The two groups were not significantly different in terms of inflammation and healing process [BOP, gingival consistency and color], after 7 days [p> 0.05]

Conclusion: The study results showed no difference in use of Coe-Pak[TM] dressing with and without propolis extract in terms of postoperative pain and healing processr following the crown lengthening surgery. More studies are required to confirm these results

Cimento cirúrgico periodontal: usar ou não usar? / Periodontal dressing material: to use or not to use?

Existe grande discussão sobre a real necessidade e os benefícios da utilização do cimento cirúrgico nas feridas periodontais. O objetivo dessa revisão de literatura foi realizar um levantamento bibliográfico nas bases de dados PubMed e Science Direct abordando sobre a utilização do cimento cirúrgico em procedimentos periodontais. Os curativos periodontais são indicados em procedimentos específicos, como aqueles que deixam área cruenta e necessitam de estabilidade para o retalho. Algumas características pós-operatórias, como diminuição da sintomatologia dolorosa, controle de infecções e ajuda na cicatrização, são atribuídas a esses materiais, apesar de não existir um consenso na literatura sobre sua efetividade. Entretanto, pode ser considerado irritante aos mesmos, por predispor ao acúmulo de placa bacteriana ou pelo fato de desintegrar-se ou movimentar-se, criando o atrito mecânico e, desta forma, retardar o processo de cura. Como opção ao cimento cirúrgico, tem-se discutido sobre a utilização de bochechos antimicrobianos, que reduzem o biofilme e também o desconforto pós-operatório. Porém, não são capazes de evitar a impacção alimentar ou lesões traumáticas na ferida periodontal, e os pacientes costumam relatar sentir-se mais seguros no pós-operatório quando utilizam o cimento cirúrgico. Pôde-se concluir que o cimento cirúrgico parece exercer um pequeno efeito positivo sobre a ferida cirúrgica periodontal, sendo necessários novos estudos clínicos para que se possa realizar a correta indicação para sua utilização.

There is a great discussion about the real need and the benefits about periodontal dressing use on periodontal wounds. The aim of this revision is to collect articles in data bases (PubMed and Science Direct) about the use of periodontal dressing in periodontal surgery sites. Periodontal dressings are indicated in specific procedures as surgeries that leave an open wound or those which want flap stability. The benefits of periodontal dressing are pain control, infection control, acceleration of wound healing. There is no consensus in literature about their efficacy. Some address the possibility of being a local irritant factor if it disintegrates or dislodges or may predispose bacterial biofilm accumulation, which results in retardation of wound healing. As an option of periodontal dressings there are the antimicrobial mouthwashes because they reduce the bacterial biofilm and reduce the post-operative discomfort. The disadvantage of this substitution is the absence of a mechanical barrier to avoid trauma and accumulation of debris. Besides, the mechanical barrier gives more comfort and safety to the patient. It can be concluded that the periodontal dressing exerts a minimal positive effect on periodontal wound healing and there is a need of acorrect indication for its use.

Effectiveness of HemCon Dental Dressing versus conventional method of haemostasis in 40 patients on oral antiplatelet drugs

The purpose of the study was to evaluate the effectiveness of the HemCon Dental Dressing [HDD] in controlling post extraction bleeding and to ascertain its role in healing of extraction wounds, as compared to control. The 40 participants in the study were all receiving oral antiplatelet therapy [OAT]. A total of 80 extractions were conducted without altering the patients' drug therapy. The extraction sites were divided into 2 groups: one group received a HDD, and the control group where the conventional method of pressure pack with sterile gauze under biting pressure [followed by suturing if required] was used to achieve haemostasis. All HemCon treated sites achieved haemostasis sooner [mean = 53 seconds] than the control sites [mean = 918 seconds] which was statistically significant [P <0.001]. Postoperative pain in the HDD group [1.74] was also significantly lower than in the control group [5.26] [P <0.001]. Approximately 72.5% of HDD-treated sites showed significantly better postoperative healing when compared to the control site [P <0.001]. HDD proved to be an excellent haemostatic agent that significantly shortened the bleeding time following dental extraction in patients on OAT. Additionally, HDD offered significantly improved post-operative healing of the extraction socket and less postoperative pain

Empleo del Tisuacryl en la protección de heridas quirúrgicas gingivales: Matanzas 2004 / Tisuacryl usage in protecting gingival surgical injury: Matanzas 2004

Los procederes quirúrgicos en el tratamiento de la gingivitis crónica fibroedematosa y fibrosa dejan una superficie expuesta de tejido conectivo muy dolorosa que necesita ser protegida minimizando la posibilidad de infección y hemorragia postoperatoria. Con este fin se utilizan los apósitos periodontales con eugenol, sin eugenol, con contenido graso y con medicamentos. El Tisuacryl tiene la propiedad de adherirse al tejido vivo y permite sellar heridas recientes. Teniendo esto en cuenta se realizó un ensayo clínico fase II, controlado, aleatorizado y abierto utilizando el diseño de grupos paralelos, para evaluar su eficacia terapéutica en la protección de heridas quirúrgicas gingivales resultantes de la gingivoplastia frente al cemento quirúrgico Quirucem. El universo de trabajo estuvo constituido por 60 pacientes de 12 a 35 años de uno y otro sexos portadores de gingivitis crónica fibrosa o fibroedematosa que acudieron al servicio de Periodoncia de la CEDE III Congreso del PCC de Matanzas en el período comprendido de mayo 2003 a mayo 2004. Los pacientes del grupo de estudio no presentaron edema gingival postquirúrgico a los 7 días de intervenidos, el 93,3 por ciento de éstos refirió comodidad para la masticación, deglución y fonación y el 60 por ciento se encontró en la categoría de Buena. El adhesivo tisular Tisuacryl presentó mayor eficacia que el cemento quirúrgico Quirucem en la protección de heridas quirúrgicas gingivales resultantes de la gingivoplastia. No se presentaron eventos adversos asociados a la aplicación de Tisuacryl.

The surgical procedure in treating chronic fibrous and fibro-edematous gingivitis leaves a very painful exposed surface of connective tissue that has to be protected, minimizing the possibility of post-surgery infection and hemorrhage. With that purpose we use periodontal dressings with eugenol, without eugenol, with fat contain and with drugs. Tisuacryl has the property of adhering to the lively tissue, and allows to seal recent injures. Having this into account we carried out a controlled, open, randomized, phase II clinical trial using the design of parallel groups, to evaluate the therapeutic efficacy in protecting gingival surgical injury resulting from the gingivoplasty versus surgical cement Quirucem. The working universe was formed by 60 12-to-60 years-old patients of both sexes having fibrous and fibro-edematous gingivitis, who assisted the Periodontics Service of the Specialized Teaching Dental Clinic III Congress of the CCP, Matanzas, in the period from May 2003 to May 2004. The patients of the study group did not present post-surgical gingival edema seven days after being surgically operated; 93,3 por ciento of them referred commodity for masticating, deglutition and phonating and 60 por ciento was in the category of Good. The tissue adhesive Tisuacryl presented higher efficacy than surgical cement Quirucem in protecting surgical gingival injuries resulting from gingivoplasty. No adverse events associated to the application of Tisuacryl were reported.

[ role of mix propolis and calcium hydroxide dressings in treating the periapical lesions]

The ain of this research was to know the real role of mix propolis and calcium hydroxide dressings in treating the periapical lesions of non-vital closed apexes teeth. After know a site of its chemosynthesis. To approach this goal a clinical study has been performed on a 60 cases divided into 3 original groups: Group [1]: 20 closed apexes teeth /prepared in rotary technique [K3] and put Calcium Hydroxide dressing, then sealed by Gutta-Percha. Group [2]: 20 Closed apexes teeth /prepared in rotary system [K3] and put propolis dressing, then sealed by Gutta-Percha. Group [3]: 20 Closed apexes teeth /prepared in rotary system [K3] and put a mix of propolis and Calcium Hydroxide dressing, then sealed by Gutta-Percha After that, we observant redial sign during 6 months later, we observant radial sign and compare the size of periapical lesions. Statistical study revealed that group 2 [60%] was better than group 1 [50%] of complete success but in group 3 [80%] mixing propolis and calcium hydroxide dressings proved its activity as a dressing in non-vital root canals and its capability for inducing healing of periapical lesions

Evaluation of tissue response to periodontal dressings: histological study in tooth sockets of rats

Although the use of periodontal dressings is currently limited, there are some indications for their use. Selection of any material that will have direct contact with live tissues, such as periodontal dressings, should be careful in order to allow surgical wound healing. The aim of this study was to evaluate the intensity of inflammatory response and bone formation in tooth sockets of rats after implantation of three periodontal dressings. After removal of the right maxillary incisors of 84 male rats, each tooth socket received implantation of a polyethylene tube, 63 of which were filled with non-eugenol periodontal dressing and the remaining 21 tubes remained empty (control group). Histological evaluation assessed the intensity of inflammatory response and presence and location of bone tissue formation at postoperative periods of 7, 14 and 28 days. Statistical analysis was performed by the Kruskal-Wallis test at 5% significance level. Regarding the inflammatory infiltrate, at 28 days, there was statistically significant difference between one of periodontal dressings and control group (p<0.05). Analysis of postoperative periods, showed that the control group presented statistically significant reduction in the inflammatory infiltrate comparing the 14- and 28-day periods (p<0.05). Regarding bone tissue formation, there was difference in control group between the 7- and 28-day periods (p<0.05). Within the experimental conditions, it may be concluded that no differences were found in the inflammatory response among the groups at 7 and 14 days and that Voco pac™ dressing induced a more intensive inflammatory reaction at 28 days.

Clinical evaluation of lsodon and NaF on tooth hypersemitivity after initial periodontal therapy

Dentin hypersensitivity is a frequently problem after periodontal therapy. Many substances have been advocated for the treatment of this problem and numerous clinical studies investigated their efficacy. The aim of this clinical trial was to study the effectiveness of potassium nitrate and sodium fluoride gels for the reduction of tooth sensitivity following initial phase of periodontal therapy. In sixteen subjects following initial phase of periodontal therapy 274 sensitive teeth were detected. R and omly in one quadrant Isodan and in other quadrant sodium fluoride was applied and in the other applied no material. After one and two weeks plaque index and pain score were assessed in each group. The data obtained were analyzed by means of chi - square and Mann - whitney test. There were significant difference between the two groups [Isodan and NaF] and control group at the first week and immediately after scaling in reducing dentin hypersensitivity whereas no significant difference was found between Isodan and NaF in the whole. At the second week and immediately after scaling, there was a significant difference between Isodan and the control group [P<0.05], but there was no significant difference between NaF and the control group. Reduction of plaque index was significant in all groups between the first and the second week but there was no significant difference between groups. This study showed that both gels appear to have therapeutic effects to reduce hypersensitivity however Isodan has more prolonged effect. Also proper plaque control reduced tooth hypersensitivity

[Evaluation of the effect of adjunctive use of calcium hydroxide combined with periodontal dressing on dentin hypersensitivity after periodontal surgery]

Dentinal hypersensitivity is one of the most common complications which many patients complain in different ways. Dentinal hypersensitivity is caused by the opening of dentinal tubules to an oral cavity due to fractures, attritions, etc. It is a common complications after periodontal surgery. Many treatments have been suggested for this problem, till now. Calcium hydroxide is one of the materials used for treatment of root hypersensitivity after periodontal surgery. The aim of this study was to evaluate the effect of calcium hydroxide combined with periodontal dressing on root hypersensitivity after periodontal surgery. This study was done on 30 patients with severe periodontitis who needed periodontal surgery for both quadrants in each jaw. In each patient one quadrant was treated as a test and the other side was used as a control. In the test group 90mg of Calcium Hydroxide powder mixed with 1cm of Co-pack covered the site surgical. Twenty-one patients completed the procedure After surgery, a periodontal dressing combined with calcium hydroxide covered the area on the test side. The other side was used as a control and covered with a pure dressing. After one week the dressing was removed and the amount of hypersensitivity was measured with air flow and an explorer using the visual analog scale. Data were analyzed using the Wilcoxon sign rank test. The results showed that there were not any significant differences between the two sides in root sensitivity, but Plaque index in the test sides was lower than the control side. The periodontal dressing can not be used as a carrier for calcium hydroxide to reduce root hypersensitivity after periodontal surgery. Decrease in plaque accumulation after using the combination of calcium hydroxide and periodontal dressing may accelerate surgical wound healing but further investigations are necessary

Injerto óseo en el tratamiento de periodontitis agresiva. Reporte de un caso / Bone graft in the treatment of aggressive periodontitis. Report of a case

Se presenta el caso de un paciente femenino de 38 años de edad a quien se diagnosticó periodontitis agresiva generalizada con evolución de aproximadamente 4 años, período durante el cual se presentaron abscesos periodontales agudos en varias zonas y la pérdida de varios órganos dentarios. El tratamiento periodontal consistió en fase 1 periodontal, cirugía periodontal y la colocación de un injerto Bio-Oss en algunas áreas específicas. Después de 14 meses se encontró una integración del injerto al tejido óseo y una neoformación ósea que cambió radicalmente el pronóstico de las piezas dentales involucradas

Clinical response of early onset periodontitis to periodontal therapy supported by adjunctive tetracycline and metronidazole: long term follow-up

Early onset periodontitis EOP is infected periodontal disease, affecting individuals younger than thirty-five years old. It is characterized by a rapid rate of bone loss and disease progression with defects in host response and specific etiological microbial flora. The purpose of the study is to evaluate the response of different types of EOP not associated with systemic diseases and with Papillion- Lefevre syndrome to periodontal therapy in long-term follow-up patients 9 from 6 families were studied, exhibiting localized EOP [LEOP] and generalized EOP [GEOP] aged from 3-21 years old. Clinical and radiographic examination were performed. Initial phase of treatment composed of oral hygiene instructions, hygiene instructions, scaling and root planning, subgingival irrigation with anti microbial agent and surgery. Adjunctive antibiotic tetracycline in LEOP or metronidazole + amoxycillin in GEOP. Scaling and root planning, antibiotics and the anti-inflammatory agent ibuprofen were administrated in phases of maintenance. More clinical and radiographic improvement was evident in LEOP. GEOP was characterized by an increased tendency of teeth loss during the temporary denture and acute phases. Adjunctive therapy with metronidazole gave more adequate response than tetracycline in GEOP, and acute phases of LEOP. Topical application of metronidazole was effective in resolution of persistent periodontal pockets. Puberty was associated with recurrence of inflammatory gingival overgrowth, that was controlled by ciproflex administration. lboprofen reduced dermatic hyperkeratosis of Papillon-Lefevre syndrome. Conclusion:. Periodic periodontal treatment changes the type of lesion and reduces number of infected teeth. Period of clinical improvement did not signify complete resolution of EOP. Antibiotic administration may introduce modification in periodontal environment and determine the type of response

Hidróxido de cálcio associado ao tricresol formalina como curativo de demora: resposta pós-operatória / Association of calcium hydroxide paste with formocresol as temporary treatment: postoperative answer

O presente trabalho vem mostrar o emprego da associaçäo de hidróxido de cálcio [Ca(OH)2] com tricresol formalina, utilizada entre sessöes de tratamento endodôntico, como curativo de demora. No presente trabalho, foram utilizados 320 dentes, uni e multirradiculares, em que, após o preparo químico-mecânico do canal radicular, foi colocada, como curativo de demora, a associaçäo de hidróxido de cálcio com tricresol formalina. Na análise de resultados, observou-se pós-operatório excelente em 85 por cento, bom em 6,9 por cento, regular em 4,4 por cento e ruim em 3,7 por cento dos casos

Reparaçäo dos tecidos periapicais com diferentes reformulaçöes de Ca(OH)² : estudo em cäes / Healing process of periapical tissues with 3 different formulations of calcium hydroxide: study in dogs

Neste experimento empregaram-se 3 formulaçöes diferentes de Ca(OH)² como curativo de demora a curto prazo (3 dias) em dentes de cäes com lesäo periapical e, em seguida, os canais foram obturados com um cimento à base de óxido de cálcio. Seis meses após o tratamento, os resultados foram analisados histomorfologicamente. Os dados obtidos näo evidenciaram diferença apreciável entre os 3 curativos estudados (Calen, Calen + p-monoclorofenol canforado, Ca(OH)² + anestésico). A incidência média de reparo completo foi de 50 por cento, enquanto a grande maioria dos espécimes restantes encontrava-se em processo de reparaçäo

A Comparative Study of Clinical Sffects Following Periodontal Surgery with and without Dressing / 대한치주과학회지

Since they were introduced by Ward in 1923, periodontal dressing have been routinely used following the periodontal surgery to avoid pain, infection, desensitizing teeth, inhibiting food impaction of the surgical areas, and immobilizing injured areas. Recently, however, the value of periodontal dressings and their effects on periodontal wound healing have been questioned, several authors have been reported that the use of dressing has little influence on healing following periodontal surgical procedures. In addition, there is evidence that when good flap adaptation is achieved, the use of a periodontal dressing does not add to patient comfort nor promote healing. The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of periodontal dressing following periodontal surgery. Twenty-eight patients, 11 male and 17 female. were selected for this study; The age range was 31 to 56, with an average of 40.2years. Patient selection was based on existence of two bilateral sites presenting similar periodontal involvement, as determined by clinical and radiographic assessment, and requiring comparable bilateral surgical procedures. Using a splitmouth dressing. one site received a periodontal dressing while the other site did not. Pain assessment was made according to a horizontal, rating scale(0-10). After at least a two - week period, the second surgical precedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered, and were asked of their preference of either, dressed or undressed. The results were as follows: 1. A similar trend for mean pain and discomfort scores as assessed by patients both dressed and saline-treated procedures was evident during 7-day postsurgical period. 2. Statistical analysis of differences between the dressed side and saline-treated side with respect to pain, discomfort and patient's experiences revealed that both treatment sides behaved similarly at any postoperative day(P>0.05). 3. Considering the patient's preference, on the basis of pain and discomfort experienced, 43% preferred the saline-mouthwash and 32% preferred the dressing, 25% showing no preference for either the dressing or the saline-mouthwash. There is evidence to support the use of a periodontal dressing in retention of an apically positioned flap by preventing coronal displacement, or its use to provide additional support to stabilize a free gingival graft. However, there will always be a use for periodontal dressing although routine use of dressings may decrease because of better surgical techniques and the use of antibacterial mouth rinses.

Utilizaçäo do tricresol formalina como curativo de demora em endodontia / The use of tricresol formalin like a temporary dressing in endodontics

Foi realizada uma revisäo da literatura sobre a utilizaçäo do tricresol formalina como curativo de demora em Endodontia, bem como suas indicaçöes e efeitos adversos. Os autores que defendem seu uso baseiam-se em dados clínicos, radiográficos e microscópicos

O uso da clorexidina no pós-operatório periodontal: revista da literatura / Utilization of chlorhexidine after periodontal surgery: a review of the literature

Busca-se, nesta revisäo da literatura, avaliar o papel da clorexidina no tratamento periodontal, tendo como base o seu mecanismo de açäo sobre os microorganismos, em especial, sua aplicabilidade no pós-operatório periodontal imediato

Avaliaçäo histopatológica dos tecidos apicais e periapicais de dentes de cäes após biopulpectomia e utilizaçäo de diferentes curativos de demora / Evaluate of histopatologic of the apical and periapical tissue in dog's tooth after biopulpectomy and using differents antibacterial dressing

O objetivo deste trabalho foi avaliar, histopatologicamente, o comportamento dos tecidos apicais e periapicais, após colocaçäo de diferentes curativos de demora, em diferentes períodos de tempo. Foram utilizados pré-molares de cäes, com vitalidade pulpar, cujos canais radiculares foram, após remoçäo da polpa e preparo biomecânico, preenchidos na mesma sessäo de tratamento com os seguintes curativos: Pasta Calen (à base de hidróxido de cálcio); Pasta Calen + PMCC; Pasta Calen + PMC. Como grupo-controle positivo, os canais radiculares foram deixados vazios e como controle negativo foi utilizado o Otosporin. Decorridos 7, 15 e 30 dias da colocaçäo do curativo, os animais foram sacrificados e as raízes submetidas ao processamento histológico de rotina. Os resultados mostraram que: a) a pasta Calen, em todos os períodos experimentais, e o Otosporin no período de 7 dias, apresentaram a melhor resposta tecidual; b) a adiçäo do PMCC e PMC (ao hidróxido de cálcio conferiu às pasta maior capacidade de agressäo aos tecidos, em todos os períodos, sendo esta resposta mais acentuada na pasta contendo PMC; C) o grupo-controle positivo (canal vazio) foi o que apresentou a pior resposta tecidual

Evaluación de apósitos intraalveolares con clorhexidina en la prevención de alveolitis post-odontectomía de terceros molares mandibulares / Alveolitis prevention

Una de las complicaciones más frecuentes posterior a odontectomías de terceros molares, es la alveolitis. Para la prevención de esta complicación se han utilizado diferentes agentes antimicrobianos tópicos, como son lincomicina, terracortil, oxitetracilina, tetracilina, metronidazol, clorhexidina. El propósito de este estudio es evaluar el efecto de la clorhexidina al 0.2 por ciento. El estudio se realizó en 50 pacientes entre los 12 y 17 años con un método prueba clinica prospectivo doble ciego. A los pacientes se les realizó odontectomía de terceros molares bilateralmente y se aplicó aleatoriamente en cada sitio quirúrgico esponja reabsorvible embebida en clorhexidina al 0.2 por ciento para el lado estudio y en solución salina para el lado control. Se estudiaron las variables dolor, edema halitosis y formación de coágulo. Los resultados no mostraron efectividad en la presencia de la alveolitis pero si es efectiva en la prevención del dolor y del edema post-operatorio.

Evoluçäo do conhecimento em cicatrizaçäo periodontal / The development of knowledge on periodontal healing

Desde o conceito de Gottlieb e de Waerhaug até o presente, o conhecimento de cicatrizaçäo periodontal passou por várias fases que influenciaram diferentemente a terapia periodontal. Nesta revisäo, analisa-se a evoluçäo desse conhecimento, cuja dinâmica tem sido tal, que a própria Academia Americana de Periodontia, em 6 anos (1986/1992), redefiniu "nova inserçäo". O conhecimento inicial é descrito sob uma análise crítica das limitaçöes das medidas clínicas de avaliaçäo do potencial de cicatrizaçäo dos diferentes tecidos do periodonto, e introduz-se a atual mudança de perspectiva de dirigir a participaçäo desses tecidos

Apósito quirúrgico y clorhexidina en cirugía periodontal. Molestias postoperatorias / Surgical dressing and chlorhexidine in periodontal surgery. Postoperative discomfort

En 24 pacientes, 9 hombres y 15 mujeres, se practicaron intervenciones a colgajo de bisel reverso bilaterales, equiparadas en número y tipo de dientes y profundidad de las bolsas al sondaje. Previamente todos los pacientes recibieron instrucciones para mantener buena higiene bucal, detartraje, alisamiento radicular y equilibración de la oclusión. El sitio de intervención fue protegido por un apósito quirúrgico o se lo dejó sin protección, y esto se realizó en forma alternada en cada paciente, después de por lo menos un mes de la primera intervención. En todos los casos se prescribió enjuagatorios de clorhexidina 0,12 por ciento por un minuto, dos veces al día, por 7 días postoperatorios. Cada paciente llenó una ficha para anotar el dolor postoperatorio en una escala de 0 a 3, y un cuestionario para evaluar los efectos secundarios postoperatorios de los procedimientos quirúrgicos. En base al análisis de los resultados se concluye que cuando se ha practicado enjuagatorios postoperatorios con clorhexidina 0.12 por ciento parece no ser necesaria la utilización de un apósito quirúrgico en cuanto se refiere al dolor después de la cirugía periodontal empleando el colgajo de espesor total colocado apicalmente