RESUMO
BACKGROUND: Free gingival graft (FGG) is a highly predictable method to increase the width of keratinized gingiva. Various materials have been reported to accelerate the wound healing process. Considering the positive effect of EPO on dermal wound healing this study aimed to investigate the effects of EPO on the rate of healing and degree of inflammation in free gingival grafts. METHODS: Seventeen patients with bilateral lack of keratinized gingiva in mandible were selected for this clinical trial. The surgical intervention was performed after phase I periodontal therapy. Recipient site was prepared apical to the mucogingival line, and FGG was harvested from the palate. Before graft placement, the test side and control side were treated with 1 ml of EPO 4000 IU/ml and distilled water, respectively, for 2 min. On days 7, 14, 21, 28, 60, and 90 after surgery, the grafted sites were examined by blinded observers to compare the healing and inflammation of the areas. RESULTS: All the 17 patients completed the surgeries and follow-up examinations. Direct examination revealed significantly better healing in EPO group only on the 28th day. Assessment of the photographs showed a significant value in favor of the test group at some other time points as well. The EPO group demonstrated less inflammation, which was statistically significant in many time points. The graft area was 80.88 ± 30.21 mm2 and 71.35 ± 15.62 mm2 in the EPO and control groups, respectively. The difference was not significant, though. CONCLUSIONS: Topical application of erythropoietin can accelerate the healing of gingival grafts and reduce the inflammation during healing period. The final graft outcome, nevertheless, does not seem to be influenced by EPO. Trial registration This was a split-mouth randomized controlled clinical trial (IRCT201201278830N1). The first registration date: 2016-10-22.
Assuntos
Eritropoetina , Retração Gengival , Gengiva , Humanos , Mandíbula , Palato , Resultado do Tratamento , CicatrizaçãoRESUMO
Introduction:Porphyromonas gingivalis is one of the major pathogens in the development and progression of periodontal disease. Antimicrobial photodynamic therapy (aPDT) is a new approach which is sorted in non-invasive phototherapy for bacterial elimination. This in vitro study was conducted to compare photodynamic inactivation using Radachlorin and Toluidine blue O (TBO) as photosensitizers on P. gingivalis. Methods: Bacterial suspensions (200 µL) of P. gingivalis were exposed to either TBO with concentration of 0.1 mg/mL associated with portable light-emitting diode (LED) device (peak wavelength: 630 nm, output intensity: 2.000 mW/cm2, tip diameter: 6.2 mm) or 0.1% Radachlorin® and laser irradiation (InGaAlP, Peak wavelength: 662±0.1% nm, output power: 2.5 W, energy density: 6 J/cm2, fiber diameter: 2 mm). Those in control groups were subjected to laser irradiation or LED alone, Radachlorin® or TBO alone, and one group received neither photosensitizer nor light irradiation. Then counting of colony forming units (CFU) was performed to determine the bactericidal effects in each subgroup. Results: LED-based aPDT reduced the colony count of P. gingivalis more than that of TBO (P<0.001) or LED group (P=0.957). Also, laser-based aPDT had a great reduction in colony count of P. gingivalis in comparison with Radachlorin® (P<0.001) or laser irradiation alone (P=0.28). In addition, the colony count reduction of laser-based aPDT was significantly more than LED-based aPDT (P<0.05). Conclusion: Considering the results of this study, the viability of P. gingivalis was more affected by the combination of laser and Radachlorin® 0.1% in comparison with LED and TBO 0.1.
