AIM The aim of this study was to evaluate the role of a connective tissue graft (CTG) or a collagen matrix (CM) interpositioned between flaps and non-shedding hard surfaces on wound stability. MATERIAL AND METHODS Sixty bone dehiscence defects were prepared in five Beagle dogs. Three treatments were performed in 12 sites per dog: (1) repositioned flaps were sutured onto instrumented dentin surfaces (control), (2) repositioning of flaps with an interpositioned CTG and (3) repositioning of flaps with the application of a CM. To allow postoperative healing with n = 5 for 1, 3, 7 and 14 days before evaluation, the sutures were removed, incision lines retraced and tensile forces applied to the flaps. The minimum magnitude of forces required to detach the flaps from the wound bed was recorded. RESULTS After 1 week of healing, 6 N had to be applied to disrupt flaps from their wound bed in the CTG group. In the control group, a similar magnitude of resistance was achieved after 2 weeks (6.1 N). Flap resistance to tearing was highest in the CTG group (maximum 9.1 N) 2 weeks postoperatively. On the third postoperative day, the mean tearing forces of all groups differed significantly, displaying a 50% lower resistance to tearing in the CM compared to the CTG group. In comparison, flap resistance to tearing forces established earlier and in higher magnitude in sites with an interpositioned CTG than in flaps repositioned on dentin or CM. CONCLUSIONS Application of a CTG, sutured to a non-shedding hard surface, significantly increased flap resistance to tearing when applying disrupting forces compared to controls. A less pronounced effect was achieved by interpositioning of a CM.
Accepted ArticleThis article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jcpe.12526 This article is protected by copyright. All rights reserved.
Aims: Oral hygiene is key to prevent periodontal disease (PD). The efficacy of chlorhexidine-containing products has been largely proven, often being tooth discoloration an unwanted associated side-effect. Importantly, some differences related to the pharmaceutical presentation of these products have also been reported. This study aimed to evaluate the efficacy of two different pharmaceutical forms [toothpaste (TP) and mouthwash (MW)] of a new product containing chlorhexidine, dexpanthenol, allantoin and bioadhesive excipient (CDAB) (Bexident ® Gums Coadjuvant Treatment) on volunteers with PD. Their preferences, acceptability and cosmetic properties, as well as tooth discoloration, were also assessed.
Materials and methods:Total 60 subjects showing mildmoderate symptoms of gingivitis were randomly assigned to two different groups: one receiving TP (n = 30) and the other one receiving MW (n = 30). Periodontal disease index (PDI) was used to evaluate clinical signs at baseline (T0) and after 21 days (T21) of daily use of the products. Satisfaction was assessed through the affirmative/negative answers obtained with the visual analog scale (VAS).Results: All participants completed the study. A significant improvement of PDI score after treatment was reported in both groups (T21/T0) (p < 0.001). Thus, gingivitis improved from moderate to negative [increase = 20.0% (TP)/36.7% (MW)] and from mild to negative [increase = 56.7% (TP)/50.0% (MW)]. After treatment, all subjects reported to have healthier and/or less bleeding teeth (TP 9.0/9.4; MW 8.0/8.2) and would recommend the product (TP:100%/MW:96.6%) with no specific preference regarding its presentation. No change of teeth color was observed.
Conclusion:Subjects with PD who received oral care with a new formulation of either chlorhexidine-containing TP or MW for 21 days, reported a significant improvement of their symptoms and resolution of the gingivitis with no associated tooth discoloration. Patients did not show a specific preference for any of the pharmaceutical presentations.Clinical significance: This new formulation of a chlorhexidinecontaining product in both TP and MW forms resulted effective for PD treatment and well accepted by the patients.
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