A Narrative Review on Means to Promote Oxygenation and Angiogenesis in Oral Wound Healing

Abstract

Oral mucosa serves as the primary barrier against pathogen invasions, mechanical stresses, and physical trauma. Although it is generally composed of keratinocytes and held in place by desmosomes, it shows variation in tissue elasticity and surface keratinization at different sites of the oral cavity. Wound healing undergoes four stages of tissue change sequences, namely haemostasis, inflammation, proliferation, and remodelling. The wound healing of oral hard tissue and soft tissue is largely dependent on the inflammatory response and vascular response, which are the targets of many research. Because of a less-robust inflammatory response, favourable saliva properties, a unique oral environment, and the presence of mesenchymal stem cells, oral wounds are reported to demonstrate rapid healing, less scar formation, and fewer inflammatory reactions. However, delayed oral wound healing is a major concern in certain populations with autoimmune disorders or underlying medical issues, or those subjected to surgically inflicted injuries. Various means of approach have been adopted to improve wound tissue proliferation without causing excessive scarring. This narrative review reappraises the current literature on the use of light, sound, mechanical, biological, and chemical means to enhance oxygen delivery to wounds. The current literature includes the use of hyperbaric oxygen and topical oxygen therapy, ultrasounds, lasers, platelet-rich plasma (PRP)/platelet-rich fibrin (PRF), and various chemical agents such as hyaluronic acid, astaxanthin, and Centella asiatica to promote angiogenesis in oral wound healing during the proliferation process. The arrival of a proprietary oral gel that is reported to improve oxygenation is highlighted.

Surgical management of peri-implantitis in adjunction with BlueM oxygen therapy: a case report with 5-years follow-up

“…8,9 The topical application of active oxygen can be involved in reducing inflammation, suppressing disease progression, and promote tissue healing (i.e., protein synthesis, cellular proliferation, angiogenesis, and the restoration of vessels). 10 Accordingly, the protocol of topical oxygen therapy by BlueM can be recommended for the management of periimplantitis.…”

“…8,9 The BlueM formula is formed by chemical complexation of sodium perborate with specific carriers such as glycerol and cellulose, which provides controlled and slow release of oxygen. 10 Indeed, the active oxygen formula by BlueM is based on different antimicrobial mechanisms of action than other disinfectant agents. Clinically, the BlueM oxygen gel showed potential antimicrobial efficacy against the colonization and growth of pathogenic biofilms that associated with periimplantitis.…”

Effectiveness of Topical Oxygen Therapy in Gingivitis and Periodontitis: Clinical Case Reports and Review of the Literature

“…Oxygen therapy has been in use for almost a century and can be administered either systemically or topically. In addition to improving wound healing, oxygen administration is shown to promote angiogenesis, enhance chemotaxis of immune cells and inhibit inflammation and infection [ 16 , 17 ]. While hyperbaric oxygen is an effective route of systemic administration, local oxygen administration is still challenging in terms of obtaining a suitable carrier, which can deliver oxygen to the tissues [ 17 ].…”

“…In addition to improving wound healing, oxygen administration is shown to promote angiogenesis, enhance chemotaxis of immune cells and inhibit inflammation and infection [ 16 , 17 ]. While hyperbaric oxygen is an effective route of systemic administration, local oxygen administration is still challenging in terms of obtaining a suitable carrier, which can deliver oxygen to the tissues [ 17 ]. Topical toothpaste and oral gel formulations, which release active oxygen molecules are not only capable of controlling plaque buildup, but are also effective against gingivitis and periodontitis, similar to results of subgingival scaling [ 7 , 18 ].…”

Effectiveness of Hyperbaric Oxygen Therapy in the Management of Osteoradionecrosis of the Jaw: A Systematic Review

“…8 In irradiated tissues, it has been hypothesized that HBOT promotes angiogenesis, neovascularization, fibroblast and osteoblast proliferation, and collagen production. 9 However, the benefit of HBOT in improving the healing of tissues in patients with ORN remains controversial because of low evidence. 10 Hence, there is a need to investigate the clinical effects of HBOT on the healing efficacy in ORN patents.…”