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      • Record: found
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      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

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          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.

          Key words:Impacted lower third molar, postoperative wound healing, chitosan, chlorhexidine, allantoin, dexpanthenol, postoperative period.

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          Most cited references 29

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          Chitosan chemistry and pharmaceutical perspectives.

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            Chitin and Chitosan Preparation from Marine Sources. Structure, Properties and Applications

            This review describes the most common methods for recovery of chitin from marine organisms. In depth, both enzymatic and chemical treatments for the step of deproteinization are compared, as well as different conditions for demineralization. The conditions of chitosan preparation are also discussed, since they significantly impact the synthesis of chitosan with varying degree of acetylation (DA) and molecular weight (MW). In addition, the main characterization techniques applied for chitin and chitosan are recalled, pointing out the role of their solubility in relation with the chemical structure (mainly the acetyl group distribution along the backbone). Biological activities are also presented, such as: antibacterial, antifungal, antitumor and antioxidant. Interestingly, the relationship between chemical structure and biological activity is demonstrated for chitosan molecules with different DA and MW and homogeneous distribution of acetyl groups for the first time. In the end, several selected pharmaceutical and biomedical applications are presented, in which chitin and chitosan are recognized as new biomaterials taking advantage of their biocompatibility and biodegradability.
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              The effect of mouthrinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man.

               C R Schiött,  H Löe (1969)
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                Author and article information

                Journal
                Med Oral Patol Oral Cir Bucal
                Med Oral Patol Oral Cir Bucal
                Medicina Oral S.L.
                Medicina Oral, Patología Oral y Cirugía Bucal
                Medicina Oral S.L.
                1698-4447
                1698-6946
                November 2016
                31 July 2016
                : 21
                : 6
                : e696-e702
                Affiliations
                [1 ]Master in Oral Surgery. University of Seville
                [2 ]Associate Professor of Dentistry in Handicapped Patients. University of Seville
                [3 ]Professor of Oral Surgery. University of Seville
                Author notes
                Facultad de Odontología de Sevilla C/ Avicena s/n 41009 Sevilla, Spain , E-mail: danieltl@ 123456us.es

                Conflict of interest statement: The authors have declared that no conflict of interest exist.

                21281
                10.4317/medoral.21281
                5116111
                27475700
                Copyright: © 2016 Medicina Oral S.L.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research
                Oral Surgery

                Surgery

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