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

Overview

Journal Med Oral Patol Oral Cir Bucal

Specialty Dentistry

Date 2016 Aug 1

PMID 27475700

Citations 29

Authors

M Madrazo-Jimenez

A Rodriguez-Caballero

M-A Serrera-Figallo

R Garrido-Serrano

A Gutierrez-Corrales

J-L Gutierrez-Perez

D Torres-Lagares

Affiliations

Soon will be listed here.

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.

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References

Gocmen G, Gonul O, Oktay N, Yarat A, Goker K . The antioxidant and anti-inflammatory efficiency of hyaluronic acid after third molar extraction. J Craniomaxillofac Surg. 2015; 43(7):1033-7. DOI: 10.1016/j.jcms.2015.04.022. View

Rahban S, Garner W . Fibroproliferative scars. Clin Plast Surg. 2003; 30(1):77-89. DOI: 10.1016/s0094-1298(02)00069-x. View

Ebner F, Heller A, Rippke F, Tausch I . Topical use of dexpanthenol in skin disorders. Am J Clin Dermatol. 2002; 3(6):427-33. DOI: 10.2165/00128071-200203060-00005. View

Diaz-Sanchez R, Pachon-Ibanez J, Marin-Conde F, Rodriguez-Caballero A, Gutierrez-Perez J, Torres-Lagares D . Double-blind, randomized pilot study of bioadhesive chlorhexidine gel in the prevention and treatment of mucositis induced by chemoradiotherapy of head and neck cancer. Med Oral Patol Oral Cir Bucal. 2015; 20(3):e378-85. PMC: 4464927. DOI: 10.4317/medoral.20338. View

Cosyn J, Sabzevar M . Subgingival chlorhexidine varnish administration as an adjunct to same-day full-mouth root planing. II. Microbiological observations. J Periodontol. 2007; 78(3):438-45. DOI: 10.1902/jop.2007.060222. View

Hammad H, Hammad M, Abdelhadi I, Khalifeh M . Effects of topically applied agents on intra-oral wound healing in a rat model: a clinical and histomorphometric study. Int J Dent Hyg. 2011; 9(1):9-16. DOI: 10.1111/j.1601-5037.2009.00410.x. View

Kumar M, Muzzarelli R, Muzzarelli C, Sashiwa H, Domb A . Chitosan chemistry and pharmaceutical perspectives. Chem Rev. 2004; 104(12):6017-84. DOI: 10.1021/cr030441b. View

Bouloux G, Steed M, Perciaccante V . Complications of third molar surgery. Oral Maxillofac Surg Clin North Am. 2007; 19(1):117-28, vii. DOI: 10.1016/j.coms.2006.11.013. View

Veraldi S, Menter A, Innocenti M . Treatment of mild to moderate seborrhoeic dermatitis with MAS064D (Sebclair), a novel topical medical device: results of a pilot, randomized, double-blind, controlled trial. J Eur Acad Dermatol Venereol. 2008; 22(3):290-6. DOI: 10.1111/j.1468-3083.2007.02404.x. View

10.

Lee C, Zhang S, Leung Y, Li S, Tsang C, Chu C . Patients' satisfaction and prevalence of complications on surgical extraction of third molar. Patient Prefer Adherence. 2015; 9:257-63. PMC: 4332291. DOI: 10.2147/PPA.S76236. View

11.

Loots J, Loots G, Joubert W . The effect of allantoin on cellular multiplication in degenerating and regenerating nerves. S Afr Med J. 1979; 55(2):53-6. View

12.

Sahin M, Inan S, Ozturkcan S, Guzel E, Bilac C, Giray G . Comparison of the effects of Contractubex® gel in an experimental model of scar formation in rats: an immunohistochemical and ultrastructural study. J Drugs Dermatol. 2011; 11(1):74-81. View

13.

Torres-Lagares D, Gutierrez-Perez J, Hita-Iglesias P, Magallanes-Abad N, Flores-Ruiz R, Basallote-Garcia M . Randomized, double-blind study of effectiveness of intra-alveolar application of chlorhexidine gel in reducing incidence of alveolar osteitis and bleeding complications in mandibular third molar surgery in patients with bleeding disorders. J Oral Maxillofac Surg. 2010; 68(6):1322-6. DOI: 10.1016/j.joms.2009.08.022. View

14.

Staiger C . Comfrey: a clinical overview. Phytother Res. 2012; 26(10):1441-8. PMC: 3491633. DOI: 10.1002/ptr.4612. View

15.

Gehring W, Gloor M . Effect of topically applied dexpanthenol on epidermal barrier function and stratum corneum hydration. Results of a human in vivo study. Arzneimittelforschung. 2000; 50(7):659-63. DOI: 10.1055/s-0031-1300268. View

16.

Wong R, Bensadoun R, Boers-Doets C, Bryce J, Chan A, Epstein J . Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC Skin Toxicity Study Group. Support Care Cancer. 2013; 21(10):2933-48. DOI: 10.1007/s00520-013-1896-2. View

17.

Sridhar V, Wali G, Shyla H . Evaluation of the perioperative use of 0.2% chlorhexidine gluconate for the prevention of alveolar osteitis after the extraction of impacted mandibular third molars: a clinical study. J Maxillofac Oral Surg. 2012; 10(2):101-11. PMC: 3177521. DOI: 10.1007/s12663-011-0206-0. View

18.

Celebi S, Tepe C, Yelken K, Celik O . Efficacy of dexpanthenol for pediatric post-tonsillectomy pain and wound healing. Ann Otol Rhinol Laryngol. 2013; 122(7):464-7. DOI: 10.1177/000348941312200710. View

19.

Loe H, SCHIOTT C . The effect of mouthrinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man. J Periodontal Res. 1970; 5(2):79-83. DOI: 10.1111/j.1600-0765.1970.tb00696.x. View

20.

Torres-Lagares D, Recio-Lora C, Castillo-Dali G, Ruiz-de-Leon-Hernandez G, Hita-Iglesias P, Serrera-Figallo M . Influence of state anxiety and trate anxiety in postoperative in oral surgery. Med Oral Patol Oral Cir Bucal. 2014; 19(4):e403-8. PMC: 4119318. DOI: 10.4317/medoral.19604. View