ABSTRACT Green tea (Camellia sinensis) has high level of flavonoids which are proven to have anti-inflammatory activity. Effect of flavonoids can be enhanced by nano-chitosan capsulation as drug carrier. Chitosan is polysaccharide derived from crustacean shells that mostly used as matrix of various drugs and plant extracts. The aim of this study was to determine the effectivity of flavonoids in green tea extract in nanochitosan capsulation towards the number of fibroblasts on proliferative phase of gingival wound healing process. Green tea was extracted, encapsulated with nano-chitosan and then made into gel. Gingiva labial of 24 male white 3-month-old Wistar rats were wounded by punch biopsy (2 mm diameter), then were treated two times a day, and were divided randomly into four groups of topical gel applications: green tea extract gel encapsulated nano-chitosan, green tea extract gel, base gel as negative control, and NSAIDs gel as positive control, starting at 0 day until 7th day. At 5th and 7th day, three rats from each group were decapitated and the mandibular gingiva was taken in order to make histology slides with hematoxylin eosin staining. Under microscope, the number of fibroblasts were examined. The data were analysed using ANOVA test with 95% confidence level. The results showed that the number of fibroblasts on proliferative phase was significantly higher than control negative (p < 0.05) and has no significant differences (p > 0.05) with control positive. In conclusion, topical application of green tea extract gel encapsulated nano-chitosan was effective to accelerate rats gingival wound healing process by increasing the fibroblasts.
Camellia sinensis ; Chitosan ; Gingiva--injuries ; Wound Healing ; Rats, Wistar

PURPOSE: Numerous indices have been proposed to analyse wound healing in oral soft tissues, but each has specific shortcomings. A new method of analysis, the Early Wound Healing Score (EHS), was evaluated in the present study. The aim was to assess more accurately early healing by primary intention of surgical incisions in periodontal soft tissues. METHODS: Twenty-one patients were treated with different surgical procedures comprising 1 or 2 vertical releasing incisions as part of a surgical access flap. Twenty-four hours after surgery, early wound healing at the vertical releasing incisions was assessed using the EHS. This score assessed clinical signs of re-epithelialization (CSR), clinical signs of haemostasis (CSH), and clinical signs of inflammation (CSI). Since complete wound epithelialization was the main outcome, the CSR score was weighted to be 60% of the total final score. Accordingly, a score of 0, 3, or 6 points was possible for the assessment of CSR, whereas scores of 0, 1, or 2 points were possible for CSH and CSI. Higher values indicated better healing. Accordingly, the score for ideal early wound healing was 10. RESULTS: Thirty vertical releasing incisions were assessed in 21 patients. At 24 hours after incision, 16 vertical releasing incisions (53.33%) received the maximum score of CSR, while 6 cases (20%) received an EHS of 10. None of the cases received 0 points. CONCLUSION: The EHS system may be a useful tool for assessing early wound healing in periodontal soft tissue by primary intention after surgery.
Gingiva ; Humans ; Inflammation ; Intention ; Methods ; Periodontal Diseases ; Re-Epithelialization ; Soft Tissue Injuries ; Symptom Assessment ; Wound Healing ; Wounds and Injuries

The autogenous free gingival graft is the most predictable procedure currently used to increase the width of the attached gingiva in periodontics. But the major disadvantage of the procedure is to create the multiple surgical wounds at both a donor site and a recipient site. The other problem is the limited amount of available graft material in oral cavity. Therefore, recent researches have been focused to develop the biomaterial to substitute the autogenous gingival tissue. The purpose of this study was to evaluate the histologic healing after grafting of bilayer artificial dermis, compared to the free gingival graft. Four non-smoking subjects (mean age, 32.5 years) in systemically healthy state and good oral hygiene were selected according to their particular needs for correction of mucogingival problems as suggested by Nabers(1966). The recipient sites were prepared through the procedure for the free gingival graft and were grouped according to the graft materials: Experimental group(n=5) - bilayer artificial dermis (Terudermis(R); Terumo Co. Japan) and Control group(n=6) - free gingival graft with autogenous palatal mucosa. Biopsies were harvested at 1, 2, 3 and 6 weeks postsurgery to evaluate histologically. At the third week in the experimental group and at the second week of in the control group, the grafts has been clinically stabilized on the recipient bed and the graft border has been blended into the surrounding tissue. In the experimental group after 1 week of grafting, the epithelial migration from the adjacent tissue to graft material was seen and after 3 weeks of grafting, the : nflmmation decreased, collagen layer of the artificial dermis was lost and the basement membrane of epithelium was formed. After 6 weeks of grafting, both groups demonstrated orthokeratinized epithelium and increased thickness of epithelial tissue and the rete peg formation, similar to the adjacent tissue. Histologic evaluation revealed a biologic acceptance and incorporation of the collagen layers of the graft tissue to the host tissue, without foreign body reaction. In conclusion, a bilayer artificial dermis is essentially similar to autogeneous free gingival graft in the correction of mucogingival problems, and has the advantages of decreased patient morbidity (no donor site) and availability of abundant amounts of graft material when needed.
Basement Membrane ; Biopsy ; Collagen ; Dermis* ; Epithelium ; Foreign-Body Reaction ; Gingiva ; Humans ; Methods ; Mouth ; Mucous Membrane ; Oral Hygiene ; Periodontics ; Tissue Donors ; Transplants* ; Wounds and Injuries

PURPOSE: Mandibulotomy approach and mandible sparing approach are most common methods for oropharyngeal cancer surgery. Good surgical view and convenience of flap inset are advantages of mandibulotomy approach but deformity of mandible contour, postoperative malocclusion and radionecrosis are its limitations. To make up for the limitations, mandible sparing method is commonly performed, but limited surgical view and difficulties of flap inset are the weak points of this approach. The purpose of the study is to compare mandibulotomy and mandible sparing approaches in postoperative complications and progression of the treatment in oropharyngeal cancer operation and reconstruction. METHODS: Single reconstructive microsurgeon operated for oropharyngeal cancer patients with different surgeons of head and neck department who prefer mandibulotomy and mandible sparing approach respectively, and we compared the frequency of postoperative complication, operation time, duration of hospitalization and recurrence rate between two different surgical approaches. RESULTS: Mandibulotomy approach was used in 18 patients and mandible sparing approach was used in 15 patients. In mandibulotomy approach, there happened one case of teeth injury and one case of necrosis of skin and gingiva, but there happened no malocclusion and radionecrosis. In mandible sparing approach, there were 3 cases of fistula and 2 cases of infection which are significantly higher than mandibulotomy approach. There were no significant differences between early regional recurrence and duration of hospitalization. CONCLUSION: In this study we compared two different methods for the surgical approach in oropharyngeal cancer surgery. As mandible sparing approach has difficulties of limited surgical view, it can be used for the limited indications of anterior tongue and mouth floor cancer. Mandibulotomy approach has advantages of good surgical view and convenience of flap inset. In this method preservation of gingival tissue, watertight fashion suture, delicate osteotomy and plate fixation to maintain occlusion are the key points for the successful results.
Congenital Abnormalities ; Fistula ; Gingiva ; Head ; Hospitalization ; Humans ; Malocclusion ; Mandible ; Mouth Floor ; Neck ; Necrosis ; Oropharyngeal Neoplasms ; Osteotomy ; Postoperative Complications ; Recurrence ; Skin ; Sutures ; Tongue ; Tooth Injuries