Madrazo-Jiménez M, Rodríguez-Caballero Á, Serrera-Figallo M-Á, Garrido-Serrano R, Gutiérrez-Corrales A, Gutiérrez-Pérez J-L, Torres-Lagares D
Facultad de Odontología de Sevilla, C/ Avicena s/n 41009, Sevilla, Spain,
Med Oral Patol Oral Cir Bucal. 2016 Nov 1;21(6):e696-e702. doi: 10.4317/medoral.21281.
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.
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.
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.
The gel composed of chitosan, 0.2% chlorhexidine, allantoin and dexpanthenol did not aid in patients' postoperative comfort; however, improved wound healing was observed.
尽管人们努力预防术后不适，但下颌阻生第三磨牙手术拔除仍存在许多即时副作用。愈合是一个生理过程，通过该过程口腔黏膜完整性的丧失得以恢复，受损组织得以修复。贝西登术后凝胶（ISDIN，西班牙）是一种含有壳聚糖、0.2%洗必泰、尿囊素和泛醇的局部用凝胶。虽然这种凝胶有许多临床适应症，但尚无已发表的临床试验评估其在下颌阻生第三磨牙手术中的应用。本研究旨在临床评估一种含有壳聚糖、0.2%洗必泰、尿囊素和泛醇的凝胶对下颌阻生第三磨牙拔除术后伤口愈合以及术后副作用和并发症减少的疗效。
对总共50例双侧对称的下颌阻生第三磨牙拔除术进行了一项双盲设计研究，这些病例被随机分为对照组（CG = 25）或实验组（EG = 25）。所有患者均被告知研究目的并提供了书面同意书。所有手术均由同一位牙科医生按照标准手术方案进行。由另一位不知道所应用治疗方法的牙科医生提供随访护理。实验组每天3次向手术伤口涂抹10毫升由壳聚糖、0.2%洗必泰、尿囊素和泛醇组成的局部用凝胶，持续10天，对照组患者不涂抹任何凝胶。
就潜在的混杂变量而言，两组具有同质性。在术后肿胀和疼痛方面未发现显著结果。两组在术后期间均未出现伤口愈合不良或感染并发症。在所有记录的随访中（第7天p = 0.001，第14天p = 0.01），实验组伤口的美观外观更好。总体治疗耐受性在两组中均令人满意且相似。
由壳聚糖、0.2%洗必泰、尿囊素和泛醇组成的凝胶对患者术后舒适度没有帮助；然而，观察到伤口愈合得到改善。
