Nityasri A, Prasad Kavitha, Deveswaran R, Ranganath K
Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, Bengaluru, 560054, India.
Drug Design and Development Centre, Faculty of Pharmacy, Ramaiah University of Applied Sciences, Bengaluru, India.
Oral Maxillofac Surg. 2025 Mar 22;29(1):72. doi: 10.1007/s10006-025-01358-y.
Diabetic patients are associated with a series of post extraction complications, such as delayed healing, greater risk of infections, persistent pain, dry socket and delayed bone formation. There is paucity of studies which indicate the influence of glycemic index and antibiotic prophylaxis in prevention of complications after minor surgical procedures. Various adjuncts such as hydrogels, curcumin and platelet gels are used in the extraction socket to augment healing, minimize complications and promote bone regeneration.
To assess the effect of hyaluronic acid gel with and without metronidazole on wound healing in post extraction sockets of diabetic patients.
A double blind randomized controlled study was conducted at FDS, RUAS, Bengaluru, India. Diabetic patients indicated for simple extraction of mandibular molars were randomly divided into two groups and prescribed oral metronidazole 1 h prior to extraction. After extraction, 1% hyaluronic acid gel was placed in the sockets of patients in Group A and Group B received 1% hyaluronic acid gel with 5% metronidazole. Soft tissue healing was assessed after one week using wound healing index and photographs of the socket with AutoCAD program. Pain was assessed by VAS. Hard tissue healing was evaluated radiologically using CBCT scans taken immediately after extraction and after one month and analyzed in the 3D slicer software. Pain was assessed by VAS, number of rescue analgesics, complications if any.
There was no statistically significant difference in hard and soft tissue healing and pain scores between the two groups. However, it was statistically significant between the two-time intervals within each group.
In patients with short term glycemic control, use of a single dose of oral metronidazole prior to extraction and placement of 1% hyaluronic acid gel in the extraction socket resulted in uneventful healing with evidence of bone formation at one month. Addition of 5% metronidazole to the gel seems to have no added advantage.
Not registered.
糖尿病患者术后会出现一系列拔牙并发症，如愈合延迟、感染风险增加、持续性疼痛、干槽症和骨形成延迟。关于血糖指数和抗生素预防对小型外科手术后并发症预防影响的研究较少。各种辅助材料如水凝胶、姜黄素和血小板凝胶被用于拔牙窝，以促进愈合、减少并发症并促进骨再生。
评估含和不含甲硝唑的透明质酸凝胶对糖尿病患者拔牙后创口愈合的影响。
在印度班加罗尔的拉吉夫甘地卫生科学大学牙科学院进行了一项双盲随机对照研究。拟行下颌磨牙简单拔牙的糖尿病患者被随机分为两组，拔牙前1小时口服甲硝唑。拔牙后，A组患者拔牙窝内放置1%透明质酸凝胶，B组患者接受含5%甲硝唑的1%透明质酸凝胶。一周后使用伤口愈合指数和通过AutoCAD程序拍摄的拔牙窝照片评估软组织愈合情况。采用视觉模拟评分法（VAS）评估疼痛程度。通过拔牙后即刻及术后1个月拍摄的锥形束计算机断层扫描（CBCT）进行放射学评估硬组织愈合情况，并在3D Slicer软件中进行分析。通过VAS评估疼痛程度、使用急救镇痛药的次数以及有无并发症。
两组在硬组织和软组织愈合及疼痛评分方面无统计学显著差异。然而，每组内两个时间间隔之间具有统计学显著性差异。
对于短期血糖控制良好的患者，拔牙前单次口服甲硝唑并在拔牙窝内放置1%透明质酸凝胶可实现顺利愈合，且术后1个月有骨形成迹象。向凝胶中添加5%甲硝唑似乎并无额外益处。
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