Nano Silver Effect in Rapid Wound Healing

Damascus University12 enrolled

Overview

Silver compounds have demonstrated a positive effect in most medical fields, including periodontal therapy, particularly in their nano-formulations. These nanoparticles have exhibited a significant capacity to accelerate healing and possess antibacterial and anti-inflammatory properties, in addition to their ability to mitigate pain and postoperative complications.

The objective of the current study was to evaluate tissue healing, epithelialization, postoperative pain, degree of pigmentation, and patient satisfaction following the application of a nano-silver crystal membrane compared to conventional dressing after the surgical removal of gingival melanin pigmentation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Gingival Pigmentation

Interventions

Nano Silver DressingPROCEDURE

A Nano Silver Dressing was Applied After the surgical removal of gingival melanin pigmentation

Non eugenol zinc oxide DressingPROCEDURE

A standard Non eugenol zinc oxide Dressing "Coe-PAK®" was applied after the surgical removal of gingival melanin pigmentation

Eligibility

Sex: ALLMin age: 20 YearsMax age: 40 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. Gingival Hyperpigmentation: Presence of physiological melanin pigmentation in the maxillary anterior region, categorized as Grade 3 or 4 according to the Heden Gingival Pigmentation Index. 2. Age Demographic: Patients aged 20 years or older. 3. Periodontal Health: Absence of active periodontal disease (e.g., periodontitis or gingivitis). 4. Gingival Biotype: Presence of a medium-to-thick gingival biotype. 5. Attached Gingiva: An adequate width of attached gingiva to ensure surgical stability. 6. Oral Hygiene: Demonstration of good oral hygiene with a proven ability to maintain effective plaque control throughout the study period. Exclusion Criteria: 1. Systemic Pigmentation: Presence of gingival discoloration secondary to systemic conditions or metabolic disorders. 2. Drug-Induced Pigmentation: Hyperpigmentation resulting from the administration of specific pharmacological agents. 3. Poor Oral Hygiene: Inadequate plaque control or a lack of compliance with oral self-care instructions. 4. Smoking Status: Current smokers or individuals with a recent history of tobacco use, due to its confounding effect on gingival pigmentation and wound healing. 5. Physiological Status: Pregnant or lactating women. 6. Systemic Health \& Medication: Patients with underlying systemic diseases or those receiving medications known to influence periodontal tissue integrity or inflammatory response (e.g., immunosuppressants or calcium channel blockers). 7. Periodontal Disease: Presence of active periodontitis or attachment loss.

Locations (1)

Damascus University, Faculty of Dentistry, Department of periodontology.

Damascus, Syria

Outcomes

Primary Outcomes

Wound Healing: Clinical Tissue Healing Index

The Tissue Healing Index was evaluated weekly for a total of four weeks postoperatively, according to the following five grades: * Grade 1 (Very Poor): Redness (\>50%), granulation, bleeding, and pus present. * Grade 2 (Poor): Redness (\>50%), granulation, and bleeding present; no pus. * Grade 3 (Good): Redness (\<50%), no granulation, no bleeding, and no exposed connective tissue. * Grade 4 (Very Good): Redness (\<25%), no granulation, no bleeding, and no exposed connective tissue. * Grade 5 (Excellent): Healthy pink tissue, no bleeding, and complete marginal closure.

Time frame: Measured weekly, one week postoperatively until week 4 (measured 4 times).

Epithelization: Clinical epithelialization Index

Re-epithelialization was assessed weekly for a total of four weeks postoperatively using 1% Toluidine Blue. Deep blue staining identifies denuded connective tissue, while pale blue indicates complete healing. The clinical scale is as follows: * Grade 1: No epithelial formation. * Grade 2: Partial coverage (less than 50%). * Grade 3: Substantial coverage (more than 50%). * Grade 4: Complete re-epithelialization.

Time frame: Measured weekly, one week postoperatively until week 4 (measured 4 times).

Secondary Outcomes

Pain Assessment and Analgesic Consumption

Daily postoperative pain was recorded for one week using a 100-mm Visual Analogue Scale (VAS), ranging from 0 (no pain) to 100 (unbearable). Scores were categorized as: * 1-30 mm: Mild pain. * 31-60 mm: Moderate pain. * 61-100 mm: Severe pain. Daily analgesic intake was also documented to supplement these subjective findings.

Time frame: Measured daily from day 1 till day 7 postoperatively.

Patient Satisfaction Index (PSI)

This qualitative metric categorizes the patient's subjective perception of the surgical outcome into four distinct grades. For analytical purposes, scores were dichotomized into 'Satisfied' (Grades 1-2) and 'Dissatisfied' (Grades 3-4).

Data from ClinicalTrials.gov

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