Role of turmeric in management of alveolar osteitis (dry socket): A randomised clinical study

Development of nanofibrous scaffolds containing polylactic acid modified with turmeric and hydroxyapatite/vivianite nanoparticles for wound dressing applications

Damaging the outer layer of the body (the skin) has been a common issue for decades. Fabrication of nanofibrous membranes via the electrospinning technique for the sake of making the wound healing process more facile has caught a lot of interest. For this purpose, a polymeric scaffold of polylactic acid (PLA) was doped with nanoparticles with different concentrations of turmeric/hydroxyapatite/vivianite/graphene oxide. The obtained membrane was tested by XRD, SEM, FTIR, and XPS. The surface topography of the scaffold has experienced changes upon adding different concentrations of the nanoparticles. The contact angle was measured by water droplets. It accentuated change in CA starting from 43.9o for pure condition of PLA to 67.7o for PLA/turmeric/vivianite. The thermogravimetric analysis (TGA) test stated that the PLA scaffold features are thermally stable in relatively high-temperature conditions initiating from room temperature to about 300 °C, meeting the maximum loss in mass of about 5 %. The cell viability was carried out in prepared vitro for the sample which contains PLA/turmeric/vivianite/GO, it was elucidated that the IC50 was around 3060 μg/ml.

Efficacy of topical curcuma longa in the healing of extraction sockets: A split-mouth clinical trial

Background

The healing process after dental extraction is influenced by various factors, and finding effective strategies for promoting wound healing and reducing postoperative discomfort remains a challenge. This study aimed to evaluate the effectiveness of topical Curcuma longa gel in reducing pain and promoting wound healing after dental extraction, with the secondary objective of assessing the occurrence of dry sockets. The study was a split-mouth randomized controlled trial conducted at the oral and maxillofacial surgery department over 3 months.

Materials and Methods

This split-mouth randomized controlled trial consisted of a total of 21 patients undergoing bilateral extractions. One extraction socket was randomly assigned to the test group, where Curcuma. longa gel was applied, while the contralateral socket served as the control group, receiving a placebo. Pain and wound healing were evaluated using standardized scales on the 3rd and 7th days postextraction. Descriptive statistics, paired t-tests, and unpaired t-tests were performed using the SPSS software version 19. The statistical significance was fixed at P ≤ 0.05.

Results

The test group showed significantly higher mean healing scores on the 3rd and 7th days compared to the control group. On the 7th day, the test group had significantly lower mean pain scores than the control group. No cases of dry sockets were observed in either group.

Conclusion

Topical Curcuma longa gel demonstrated positive effects in promoting wound healing and reducing pain after dental extraction. Clinicians should consider the use of Curcuma longa gel as a post-extraction medicament, particularly in cases involving multiple or traumatic extractions.

Evaluation of healing in mandibular molar extraction sockets with and without turmeric gel

Context

In the present era of allopathic medication usage, there is always a risk of toxicity. Turmeric is a wonderful natural herb with excellent healing properties and a plethora of many clinical trials in dentistry. Hence, this study aims to evaluate the efficacy of healing in mandibular molar extraction sockets with and without turmeric gel.

Aim

This study aimed to evaluate the efficacy of turmeric gel with the objective of analyzing the soft tissue healing in mandibular molar extraction sockets with and without turmeric gel.

Settings and Design

The split-mouth study design with randomization of the sites was done using the sequentially numbered opaque sealed envelope (SNOSE) in the same patient indicated for bilateral lower molar extraction. A total of 50 patients were included in the study, who were divided into group A, 25 patients in the experimental site using turmeric gel, and group B, 25 patients in the control site without turmeric gel.

Materials and Methods

Turmeric in the form of gel was used in the experimental site to evaluate its efficacy in soft tissue healing of the mandibular molar extraction socket. The extraction sites of the same patient were evaluated for soft tissue healing on postoperative day 1, day 7, and day 21 using Landry, Turn Bell, and Howley scale.

Statistical Analysis

A comparison of soft tissue healing between group A and group B, which showed a consequential difference in group A on day 7 with P = 0.001 and day 21 with P = 0.001, was significant.

Results

Results revealed postoperative day 1 showed a significant beginning of healthy granulation tissue formation in both the groups. There was a consequential difference in soft tissue healing in group A on postoperative day 7 and day 21 as compared to group B. The turmeric in the form of gel proved to enhance the soft tissue healing in the mandibular molar extraction socket.

Conclusions

The present study revealed that enhanced soft tissue healing of the extraction socket of the mandibular molar was present in the turmeric gel group on postoperative day 7 and day 21 than in without the turmeric gel group.

Comparative Clinical Study of the Effect of Nigella Sativa Oil on Soft Tissue Healing and Inflammation Reduction Compared to Eugenol in the Context of Dry Socket

Research background Dry socket is one of the most common complications occurring after the extraction of a permanent tooth, but despite its high incidence, there is no established treatment for this condition. Nigella sativa oil has anti-inflammatory properties and enhances wound healing. Thus, we have decided to conduct a study to evaluate the efficacy of Nigella sativa oil in the context of dry sockets.  Aim of the study This study aims to evaluate the effect of a Nigella Sativa oil dressing compared with an Eugenol dressing for the treatment of dry sockets in terms of accelerating soft tissue healing and reducing the intensity of inflammation.  Materials and methods A total of 36 patients (19 males, 17 females), ranging between 20 and 50 years, 40 sockets with Alveolar osteitis randomized into 20 sockets for each group. In the first group, Eugenol with a Gelfoam carrier was used, in the second group, Nigella Sativa oil with a Gelfoam carrier was used and after copious irrigation with normal saline in both groups. Soft tissue healing and the degree of inflammation were monitored on the third (T1) and seventh (T2) days.  Results The results of our study showed clinical and statistical superiority in favor of the Nigella Sativa oil group compared to the Eugenol group at time T2, where the P-value was less than 0.05.  Conclusions Within the limits of our study, we found that Nigella Sativa oil led to better healing of soft tissues and reduced the intensity of inflammation in the context of dry socket, and was superior in effectiveness to Eugenol, and we recommend its use for the treatment of dry socket.

Applications of Hydrogels in Drug Delivery for Oral and Maxillofacial Diseases

Oral and maxillofacial diseases have an important impact on local function, facial appearance, and general health. As a multifunctional platform, hydrogels are widely used in the biomedical field due to their excellent physicochemical properties. In recent years, a large number of studies have been conducted to adapt hydrogels to the complex oral and maxillofacial environment by modulating their pore size, swelling, degradability, stimulus-response properties, etc. Meanwhile, many studies have attempted to use hydrogels as drug delivery carriers to load drugs, cytokines, and stem cells for antibacterial, anticancer, and tissue regeneration applications in oral and maxillofacial regions. This paper reviews the application and research progress of hydrogel-based drug delivery systems in the treatment of oral and maxillofacial diseases such as caries, endodontic diseases, periodontal diseases, maxillofacial bone diseases, mucosal diseases, oral cancer, etc. The characteristics and applications of hydrogels and drug-delivery systems employed for the treatment of different diseases are discussed in order to provide a reference for further research on hydrogel drug-delivery systems in the future.

The efficacy of minocycline hydrochloride ointment versus iodoform gauze for alveolar osteitis: A prospective cohort study

Background

Alveolar osteitis (AO) is one of the most commonly encountered complication following tooth extraction, however, to date there is no standard methods of prevention and treatment. The study aims to investigate the efficiency of minocycline hydrochloride ointment (MHO) for the treatment of alveolar osteitis compared with traditional treatment with iodoform gauze (IG).

Methods/design

STROBE checklist was followed to report this study. All patients underwent tooth extraction either in our department or other hospitals, whom presented with postoperative pain, were screened out to meet the inclusion and exclusion criteria of this study about AO. Patients who fulfilled the inclusion criteria were enrolled in our prospective cohort study, and MHO or IG was administered. The Visual analog scale scores were used to assess the pain score of patients. The healing status of the extraction sockets was followed up. Differences in responses between groups were analyzed using Mann-Whitney U tests. Chi-square test was performed to explore the differences in the teeth position of AO.

Results

Of 41,371 patients underwent tooth extraction with post-operative follow-up in our departments, only 20 patients (0.05%) suffered from AO. 31 patients with AO, whose teeth were extracted in other places, were also enrolled. The incidence of AO was significantly higher in third molars than other teeth (P < 0.01). In 28 patients that were treated with MHO, the pain was relieved substantially on day 3 and almost painless on day 7. And only 25% of cases required dressing change more than once. Whilst 23 patients treated with IG, the pain was relieved on day 5, and 56.5% of cases required multiple dressing change. The difference between the two groups of VAS scores had statistical significance during treatment at 8 h, 24 h, 3d, 5d, and 7d. No allergic reaction or further infection occurred.

Conclusion

MHO has a safer and higher therapeutic effect in the treatment of AO compared with traditional treatment with IG. MHO may become a preferred treatment modality for AO.

Supplementary information

The online version contains supplementary material available at 10.1186/s12903-022-02468-9.

Effectiveness of Curcumin in Reducing Self-Rated Pain-Levels in the Orofacial Region: A Systematic Review of Randomized-Controlled Trials

The aim was to systematically review randomized controlled trials (RCTs) that assessed the effectiveness of curcumin in reducing self-rated pain levels in the orofacial region (OFR). The addressed focused question was “Is curcumin effective in reducing self-rated pain levels in the OFR?”. Indexed databases (PubMed (National Library of Medicine), Scopus, EMBASE, MEDLINE (OVID), and Web of Science) were searched up to and including February 2022 using different keywords. The inclusion criteria were (a) original studies (RCTs) in indexed databases; and (b) studies assessing the role of curcumin in the management of pain in the OFR. The risk of bias was assessed using the Cochrane risk of bias tool. The pattern of the present systematic review was customized to primarily summarize the pertinent information. Nineteen RCTs were included. Results from 79% of the studies reported that curcumin exhibits analgesic properties and is effective in reducing self-rated pain associated with the OFR. Three studies had a low risk of bias, while nine and seven studies had a moderate and high risk of bias, respectively. Curcumin can be used as an alternative to conventional therapies in alleviating pain in the OFR. However, due to the limitations and risk of bias in the aforementioned studies, more high-quality RCTs are needed.

Controlled release of silibinin in GelMA hydrogels inhibits inflammation by inducing M2-type macrophage polarization and promotes vascularization in vitro

A dry socket is one of the most common complications after tooth extraction. The main etiologies are the loss of blood clots in the socket and the inflammation reaction caused by infection. Current studies on how to prevent dry sockets could not solve these two etiologies at the same time. Recent studies have demonstrated the anti-inflammation role of silibinin. In this study, silibinin was engineered into GelMA hydrogels (Sil-GelMA) with a concentration of 30 mM. The surface characteristics were observed by scanning electron microscopy and the successful loading of silibinin was detected by FTIR spectrometry. The Sil-GelMA hydrogels presented the sustained release ability of silibinin and slow degradation performance of GelMA. Furthermore, silibinin inhibited the inflammatory reaction by inducing M2-type macrophage polarization, promoting the secretion of anti-inflammatory factors (CD206, IL-10) and inhibiting the secretion of anti-inflammatory factors (IL-1β, iNOS). Silibinin also increased the secretion of vascularization-related factor VEGF and promoted vascularization in vitro. This study suggested that the Sil-GelMA hydrogels not only had an anti-inflammatory effect, but also had the potential to promote vascularization. Based on these results, the Sil-GelMA hydrogels might provide a promising prospect for prevention of dry sockets in the future.

Pain Relief and Antimicrobial Activity in Alveolar Osteitis after Platelet-Rich Fibrin Application—A Non-Randomized Controlled Study

The objective was to compare pain relief in alveolar osteitis achieved by the application of platelet-rich fibrin (PRF) and aspirin cones, and to assess the influence of both treatments on bacterial concentrations in post-extraction wounds. A split-mouth, single-center, non-randomized controlled trial was conducted in 30 patients. Pain relief was assessed using the visual analog scale at three time points (before, 24 h after, and 48 h after intervention). Bacterial concentrations were evaluated from cultures of swab samples collected at the three time points. A Wilcoxon matched-pairs signed-rank test was performed to detect differences in distributions of scalar variables between treatment with PRF and aspirin cones. Pain relief at 24 h and 48 h after treatment was significantly higher (p = 0.003) with PRF application than with aspirin cone placement. Additionally, PRF application caused a significantly higher reduction in aerobic bacteria concentration, an average increase, instead of a decrease, in lactic acid bacilli concentration in the first 24 h, and a significantly greater increase in streptococci concentration at 48 h follow-up. PRF provides better pain relief than aspirin cones in alveolar osteitis. Bacterial concentrations in the extraction wounds are consistent with the pain relief achieved after PRF or aspirin application.

Clinical management of alveolar osteitis. A systematic review

Background

Alveolar Osteitis (AO) is one of the most common complications of tooth extraction. Several therapeutic interventions have been described for the treatment of AO, however, there are no treatment standardized protocols. The aim of this study was to conduct a systematic review on the efficacy in pain control of the different treatments for AO. The feasibility of the application of these interventions is also discussed.

Material and Methods

A structured electronic and hand search strategy was applied to PubMed, Scopus, Cochrane Library, OpenGrey, and Google Scholar between January 2010 and July 2020 to identify studies according to PRISMA guidelines. The inclusion criteria were original English and Spanish clinical trials that analyzed pain-control parameters according to visual analog scale (VAS, 0-10 scale), or pain relief patients’ percentages. Those treatments that reach VAS ≤ 4 on day 2 or before; or ≥ 85% of patients with absence of pain symptoms at day 7 or before were considered accepTable for their recommendation.

Results

The final review included 17 clinical trials. Among them, there were analyzed a total of 39 different AO treatments. 53,8% of the treatments fulfill the proposed parameters for pain control.

Conclusions

Treatment alternatives are multiple, heterogeneous, and difficult to compare. The management of AO is summarized in basic (intra-alveolar irrigation) and specific procedures (Alveogyl®, Neocones®, SaliCept Patch®, Low-Level Laser, Platelet-Rich Fibrin) that reach pain control success. They could be selected according to their availability and advantages or disadvantages.

Key words:Dry socket, alveolar osteitis, treatment, management, pain control, pain relief.

A Comparative Clinical Study between Concentrated Growth Factor and Low-Level Laser Therapy in the Management of Dry Socket

OBJECTIVE

 A dry socket is a well-recognized complication of wound healing following tooth extraction. Its etiology is poorly understood and commonly occur among healthy patients. As such, management strategies for dry socket has always been empirical rather than scientific with varying outcome. The aim of this study is to investigate the efficacy of concentrated growth factor (CGF) and low-level laser therapy (LLLT) and compared them to the conventional treatment in the management of dry socket.

MATERIALS AND METHODS

 Sixty patients with one dry socket each, at University Dental Hospital Sharjah, were divided into three treatment groups based on their choice. In group I (n = 30), conventional treatment comprising of gentle socket curettage and saline irrigation was done. Group II (n = 15) dry sockets were treated with CGF and group III (n = 15) sockets were lased with LLLT. All dry socket patients were seen at day 0 for treatment and subsequently followed-up at 4, 7, 14, and 21 days. Pain score, perisocket inflammation, perisocket tenderness, and amount of granulation tissue formation were noted.

STATISTICAL ANALYSIS

 Data were analyzed as mean values for each treatment group. Comparisons were made for statistical analysis within the group and among the three groups to rank the efficacy of treatment using one-way analysis of variance (ANOVA). Statistically significant difference is kept at p < 0.05.

RESULTS

 Conventional treatment group I took more than 7 days to match the healing phase of group II CGF treated socket and group III LLLT irradiated socket (p = 0.001). When healing rate between CGF and LLLT are compared, LLLT group III showed a delay of 4 days compared with CGF in granulation tissue formation and pain control.

CONCLUSION

 CGF treated socket was superior to LLLT in its ability to generate 75% granulation tissue and eliminate pain symptom by day 7 (p = 0.001).

Management of dry socket with low-level laser therapy

OBJECTIVE

The aim of this study is to investigate the efficacy of delivering low-level laser therapy (LLLT) in the management of dry socket at University Dental Hospital Sharjah.

MATERIALS AND METHOD

Forty-five patients with dry socket were divided into two treatment groups. Group I dry socket patients (n = 30) received conventional treatment while group II patients (n = 15) were irradiated with LLLT at a setting of 200-mW, 6-J, continuous-wave mode using an R02 tipless handpiece (Fotona Er:YAG, Europe), on the buccal, lingual, and middle surfaces of the socket for 30 s from a delivery distance of 1 cm. Pain score and quantification of granulation tissue in the socket were recorded at 0, 4, and 7 days post-dry socket treatment.

RESULTS

Results showed that the LLLT-irradiated group II sockets showed a much lower VAS pain score of 1-2 as early as day 4, and a richer amount of granulation tissue compared to the conventional treated group I socket. The amount and rate of granulation tissue formation in the dry socket are inversely proportional to the pain score showing significant clinical effectiveness of LLLT on promoting the healing of the dry socket, with improvement in symptoms (P = .001). Conventionally treated dry sockets take at least 7 days to match the effective healing of an LLLT-irradiated dry socket.

CONCLUSION

LLLT irradiation influences biomodulation of dry socket healing by dampening inflammation, promoting vascularization, stimulating granulation, and controlling pain symptoms.

CLINICAL RELEVANCE

LLLT may be an additional effective tool for managing dry sockets in general dental practice.

The Efficacy of Concentrated Growth Factor in the Healing of Alveolar Osteitis: A Clinical Study

Background

A dry socket also referred to as alveolar osteitis (AO) is a common postoperative complication following tooth extraction, due to the disruption of the clot within the wound. This study aimed to evaluate the efficacy of concentrated growth factor (CGF) in the healing of alveolar osteitis following tooth extraction.

Methods

The study was conducted at University Dental Hospital Sharjah, UAE. Patients undergoing tooth extraction at the oral surgery clinic were advised to return immediately if they suffer from pain. Over the following first week after tooth extraction, patients who reported pain symptoms were recalled and all dry sockets were identified. The patients were divided into two groups. Group I patients received conventional treatment with socket curettage and saline irrigation only, while in group II CGF was inserted into the socket. Both groups were observed for pain score and quantification of granulation tissue formation.

Results

A total of 40 dry socket patients, aged between 18 and 60 years, from a total of 1,250 patients, were included in the study. 30 patients were given conventional treatment while another 10 patients were given CGF. Patients who received CGF had a pain score of 7-10 at presentation, and the pain score dropped to 0-3 on day 4 and further improved to 0-1 on day 7 (p = 0.001). Granulation tissue formation appeared in the conventional group I on day 7 while the CGF group II showed earlier granulation tissue formation by day 4 (p = 0.001). The posttreatment pain score is inversely proportional to the amount and rate of granulation tissue formation in the socket.

Conclusion

The study suggests that delivery of CGF into a dry socket helps relieve pain and expedite the wound healing process as shown by a statistically much lower pain score and earlier and more rapid formation of granulation tissue when compared to the conventional alveolar osteitis therapy.

In the Back Drop of Overuse of Synthetic Drugs, can Botanicals be One of the Answers: A Pilot Study on the Medicinal Use of Chlorophytum and Curcuma by Tribals of Central India

Background:

In several recent surveys, it has been found that more people suffer because of over and indiscriminate use of synthetic drugs, chemicals and antibiotics, particularly with regard to issues like drug sensitivity, resistance, immune disturbances, and economic burdens, ultimately leading to a weak prognosis of a large number of diseases, eventually defeating the purpose of medicinal efficacy. We propose the old age use of scientifically validated natural compounds of plants and their products for a strong immune system along with a successful treatment regimen which can be effective as well as safe without side effects.

Objective:

The aim of the present work is to evaluate the various medicinal uses and applicability of Chlorophytum borivilianum, Chlorophytum tuberosum and Curcuma longa as natural plant-based ingredients by tribal communities.

Methods:

A survey was carried on the rural folks who used natural botanicals for alleviating their several common disorders successfully. Chlorophytum species of Liliaceae and Curcuma of Zingiberaceae are traditional rare Indian medicinal herbs widely used in the indigenous system of medicine since ancient time. A total number of 196 individuals were interviewed which included both men and women, in which the main objective was to explore the different forms of these medicinal plant species used with water or with milk by tribal folk for their wide range of common ailments such as pain in joints, loss of appetite, cold, sore throat, fever and general weakness.

Results:

The tribal people were found to use these plants for many of their problems such as physical weakness, natal and postnatal problems, lactation problems, cold and fever, sore throat, inflammation, joint pain, etc. Many of them (60-80%) were able to overcome their varied health problems to a great extent such as inflammation (69.4%), joint pain and arthritis (66.6%), sore throat and cold (87.5%), physical weakness (66%), natal and postnatal problems (75%).

Conclusion:

The findings strongly support the use of natural compounds for a safe and effective means of treating loss of appetite, general weakness, pain of the joints, inflammation and other related ailments by the people of tribal areas of Border States of MP and Maharashtra, having little access to modern health care facilities.

Efficacy of plasma rich in growth factor used for dry socket management: a systematic review

Background

The main aim of this systematic review was to assess the dry socket management using plasma rich in growth factor (PRGF) in terms of pain relief, alveolar fossa healing, inflammation, the incidence of dry socket.

Material and Methods

PubMed, Cochrane Library, Elsevier Science Direct, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI) and VIP database were searched for the related articles without language limitation. Two reviewers independently searched and evaluated relevant studies. This review has been registered in the website PROSPERO (CRD42018087252).

Results

28 articles were retrieved on PubMed and 98 on other electronic databases in the initial search. In the end, 4 randomized controlled trials (RCTs) were included, with a total of 139 patients enrolled. The descriptive results indicated that the use of PRGF may help reduce pain and inflammation after tooth extraction. To some extent, it is beneficial to the management of dry socket after extraction.

Conclusions

Quality assessment indicated all the included studies were judged to be at high risk of bias with low quality. Hence, it was impossible to make a recommendation for clinical use of PRGF based on the current evidence. Clearly, a multicenter clinical randomized controlled trial is needed urgent to evaluate the safety and efficacy of PRGF for dry socket management.

Key words:plasma rich in growth factor, PRGF, dry socket, systematic review.