SCI Dental Literature – “Intelligent Protective Gel” Dental Application

Recently, the Department of Oral and Maxillofacial Surgery at the First Affiliated Hospital of Anhui Medical University published an SCI-indexed paper on the application of the thermosensitive biomaterial 'Smart Protective Gel' after impacted tooth extraction, observing its impact on postoperative complications and quality of life. Through observation of indicators such as pain, swelling, wound healing, and limited mouth opening, the study verified the clinical efficacy of 'Smart Protective Gel' and its ability to improve postoperative quality of life and patient comfort.

The impact of thermosensitive hydroxybutyl chitosan (HBC) hydrogel on postoperative complications and quality of life after mandibular third molar extraction

Objective: The aim of this study was to measure and compare the differences in pain, swelling, jaw, wound healing, and quality of life (QOL) between patients with third molar extraction and control patients.

Extraction of impacted third molars (M3s) is one of the most common surgeries in oral and maxillofacial surgery. The release of inflammatory mediators, inflammatory cells, and protein-rich exudate from the surgical wound, along with inflammation affecting the masticatory muscles, are all causes of postoperative complications such as pain, swelling, and limited mouth opening. These are also major factors affecting the postoperative quality of life (QOL) of patients.

HBC exhibits excellent temperature sensitivity; it is a flowing liquid at low temperatures and transforms into a soft gel above 20°C. HBC hydrogel possesses good hygroscopicity, moisturizing properties, anti-immunogenic activity, antibacterial ability, and good biocompatibility, tissue compatibility, and cell compatibility.

Treatment methods: All surgeries were performed in the same operating room, using the same surgical procedures, extraction instruments, and materials. The maxillofacial region and surgical area were disinfected preoperatively with 0.5% povidone-iodine solution. Anesthesia was then administered once with 2% lidocaine and 1:100,000 epinephrine solution to block the inferior sphenoid nerve, lingual nerve, and buccal nerve. All patients underwent full-thickness triangular flap closure with 4-0 absorbable sutures. Both groups received cefdinir capsules (0.1 g every 8 hours), ornidazole tablets (0.5 g every 12 hours), and acetate dexamethasone tablets (0.75 mg, 3 tablets once daily) for 3 consecutive days. Postoperative precautions and oral hygiene instructions were provided. Intraoral sutures were removed on postoperative day 7. The only difference between the two groups was that the study group underwent HBC treatment of the extraction wound surface after suturing.

result:

On postoperative days 1 and 3, the pain scores of the HBC group decreased significantly.

On the third day after surgery, there was a statistically significant difference in the degree of swelling between the two groups of patients.

The difference in oral opening degree between the first and third postoperative days was statistically significant.

On the third day after surgery, there were significant differences between the HBC group and the control group in terms of social isolation, diet, sleep, appearance and QOL.

The healing of the soft tissue on the surface of the extraction socket can be roughly divided into several stages, including hemostasis, inflammation, cell proliferation and tissue remodeling, which is an orderly, repetitive and complex biochemical reaction.

Hemoglobin (HBC) participates in all stages of wound healing. In the early stages of wound healing, HBC promotes the coagulation process. During the inflammatory phase of wound healing, HBC stimulates the proliferation of various immune cells, regulates the expression of inflammatory factors, and promotes an earlier transition from the inflammatory phase to the wound repair phase. As a primary repair material, HBC has significant advantages in maintaining wound moisture and promoting autolytic debridement. It creates a moist local environment in the wound, maintains the activity of endogenous enzymes, and thus promotes the autolysis of protein exudates. It reduces postoperative swelling through autolytic debridement and regulation of the inflammatory response caused by surgical trauma.

The results of this study indicate that HBC hydrogel dressing applied to the wound after impacted mandibular M3 tooth extraction can reduce postoperative pain and swelling, promote wound healing, improve oral opening and extraction wound healing, and improve postoperative quality of life and patient comfort.