A Comparative Experimental Study Of Healing Effect Of Different Oral Wound Dresssings For Oral Ulcers
Abstract
Objectives: Wound dressings protect the wound and accelerate the healing of ulcers. This study was designed to assess the impact of distinct the impact of oral dressings for the wound healing phase of experimentally produced traumatic oral ulcers.
Materials and Methods: The study included 45 male Sprague-Dawley rats, which were randomly allocated into three groups: Group 1, Group 2 and Control Group.Two different wound dressings were applied: hyaluronic acid (Group 1) and a wound dressing composed of a combination of bioactive materials (Group 2). Tissue samples were taken in the 3rd, 7th,14th days and evaluated histopathologically. The Kruskal–Wallis test was applied to compare numerical data across groups, followed by post-hoc testing to identify intergroup differences. Categorical variables were compared using the Chi-square test.
Results: Group 1 exhibited enhanced overall efficacy, with a notable decrease in ulceration recorded on days 3, 7, and 14 in Group 2. Edema was more noticeable in Group 2 than in Group 1. Group 2 revealed superior efficacy in facilitating granulation tissue production in early phase. Both groups demonstrated enhanced migration of polymorphonuclear leukocytes and mononuclear cells to the ulcer location.
Conclusions: Both wound coverings positively affected the wound healing process by regulating distinct phases of healing.
Keywords
Ethical Statement
This study was conducted in accordance with the principles of the Declaration of Helsinki (revised 2008). Ethical approval for the experimental procedures was obtained from the Hacettepe University Animal Experiments Local Ethics Committee, under approval number (2019/08-13). All efforts were made to minimize animal suffering and the number of animals used. This study was also designed and reported in accordance with the ARRIVE guidelines to ensure transparency and reproducibility in the use of animal models.
References
- 1. Bruce AJ. Acute oral ulcers. Dermatol Clin 2003;21(1):1-15.
- 2. Horng HC, Chang WH, Yeh CC, Huang BS, Chang CP, Chen YJ, et al. Estrogen effects on wound healing. Int J Mol Sci 2017;18(11):2325.
- 3. Sveinsson SJ, Holbrook WP. Oral mucosal adhesive ointment containing liposomal corticosteroid. Int J Pharm 1993;95(1-3):105-109.
- 4. Kurtoğlu Ah, Karataş A. Current approaches to wound therapy: modern wound dressings. Ankara Ecz Fak Derg 2009;38(3):211-232.
- 5. Fraser JRE, Laurent TC, Laurent U. Hyaluronan: its nature, distribution, functions and turnover. J Intern Med 1997;242(1):27-33.
- 6. Ovington LG. Advances in wound dressings. Clin Dermatol 2007;25(1):33-38.
- 7. El Fawal GF, Abu-Serie MM, Hassan MA, Elnouby MS. Hydroxyethyl cellulose hydrogel for wound dressing: Fabrication, characterization and in vitro evaluation. Int J Biol Macromol 2018;111:649-659.
- 8. Reddy N, Yang Y. Citric acid cross-linking of starch films. Food chemistry 2010;118(3):702-711.
- 9. Azzi A, Ricciarelli R, Zingg JM. Non‐antioxidant molecular functions of α‐tocopherol (vitamin E). FEBS Lett 2002;519(1-3):8-10.
- 10. Torfs E, Brackman G. A perspective on the safety of parabens as preservatives in wound care products. Int Wound J 2021;8(2):221-232.
- 11. Toma AI, Fuller JM, Willett NJ, Goudy SL. Oral wound healing models and emerging regenerative therapies. Transl Res 2021;236:17-34.
- 12. Zhang C, Liu Y, Li W, Gao P, Xiang D, Ren X, et al. Mucoadhesive buccal film containing ornidazole and dexamethasone for oral ulcers: in vitro and in vivo studies. Pharm Dev Technol 2019;24(1):118-126.
- 13. Yu Y, Gao Y, Zeng Y, Ge W, Tang C, Xie X, et al. Multifunctional hyaluronic acid/gelatin methacryloyl core-shell microneedle for comprehensively treating oral mucosal ulcers. Int J Biol Macromol 2024;266:131221.
- 14. Polverino G, Russo F, D'Andrea F. Bioactive dressing: a new algorithm in wound healing. Clin Med 2024;13(9):2488.
- 15. Bodner L, Dayan D, Pinto Y, Hammel I. Characteristics of palatal wound healing in desalivated rats. Arch Oral Biol 1993;38(1):17-21.
- 16. Kahnberg KE, Thilander H. Healing of experimental excisional wounds in the rat palate. (I) Histological study of the interphase in wound healing after sharp dissection. Int J Oral Surg 1982;11(1):44-51.
- 17. Chamani G, Zarei MR, Mehrabani M, Mehdavinezhad A, Vahabian M, Ahmadi-Motamayel F. Evaluation of honey as a topical therapy for intraoral wound healing in rats. Wounds 2017;29(3):80-86.
- 18. Hashemipour MA, Borna R, Gandjaliphan Nassab A. Effects of mucoadhessive paste of chlorhexidine and betamethasone on oral ulcer recovery process in rats. Wounds 2013;25(4):104-112.
- 19. Cavalcante GM, Paula RJSd, Souza LPd, Sousa FB, Mota MRL, Alves APNN. Experimental model of traumatic ulcer in the cheek mucosa of rats. Acta Cir Bras 2011;26(3):227-234.
- 20. Karapınar G, Ünür M. Current approaches in recurrent aphthous stomatitis. Clin Exp Health Sci 2018;8(1):62-66.
- 21. Otan Ozden F, Ozden B, Tunga U. Tekrarlayan aftöz ülserasyonlar ve tedavisinde güncel yaklaşımlar. Cumhuriyet Dent J 2011;(11)2:118-125.
- 22. Dalessandri D, Zotti F, Laffranchi L, Migliorati M, Isola G, Bonetti S, et al. Treatment of recurrent aphthous stomatitis (RAS; aphthae; canker sores) with a barrier forming mouth rinse or topical gel formulation containing hyaluronic acid: a retrospective clinical study. BMC Oral Health 2019;19(1):153.
- 23. Mahdi A, Al-Falahi N, Nahi H. Effects of chitosan and hyaluronic acid in healing of chemically induced oral ulcer in rabbits. Kufa J Vet Sci 2016;7(2):138-150.
- 24. Hammad H, Hammad M, Abdelhadi I, Khalieh MS. Effects of topically applied agents on intra‐oral wound healing in a rat model: a clinical and histomorphometric study. Int J Dent Hyg 2011;9(1):9-16.
- 25. Bozkurt AP, Ünlü Ö, Demirci M. Comparison of microbial adhesion and biofilm formation on orthodontic wax materials; an in vitro study. J Dent Sci 2012;15(4):493-499.
- 26. Min HS, Kang DY, Lee SJ, Yun SY, Park JC, Cho IW. A clinical study on the effect of attachable periodontal wound dressing on postoperative pain and healing. J Dent Rehabil Appl Sci 2020;36(1):21-28.
- 27. Salih HM. Protection of healing socket with attachable intraoral dressing. J Duhok Univ 2022;25(1):37-42.
- 28. Taqi GAM, Hussien MA, Dawood A. The effect of Attachable intra oral wound dressing tape on post extraction dental socket. Int J Appl Dent Sci 2024;10(1):62-65.
- 29. Rodrigues PA, Paramashivaiah R, Prabhuji MLV, Azevedo RG. Optimized healing of the donor wound area with ora-aid, the miracle mix containing polymers and vitamin e: a case series. RJDS. 2022;14(1):42-46.
- 30. Haykel M, Lateef TA. The effects of intraoperative placement of tetracycline, tetracycline+ gelatin sponge, and placebo on postoperative dry socket incidence after mandibular molar extraction: (a comparative prospective study). Kufa Med Journal 2023;19(2):71-76.
- 31. Akyildiz S, Soluk-Tekkesin M, Keskin-Yalcin B, Unsal G, Yıldız Ozel S, et al. Acceleration of fracture healing in experimental model: platelet-rich fibrin or hyaluronic acid? J Craniofac Surg 2018;29(7):1794-1798.
- 32. Dönmez YZ, Akpınar A, Göze F. Effect of topical humic acid on excisional palatal wound healing: a histopathological and histomorphometric study in rats. Cumhuriyet Dent J 2022;(24)4:326-336.
- 33. Kang S, Jang EJ, Jo HM, Kang SS, Lee MS, Yun SY, et al. Effects of a topically applied oral wound dressing film on intra-oral wound healing in rabbits. In Vivo 2022;36(4):1745-1752.
- 34. Rubin R, Strayer DS, Rubin E. Rubin's pathology: clinicopathologic foundations of medicine. 6th ed. Lippincott Williams & Wilkins, Philadelphia 2012.
- 35. Şahin S, Saygun I, Kurt B, Çanakçı FC, Akyol M, Altuğ HA, et al. Lokal antimikrobiyal ajanların palatinal bölgeden alınan greft alanındaki doku defektinin iyileşmesi üzerine etkilerinin histomorfometrik yöntemle incelenmesi. Gülhane Tıp Derg 2009;51:27-33.
Farklı Oral Yara Örtülerinin Oral Ülserlerin İyileşmesi Üzerine Etkisinin Karşılaştırmalı Deneysel Çalışması
Abstract
Amaç: Yara örtüleri, yarayı koruyarak ülserlerin iyileşmesini hızlandırır. Bu çalışma, deneysel olarak oluşturulan travmatik oral ülserlerin iyileşme süreci üzerine iki farklı oral yara örtüsünün etkisini değerlendirmek ve karşılaştırmak amacıyla tasarlanmıştır.
Gereç ve Yöntemler: Toplam 45 erkek Sprague-Dawley sıçandan oluşan çalışma üç gruba ayrılmıştır: Kontrol, Grup 1 ve Grup 2. İki farklı yara örtüsü uygulanmıştır: hyaluronik asit (Grup 1) ve biyoaktif materyallerden oluşan bir kombinasyon (Grup 2). Doku örnekleri 3., 7. ve 14. günlerde alınarak histopatolojik olarak değerlendirilmiştir. Gruplar arasındaki sayısal değişkenlerin karşılaştırılmasında Kruskal-Wallis testi, ikili karşılaştırmalarda ise post-hoc testler kullanılmıştır. Kategorik değişkenler Ki-kare testi ile analiz edilmiştir.
Bulgular: Grup 1 genel olarak daha yüksek etkinlik göstermiştir; Grup 2’de ise 3., 7. ve 14. günlerde ülserasyonun belirgin şekilde azaldığı kaydedilmiştir. Ödem, Grup 2’de Grup 1’e kıyasla daha belirgin bulunmuştur. Üçüncü günde, Grup 2 granülasyon dokusu oluşumunu kolaylaştırmada daha üstün etki göstermiştir. Her iki grup da polimorfonükleer lökositler ve mononükleer hücrelerin ülser bölgesine göçünü artırmıştır.
Sonuçlar: Her iki yara örtüsü de iyileşmenin farklı evrelerini düzenleyerek oral ülserlerin iyileşme sürecini olumlu yönde etkilemiştir.
Keywords
Ethical Statement
Bu çalışma, 2008 yılında revize edilen Helsinki Bildirgesi ilkelerine uygun olarak gerçekleştirilmiştir. Deneysel işlemler için etik onay, Hacettepe Üniversitesi Hayvan Deneyleri Yerel Etik Kurulu’ndan (onay no: 2019/08-13) alınmıştır. Hayvanların acı çekmesini ve kullanılan hayvan sayısını en aza indirmek için tüm çabalar gösterilmiştir. Ayrıca, bu çalışma, hayvan modellerinin kullanımında şeffaflığı ve tekrarlanabilirliği sağlamak amacıyla ARRIVE kılavuzlarına uygun olarak tasarlanmış ve raporlanmıştır.
References
- 1. Bruce AJ. Acute oral ulcers. Dermatol Clin 2003;21(1):1-15.
- 2. Horng HC, Chang WH, Yeh CC, Huang BS, Chang CP, Chen YJ, et al. Estrogen effects on wound healing. Int J Mol Sci 2017;18(11):2325.
- 3. Sveinsson SJ, Holbrook WP. Oral mucosal adhesive ointment containing liposomal corticosteroid. Int J Pharm 1993;95(1-3):105-109.
- 4. Kurtoğlu Ah, Karataş A. Current approaches to wound therapy: modern wound dressings. Ankara Ecz Fak Derg 2009;38(3):211-232.
- 5. Fraser JRE, Laurent TC, Laurent U. Hyaluronan: its nature, distribution, functions and turnover. J Intern Med 1997;242(1):27-33.
- 6. Ovington LG. Advances in wound dressings. Clin Dermatol 2007;25(1):33-38.
- 7. El Fawal GF, Abu-Serie MM, Hassan MA, Elnouby MS. Hydroxyethyl cellulose hydrogel for wound dressing: Fabrication, characterization and in vitro evaluation. Int J Biol Macromol 2018;111:649-659.
- 8. Reddy N, Yang Y. Citric acid cross-linking of starch films. Food chemistry 2010;118(3):702-711.
- 9. Azzi A, Ricciarelli R, Zingg JM. Non‐antioxidant molecular functions of α‐tocopherol (vitamin E). FEBS Lett 2002;519(1-3):8-10.
- 10. Torfs E, Brackman G. A perspective on the safety of parabens as preservatives in wound care products. Int Wound J 2021;8(2):221-232.
- 11. Toma AI, Fuller JM, Willett NJ, Goudy SL. Oral wound healing models and emerging regenerative therapies. Transl Res 2021;236:17-34.
- 12. Zhang C, Liu Y, Li W, Gao P, Xiang D, Ren X, et al. Mucoadhesive buccal film containing ornidazole and dexamethasone for oral ulcers: in vitro and in vivo studies. Pharm Dev Technol 2019;24(1):118-126.
- 13. Yu Y, Gao Y, Zeng Y, Ge W, Tang C, Xie X, et al. Multifunctional hyaluronic acid/gelatin methacryloyl core-shell microneedle for comprehensively treating oral mucosal ulcers. Int J Biol Macromol 2024;266:131221.
- 14. Polverino G, Russo F, D'Andrea F. Bioactive dressing: a new algorithm in wound healing. Clin Med 2024;13(9):2488.
- 15. Bodner L, Dayan D, Pinto Y, Hammel I. Characteristics of palatal wound healing in desalivated rats. Arch Oral Biol 1993;38(1):17-21.
- 16. Kahnberg KE, Thilander H. Healing of experimental excisional wounds in the rat palate. (I) Histological study of the interphase in wound healing after sharp dissection. Int J Oral Surg 1982;11(1):44-51.
- 17. Chamani G, Zarei MR, Mehrabani M, Mehdavinezhad A, Vahabian M, Ahmadi-Motamayel F. Evaluation of honey as a topical therapy for intraoral wound healing in rats. Wounds 2017;29(3):80-86.
- 18. Hashemipour MA, Borna R, Gandjaliphan Nassab A. Effects of mucoadhessive paste of chlorhexidine and betamethasone on oral ulcer recovery process in rats. Wounds 2013;25(4):104-112.
- 19. Cavalcante GM, Paula RJSd, Souza LPd, Sousa FB, Mota MRL, Alves APNN. Experimental model of traumatic ulcer in the cheek mucosa of rats. Acta Cir Bras 2011;26(3):227-234.
- 20. Karapınar G, Ünür M. Current approaches in recurrent aphthous stomatitis. Clin Exp Health Sci 2018;8(1):62-66.
- 21. Otan Ozden F, Ozden B, Tunga U. Tekrarlayan aftöz ülserasyonlar ve tedavisinde güncel yaklaşımlar. Cumhuriyet Dent J 2011;(11)2:118-125.
- 22. Dalessandri D, Zotti F, Laffranchi L, Migliorati M, Isola G, Bonetti S, et al. Treatment of recurrent aphthous stomatitis (RAS; aphthae; canker sores) with a barrier forming mouth rinse or topical gel formulation containing hyaluronic acid: a retrospective clinical study. BMC Oral Health 2019;19(1):153.
- 23. Mahdi A, Al-Falahi N, Nahi H. Effects of chitosan and hyaluronic acid in healing of chemically induced oral ulcer in rabbits. Kufa J Vet Sci 2016;7(2):138-150.
- 24. Hammad H, Hammad M, Abdelhadi I, Khalieh MS. Effects of topically applied agents on intra‐oral wound healing in a rat model: a clinical and histomorphometric study. Int J Dent Hyg 2011;9(1):9-16.
- 25. Bozkurt AP, Ünlü Ö, Demirci M. Comparison of microbial adhesion and biofilm formation on orthodontic wax materials; an in vitro study. J Dent Sci 2012;15(4):493-499.
- 26. Min HS, Kang DY, Lee SJ, Yun SY, Park JC, Cho IW. A clinical study on the effect of attachable periodontal wound dressing on postoperative pain and healing. J Dent Rehabil Appl Sci 2020;36(1):21-28.
- 27. Salih HM. Protection of healing socket with attachable intraoral dressing. J Duhok Univ 2022;25(1):37-42.
- 28. Taqi GAM, Hussien MA, Dawood A. The effect of Attachable intra oral wound dressing tape on post extraction dental socket. Int J Appl Dent Sci 2024;10(1):62-65.
- 29. Rodrigues PA, Paramashivaiah R, Prabhuji MLV, Azevedo RG. Optimized healing of the donor wound area with ora-aid, the miracle mix containing polymers and vitamin e: a case series. RJDS. 2022;14(1):42-46.
- 30. Haykel M, Lateef TA. The effects of intraoperative placement of tetracycline, tetracycline+ gelatin sponge, and placebo on postoperative dry socket incidence after mandibular molar extraction: (a comparative prospective study). Kufa Med Journal 2023;19(2):71-76.
- 31. Akyildiz S, Soluk-Tekkesin M, Keskin-Yalcin B, Unsal G, Yıldız Ozel S, et al. Acceleration of fracture healing in experimental model: platelet-rich fibrin or hyaluronic acid? J Craniofac Surg 2018;29(7):1794-1798.
- 32. Dönmez YZ, Akpınar A, Göze F. Effect of topical humic acid on excisional palatal wound healing: a histopathological and histomorphometric study in rats. Cumhuriyet Dent J 2022;(24)4:326-336.
- 33. Kang S, Jang EJ, Jo HM, Kang SS, Lee MS, Yun SY, et al. Effects of a topically applied oral wound dressing film on intra-oral wound healing in rabbits. In Vivo 2022;36(4):1745-1752.
- 34. Rubin R, Strayer DS, Rubin E. Rubin's pathology: clinicopathologic foundations of medicine. 6th ed. Lippincott Williams & Wilkins, Philadelphia 2012.
- 35. Şahin S, Saygun I, Kurt B, Çanakçı FC, Akyol M, Altuğ HA, et al. Lokal antimikrobiyal ajanların palatinal bölgeden alınan greft alanındaki doku defektinin iyileşmesi üzerine etkilerinin histomorfometrik yöntemle incelenmesi. Gülhane Tıp Derg 2009;51:27-33.
Details
| Primary Language | English |
|---|---|
| Subjects | Oral and Maxillofacial Radiology, Oral Medicine and Pathology |
| Journal Section | Research Article |
| Authors | |
| Submission Date | October 2, 2025 |
| Acceptance Date | January 10, 2026 |
| Publication Date | March 27, 2026 |
| DOI | https://doi.org/10.7126/cumudj.1795824 |
| IZ | https://izlik.org/JA77UB99MD |
| Published in Issue | Year 2026 Volume: 29 Issue: 1 |
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