Oral flurbiprofen spray for mucosal graft harvesting at the palatal area: A randomized placebo‐controlled study

İşler, Sıla Çağrı; Eraydin, Nihal; Akkale, Habibe; Özdemir, Burcu

doi:10.1002/jper.17-0381

Cited by 17 publications

(21 citation statements)

References 47 publications

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“…Limited donor tissue in the cases where inadequate amount of palatal tissue thickness and/or a bigger dimension of CTG is needed, as in the treatment of MAGRs, is claimed to be among those disadvantages (Zucchelli et al., 2010). Moreover, subepithelial CTG (SCTG), either harvested by “trap‐door” (TD) (Bruno, 1994; Harris, 1997) or “single‐incision” (SI) approaches (Hurzeler & Weng, 1999; Lorenzana & Allen, 2000), has been frequently associated with postoperative pain and discomfort, as well as palatal flap necrosis/dehiscence at the donor site (Del Pizzo et al., 2002; Griffin et al., 2006; Wessel & Tatakis, 2008; Zucchelli et al., 2010; Gobbato et al., 2016; Isler et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

De‐epithelialized gingival graft versus subepithelial connective tissue graft in the treatment of multiple adjacent gingival recessions using the tunnel technique: 1‐year results of a randomized clinical trial

Bakhishov

İşler

Bozyel

et al. 2021

J Clinic Periodontology

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Aim To compare the clinical efficacy and postoperative morbidity of de‐epithelialized gingival graft (DGG) with subepithelial connective tissue graft (SCTG) on treatment of multiple adjacent gingival recessions (MAGRs) with tunnel technique (TUN) and to evaluate histological characteristics of the palatal grafts. Materials and methods Twenty‐seven patients with MAGRs affecting at least 2 adjacent teeth were treated with either DGG + TUN or SCTG + TUN. Recession depth(RD) and width(RW), probing depth(PD), clinical attachment level(CAL), keratinized tissue height(KTH), gingival thickness(GT), and complete and mean root coverage(CRC, MRC) were evaluated at 6 and 12 months postoperatively. Multilevel analysis was performed to identify patient‐ and tooth/site‐related predictors for the 12‐month MRC outcomes. Postoperative patient morbidity and histological characteristics of palatal graft samples obtained during harvesting were investigated. Results At the 12‐month follow‐up, MRC was 91.72% ± 16.59% and 84.72% ± 19.72% in DGG + TUN and SCTG + TUN groups (p = .001). Multilevel regression analysis identified RD, KTH and GT as variables associated with MRC. No significant difference between the groups was observed regarding postoperative patient morbidity parameters. Cellularity was found significantly higher in the SCTG samples compared to the DGG samples (p < .05). Conclusions Although DGG + TUN presented higher MRC and CRC compared to SCTG + TUN in the treatment of MAGRs, treatment method was not a significant predictive factor for the amount of MRC outcomes while RD, KTH and GT were significant predictive factors.

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Section: Introductionmentioning

confidence: 99%

De‐epithelialized gingival graft versus subepithelial connective tissue graft in the treatment of multiple adjacent gingival recessions using the tunnel technique: 1‐year results of a randomized clinical trial

Bakhishov

İşler

Bozyel

et al. 2021

J Clinic Periodontology

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“…There were additional studies ( n = 3) retrieved from the electronic search which reported haemorrhagic events with flurbiprofen (in formulations synonymous with oromucosal spray/lozenge) but at a low dose other than 8.75 mg ( Türk et al, 2018 ; Isler et al, 2018 ; Dionne et al, 2004 ). These did not fulfil the eligibility criteria for the systematic review.…”

Section: Resultsmentioning

confidence: 99%

“…Where additional haemorrhagic events were identified with low doses of flurbiprofen, these were observed in patients undergoing oral surgery (e.g., tonsillectomy, palatal graft harvesting surgery, mandibular extraction) ( Türk et al, 2018 ; Isler et al, 2018 ; Dionne et al, 2004 ). Bleeding events were described as post-operative haemorrhage or delayed bleeding.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Flurbiprofen 8.75 mg Dose and Risk of Haemorrhagic Events

et al. 2021

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Oral non-steroidal anti-inflammatory drugs (NSAIDs) are known to be associated with an increased risk of bleeding. The NSAID, flurbiprofen, in the form of 8.75 mg lozenge or oromucosal spray is indicated for the symptomatic relief of sore throat. Despite the low dose as compared to alternative flurbiprofen preparations, concerns have been raised regarding its safety in terms of haemorrhagic events. This systematic review was conducted to identify existing evidence on the risk of haemorrhagic events with flurbiprofen 8.75 mg dose (any formulation), particularly where this may be due to potential interactions with other medicinal products. The systematic review examined studies reporting haemorrhagic events in patients receiving flurbiprofen 8.75 mg dose. Six individual electronic databases were searched up to 28th April 2020. Records were initially screened for relevance followed by further review of potentially eligible studies. Data extraction was performed for eligible studies and risk of bias in studies was assessed. The search strategy identified 1093 individual records. Of these, 1038 records were excluded after initial review; the majority of these records related to flurbiprofen in alternative formulations with alternative doses (e.g., eye drops, skin patches, oral tablets) thus were not considered relevant for further review. The 55 remaining records related to flurbiprofen 8.75 mg dose (any formulation) or flurbiprofen lozenge/oromucosal spray where the dose was not specified. After further review, 52 of these records were not considered eligible. Thus, only three records were included in this systematic review. The three studies reported a total of five haemorrhagic events in patients taking flurbiprofen 8.75 mg lozenge; the corresponding risk in each of the studies was 8.33, 1.98 and 1.96%. Where possible, comparison of flurbiprofen 8.75 mg lozenge to placebo produced risk ratios of 0.96 (95% CI 0.07, 13.25) and 2.00 (95% CI 0.10, 118.0). This systematic review found limited evidence on the risk of haemorrhagic events with flurbiprofen when used at a dose of 8.75 mg. Counts were low across all studies and results comparing flurbiprofen and placebo treatment arms were non-significant. However, scarcity of studies and low certainty of evidence for the outcome of haemorrhagic events limits the conclusions of this systematic review.

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“…Mucogingival tissue deformities are a group of conditions characterised by inadequate thickness of keratinised gingival tissue, which could result in gingival recession, unsatisfactory aesthetics, and poor chewing function [31][32][33][34][35]. Previous studies have demonstrated that an autogenous palatal mucosal graft was the most predictable grafting material to facilitate keratinised gingival repair [36]. However, this approach could lead to secondary damage in the donor site and other drawbacks.…”

Section: Discussionmentioning

confidence: 99%

Concentrated growth factor promotes gingival regeneration through the AKT/Wnt/β-catenin and YAP signaling pathways

Liu

et al. 2020

Artificial Cells, Nanomedicine, and Biotechnology

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Although concentrated growth factor (CGF) is known to promote gingival regeneration and improve the outcomes of clinical treatment, the mechanisms underlying its effects remain unknown. Therefore, this study aimed to elucidate the effects of CGF on gingival thickening. To this end, gingival mesenchymal stem cells (GMSCs) were treated with different concentrations of CGF, and the effects of CGF on cell proliferation and migration; collagen-1 (Col-1), fibronectin (FN), vascular endothelial growth factor (VEGF), and angiopoietin-1 (Ang-1) expression; and the AKT, Wnt/b-catenin, and Yes-associated protein (YAP) signalling pathways were investigated. The effects of CGF in vivo were also investigated in a rat buccal gingival injection model. GMSCs cultured with CGF showed improved cell proliferation and migration. Moreover, CGF treatment improved the levels of FN, Col-1, VEGF, and ANG-1. These effects of CGF were mediated by the AKT/Wnt and YAP pathways, with the AKT pathway possibly functioning upstream of the Wnt/b-catenin and YAP pathways. YAP was also shown to be overexpressed in the in vivo model. Thus, CGF can promote gingival regeneration, and YAP transport into the nucleus may be a key factor underlying this activity, which provides a novel perspective for gingival regeneration and further promotion of the clinical application of CGF.

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Oral flurbiprofen spray for mucosal graft harvesting at the palatal area: A randomized placebo‐controlled study

Abstract: Oral flurbiprofen spray reduces patient's morbidity, however it might have negative effects on epithelialization of secondary wound healing after FGG operations.

Cited by 17 publications

References 47 publications

De‐epithelialized gingival graft versus subepithelial connective tissue graft in the treatment of multiple adjacent gingival recessions using the tunnel technique: 1‐year results of a randomized clinical trial

De‐epithelialized gingival graft versus subepithelial connective tissue graft in the treatment of multiple adjacent gingival recessions using the tunnel technique: 1‐year results of a randomized clinical trial

A Systematic Review of Flurbiprofen 8.75 mg Dose and Risk of Haemorrhagic Events

Concentrated growth factor promotes gingival regeneration through the AKT/Wnt/β-catenin and YAP signaling pathways

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