%0,24’lük hyalüronik asidin labial frenektomi sonrası ağrı düzeyi ve periodontal duruma etkisi

Yıl 2024, Cilt: 29 Sayı: 2, 202 - 209, 29.05.2024

Nebi Cansın Karakan Suat Serhan Altıntepe Doğan Özgür Doğan

https://doi.org/10.21673/anadoluklin.1399941

Öz

Amaç: Labial frenulum üst dudağı alveoler krete bağlayan bir kas dokusudur. Frenektomi işlemi bu kas dokusunun kaldırılmasını içerir. Frenektomi işlemi sırasında bisturi kullanılarak gerçekleştirilen geleneksel cerrahi teknik halen en popüler yöntemdir.Çalışmanın hedefi Hyalüronik Asidin (HA) konvansiyonel frenektomi sonrası etkisini incelemektir.

Yöntemler: Çalışmada yaşları 8-14 arasında değişen 48 genç hasta yer aldı (25 kız-23 erkek). Katılımcılar rastgele olarak 2 gruba ayrıldı. Grup 1: Konvansiyonel Cerrahi ve Steril Salin (SS) (n=24) ve Grup 2: Konvansiyonel Cerrahi+HA (Aftamed, Child Gel 24% HA) (n=24). Katılımcılara ait periodontal parametreler ölçüldükten sonra frenektomi yapıldı. Operasyon sonrası ağrı değerleri bir hafta boyunca günlük olarak 10 puanlık Görsel Analog Skala (VAS) ile değerlendirildi. Frenektomi öncesi Plak İndeksi (Pİ), Gingival İndeks (Gİ), Cep Derinliği (CD), Sondalamada Kanama (SK), Keratinize Diş Eti Genişliği (KDG), Yapışık Diş Eti Kalınlığı (YDK) ölçülüp kaydedildi. Periodontal parametreler 3 ay sonra tekrar ölçülüp değerlendirildi.

Bulgular: GAS (Görsel Analog Skala) skorları değerlendirildi. 1 ve 3. gün arası ve 6. günde HA grubunda ağrı düzeyi daha az olsa da, %0,24 HA jel uygulaması ağrı düzeyinde önemli bir farka yol açmadı (p>0.05). 7. günde ağrı düzeyleri eşitti. Pİ, Gİ, CD, SK, KDG, YDK değerlerinde 3 ay sonunda önemli bir fark yoktu (p>0.05).

Sonuçlar: Bir hafta sonunda topikal HA uygulamasının ağrı düzeyinde önemli bir farka yol açmadığı görüldü. Diğer periodontal parametrelerde üç aylık takip süresince yine HA uygulamasının önemli bir değişime yol açmadığı saptandı.

Anahtar Kelimeler

Diyastem, hyalüronik asit, konvansiyonel tedavi, labial frenulum

The impact of 0.24% hyaluronic acid gel on pain level and periodontal status following labial frenectomy

Öz

Aim: The labial frenum is a mucosal fold that connects the upper lip to the alveolar ridge. Frenectomy involves the surgical removal of a mucosal fold. The traditional surgical technique utilizing a scalpel remains popular for performing a frenectomy. The study aims to examine the effectiveness of applying Hyaluronic Acid (HA) Gel after conventional frenectomy.

Methods: This research comprised 48 young patients (25 girls and 23 boys) aged 8 to 14. Participants were randomly divided into two groups. Group 1: Conventional Scalpel Surgery and Sterile Saline (SS) (n=24) and Group 2: Conventional Scalpel Surgery+HA (Aftamed, Child Gel 24% HA) (n=24). After measuring the participants’ periodontal parameters, the frenectomy was performed. Postoperative pain levels were evaluated daily for one week utilizing a 10-point Visual Analog Scale. Before frenectomy, Plaque Index (PI), Gingival Index (GI), Pocket Depth (PD), Bleeding On Probing (BOP), Keratinized Gingival Width (KGW), Attached Gingival Thickness (AGT) values were measured and recorded. The periodontal parameters were assessed and analyzed after a 3-month follow-up period.

Results: VAS (Visual Analogue Scale) was assessed. The application of Although 0.24% HA gel caused less pain from days 1-3.6, there was no significant difference in pain levels between the HA gel and control groups (p>0.05). Pain levels were equal between groups on day 7. No significant changes in PI, GI, PD, BOP, KGW, or AGT values after three months of follow-up (p>0.05).

Conclusions: During the first week after a frenectomy performed with classic scalpel surgery, the application of 0.24% HA gel did not significantly reduce pain levels. It did not result in significant changes in other measured periodontal parameters after three months of follow-up.

Anahtar Kelimeler

Conventional therapy, diastema, hyaluronic acid, labial frenum

Kaynakça

• Dioguardi M, Ballini A, Quarta C, Caroprese M, Maci M, Spirito F, et al. Labial Frenectomy Using Laser: A Scoping Review. Int J Dent. 2023;30:1–7.
• Baxter RT, Zaghi S, Lashley AP. Safety and Efficacy of Maxillary Labial Frenectomy in Children: A Retrospective Comparative Cohort Study. Int Orthod. 2022;20(2):100630.
• Gkantidis N, Kolokitha O-E, Topouzelis N. Management of Maxillary Midline Diastema with Emphasis on Etiology. J Clin Pediatr Dent. 2008;32(4):265–72.
• Ahn JH, Newton T, Campbell C. Labial frenectomy: Current Clinical Practice of Orthodontists in the United Kingdom. Angle Orthod. 2022;92(6):780–6.
• Delli K, Livas C, Sculean A, Katsaros C, Bornstein MM. Facts and Myths Regarding The Maxillary Midline Frenum and Its Treatment: A Systematic Review of the Literature. Quintessence Int. 2013;44(2):177–87.
• Mirko P, Miroslav S, Lubor M. Significance of the Labial Frenum Attachment in Periodontal Disease in Man. Part 1. Classification and Epidemiology of the Labial Frenum Attachment. J Periodontol. 1974;45(12):891–4.
• Rajani E, Biswas P, Emmatty R. Prevalence of Variations in Morphology and Attachment of Maxillary Labial Frenum in Various Skeletal Patterns - A Cross-Sectional Study. J Indian Soc Periodontol. 2018;22(3):257.
• Öztürk Özener H, Meseli SE, Sezgin G, Kuru L. Clinical Efficacy of Conventional and Diode Laser-Assisted Frenectomy in Patients with Different Abnormal Frenulum Insertions: A Retrospective Study. Laser Surg. 2020;38(9):565–70.
• Casale M, Moffa A, Vella P, et al. Hyaluronic acid: Perspectives in dentistry. A systematic review. Int J Immunopathol Pharmacol. 2016;29(4):572-82.
• Turgut Çankaya Z, Gürbüz S, Bakirarar B, Ünsal B, Kurtiş B. Evaluation of the Effect of the Application of Hyaluronic Acid Following Laser-Assisted Frenectomy: An Examiner-Blind, Randomized, Controlled Clinical Study. Quintessence Int. 2020;51(3):188–201.
• Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical Power Analyses Using G*Power 3.1: Tests for Correlation and Regression Analyses. Behav Res Methods. 2009;41(4):1149–60.
• Xie L, Wang P, Ding Y, Zhang L. Comparative Frenectomy with Conventional Scalpel and Dual-Waved Laser in Labial Frenulum. World J Pediatr Surg. 2022;5(1):e000363.
• Mazzoni A, Navarro RS, Fernandes KPS, Mesquita-Ferrari RA, Horliana ACRT, Silva T, et al. Comparison of the Effects of High-Power Diode Laser and Electrocautery for Lingual Frenectomy in Infants: A Blinded Randomized Controlled Clinical Trial. J Clin Med. 2022;11(13):3783.
• Okyay RD, Ayoğlu H. Çocuklarda Postoperatif Ağrı Yönetimi. Pediatr Pract Res. 2018;6(2):16–25.
• Chapman HR, Kirby-Turner N. Visual/Verbal Analogue Scales: Examples of Brief Assessment Methods to Aid Management of Child and Adult Patients in Clinical Practice. Br Dent J. 2002;193(8):447–50.
• Buchanan H, Niven N. Validation of A Facial Image Scale to Assess Child Dental Anxiety. Int J Paediatr Dent. 2002;12(1):47–52.
• Tancredi S, De Angelis P, Marra M, et al. Clinical Comparison of Diode Laser Assisted "v-Shape Frenectomy" and Conventional Surgical Method as Treatment of Ankyloglossia. Healthcare (Basel). 2022;10(1):89.
• Calcagno E, Barattini DF, Servetto R. Therapeutic Approach to Pediatric Oral Disorders. Minerva Pediatr. 2018;70(2):175–81.
• Nolan A, Baillie C, Badminton J, Rudralingham M, Seymour RA. The efficacy of Topical Hyaluronic Acid in the Management of Recurrent Aphthous Ulceration. J Oral Pathol Med. 2006;35(8):461–5.
• DI Pierro F, Bertuccioli A, Donato G, Spada C. Retrospective Analysis of the Effects of A Hyaluronic-Based Gum Gel to Counteract Signs and Symptoms of Teething in Infants. Minerva Pediatr. 2022;74(2):101–6.
• Uraz A, Çetiner FD, Cula S, Guler B, Oztoprak S. Patient Perceptions and Clinical Efficacy of Labial Frenectomies Using Diode Laser Versus Conventional Techniques. J Stomatol Oral Maxillofac Surg. 2018;119(3):182–6.