Ratlarda İntra-Oral Ülserlerin İyileştirilmesinde Ağız İçi Yara Örtücülerin Etkililiğinin Değerlendirilmesi
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Coşkun, S. Evaluation of the Effectiveness of Intraoral Wound Dressers in the Treatment of Intra-Oral Ulcers in Rats. Hacettepe University, Department of Oral and Maxillofacial Radiology, Thesis, Ankara, 2020. Oral ulcers are lesions characterized by tissue loss including epidermis and connective tissue. Wound dressings produced to accelerate wound healing are medical materials that help protect the wound from external factors and help accelerate the healing of ulcers that occur. The aim of this study is to investigate and compare the effects of oral wound dressings which are consist of hyaluronic acid and a combination of hydroxyethylcellulose, polycarboxylic acid, alpha tocopherol methyl paraben, on wound healing in rats. In this study, 45 healthy Spraque-Dawley male rats were used. There were 3 main groups: 2 working groups, 1 control group and 3 sub-groups under each main group. To achieve standardization, oral ulcers of 2 mm diameter and 2-3 mm depth which cover the whole epithelium and connective tissue were formed in the palatal mucosa of the oral cavity of all rats. The control group was left to secondary healing. In the first study group, a wound dressing containing hyaluronic acid was applied on the ulcer surface. In the second study group, the oral ulcer was covered with a 3x3 mm2 wound dressing containing combination of hydroxyethylcellulose, polycarboxylic acid, alpha-tocopherol and methyl paraben. On the third day, on the seventh day and on the fourteenth day, a 5 mm diameter punch biopsy was performed under general anesthesia with a 3 mm healthy mucosa around the ulcer of 2 mm. According to the results obtained from the histopathological examination, it is concluded that the oral wound dressing containing hydroxyethyl cellulose polycarboxylic acid, alpha-tocopherol and methyl paraben (HSPA) is more effective than the hyaluronic acid containing oral dressing (HAOD) for the treatment of ulceration while 3.day with 7 days are compared. It is concluded that both HAOD and HSPA reduce edema formation and HSPA is more effective than HA in preventing edema formation. There was no significant difference in the demarcation line formation of HAOD compared with the control group and HSPA is more effective than hyaluronic acid in demarcation line formation. HSPA was found to be more effective in granulation tissue formation on day 3 than HAOD, whereas the effectiveness of HSPA on day 7 and 14 did not show a significant difference with other wound dressings. There was no difference between groups in terms of scar formation, intracellular fibrin deposition and fibroblast count. On day 3, both wound dressings increased the migration and number of Polymorph Nuclear Leukocytes to the ulcer site compared to the control group, but no significant difference was found between the groups. On day 3, both wound dressings increased the migration and number of mononuclear cells to the ulcer site compared to the control group, but no significant difference was found in terms of groups and it was found that this number decreased on the 7th day when compared with the control group. On the 14th day, there was no significant difference between the groups. Both wound dressings were found to increase vascularization on the 7th and 14th days. There was no vascular congestion on days 7 and 14 for both wound dressings, but no significant difference was found between the two groups. With the findings obtained from this study; It is concluded that HAOD and HSPA show similar effects in the treatment of intra-oral ulcers in rats and there was no statistically significant difference. Key Words: Hyaluronic acid, hydroxyethyl cellulose, oral bandage, oral ulcer, polycarboxylic acid, wound dressings, wound healing.