The effect of a calendula based topical formula versus oxidized regenerated cellulose on palatal wound healing: a randomized controlled clinical trial

INTRODUCTION:Free palatal and sub-epithelial connective tissue grafts are the most commonly used grafts in periodontal plastic surgeries. The surgical technique of free palatal grafting requires harvesting of soft tissue from the palatal donor site and transplantation to an intraoral recipient one. Post-surgical complications and atypical healing processes have been described in the literature. In order to reduce the morbidity associated with mucogingival surgery, there are several ways to manage the donor site after soft tissue harvesting. Various topically applied formulas and hemostatic agents have been employed to manage post-operative healing at the donor site. OBJECTIVES: to assess the effects of Calendula based topical formula on palatal wound healing after free palatal graft surgery in comparison to oxidized regenerated cellulose. MATERIAL AND METHODS This randomized, controlled trial included twenty-four surgical sites for palatal graft procurement, divided equally into two groups, managed by the topical application of either a Calendula based formula (Group-I) or oxidized regenerated cellulose (Group-II). Palatal wound healing was assessed using photo-digital planimetry on the day of the surgery and; at seven and fourteen days, post-surgical. Pain was assessed by visual analogue scale (VAS) one, four and seven days post-surgical. RESULTS: The VAS score results showed no significant difference at days one, four and seven when comparing group I and II. For the percentages of remaining wound area, there was no significant difference in the percentages of remaining wound area. However, at day seven, there was a significant decrease in the percentage of remaining wound area in group II when compared to group I. Comparing the percentages of remaining wound area at day seven and fourteen in group I, there was a significant decrease of the percentages of remaining wound area at day fourteen. The same was found in group II. For group I, there was no significant difference between any of the recording periods. However, for group II, there was a significant decrease in the VAS scores between day one and seven, and also between day four and seven. CONCLUSION: Both materials were beneficial in improving palatal wound healing. However, oxidized regenerated cellulose exhibited better pain reduction following palatal graft procedures as reported by the study subjects when compared to the topical Calendula group