The Clinical And Histological Observation On S-marcon^? Promoting The Healing Of Peri-implant Soft Tissue

Objective:The purpose of this study was to investigate the effects of S-marcon^?on wound healing by the observation of postoperative pain and mucosal state after surgery,and histological observation of animal models.Methods:1.40 patients who subjected to a two-stage operation of implant were selected according to the inclusion criteria,they were randomly allocated in two groups:the experimental group（n=19）and the blank group（n=21）.In experimental group,before and after suture,we applied S-marcon^?gelatum around the abutment and wound,each implant used 0.5ml,and the blank group was sutured normally,no treatment was done.The pain grading table was issued after the operation,and the pain level was recorded on the day after operation,first day after operation,second day after operation,and third day after operation.The healing degree of mucosa was evaluated on the third day after operation and seventh day after operation.The bleeding rate,swelling degree and mucosal color of the corresponding sites were observed.The data were statistically analyzed using the rank sum test of two independent samples,and the difference was statistically significant with the difference of P<0.05.2.Immediate implant of 6 beagle dogs after minimally invasive extraction of the maxillary first premolars,second premolars,third premolars,each dog received two implants on the left and two on the right,the implants provided by ZDI3.3*8mm bone level implant,torque reached 25N.cm,then put the abutments.The right side was the experimental group,before and after suture,we applied S-marcon^?gelatum around the abutment and wound,each implant used 0.5ml.The left blank group was sutured normally.3 days after operation,normal saline to wipe the wound,injection of 80 thousand units of penicillin,Semi liquid food.At the third day after operation,seventh day after operation,specimens were collected on dog 1,2,3 around the abutment,from distal to mesial.At the eleventh day after operation,fifteenth day after operation,specimens were collected on dog 4,5,6 around the abutment,from distal to mesial.Number then put in formalin fixed.HE staining was used to observe the infiltration of inflammatory cells and the formation of blood vessels and collagen fibers in different periods.TNF-a and VEGF were selected to do immunohistochemical staining.The expression was observed by light microscope.The average optical density was analyzed by Image Pro Plus6.0 software,and the data were statistically analyzed by t test.The difference between P<0.05 was statistically significant.Results:1.the degree of postoperative pain,postoperative day,first day,second day after operation of postoperative pain degree in experimental group less than blank group,the difference was statistically significant（P<0.05）;The healing state of the soft tissue in the operation area:bleeding on probing,index of experimental group on postoperative day and third day after operation was better than the blank group,difference was statistically significant（P<0.05）;The postoperative mucosal swelling,the third day,seventh day after operation,the experimental group was less than the blank group on the degree of mucosa swelling,difference was statistically significant（P<0.05）;The postoperative color of oral mucosa,third day after operation,seventh day after operation,the experimental group mucosa color were normal compared with the blank group,the difference was statistically significant（P<0.05）.2.On the third day,HE staining in experimental group,the infiltration ofinflammatory cells was significantly higher than the blank group;the xpression of TNF-a in experimental group were higher than the blank group,the difference wasstatistically significant（P<0.05）;on the seventh day,HE staining showed that compared with the blank group,the formation of vascular and the formation of collagen fibers in experimental group was more;the expression of VEGF in experimental group were higher than the blank group,the difference.was statistically significant（P<0.05）;HE staining on the eleventh day,the number of collagen fiber,the number of blood vessels in blank group were less than experimental group;the expression of VEGF in experimental group was higher than the blank group,the difference was statistically significant（P<0.05）;HE staining on the fifteenth day,in experimental group,there is a large number of fibroblasts and collagen fibers;The expression of TNF-a and VEGF were different between the two groups,but the difference was not statistically significant（P>0.05）.Conclusions:1.we compared the pain grading and the mucosal healing state of the experimental group and the blank group on the third day after operation and seventh day after operation,found that the experimental group was better than the blank group in the bleeding and postoperative pain.The pain level in the experimental group was lower than the blank group on the first day and second day after surgery.On the third day after operation and seventh day after operation,the experimental group was better than the blank group in mucosal color and mucous swelling,indicated that S-marcon^?has analgesic and hemostatic efects on the day after surgery,and can promote the early healing of wound area.2.Through the establishment and sampling of animal models,HE staining and the expression of TNF-a,VEGF was detected by immunohistochemical staining were used.It was found that there were differential expression of cytokines in the third day,seventh day and eleventh day,respectively,and the experimental group was better than the blank group.The histological analysis showed that S-marcon^?played a certain role in promoting the soft tissue wound healing in inflammation stage and the proliferation stage.