USE OF SNAKE VENOM DERIVED FIBRIN GLUE FOR THE IMMOBILIZATION OF FREE GINGIVAL GRAFTS: CLINICAL AND HISTOLOGICAL STUDY.
THESIS: M. D. B. Oliveira submitted her thesis for her Doctor of Philosophy degree in Dentistry publicly examined in Faculdade de Odontologia de Bauru, Bauru School of Dentistry of Universidade de São Paulo, São Paulo University, Bauru, SP, Brazil, in 2001.
Advisor: Prof. Dr. Sebastião Luiz Aguiar Greghi
ABSTRACT: A new fibrin glue made of buffalo plasma-derived fibrinogen, calcium chloride, and thrombin-like enzyme from snake venom was evaluated for use in periodontal surgery. Evaluation included clinical and histological comparisons between free gingival grafts conventionally sutured (control side) and fibrin glue immobilized free gingival grafts (tested side).
The grafts were made on contralateral mandibular bicuspids of 15 patients, so that each subject received one treatment of each type. Clinical analysis included measurements of probing and vertical dimension of grafts at 30, 60, and 90 days postoperatively, as well as photographic follow-up at 7, 14, 30, 60, and 90 days. The patients were submitted to a questionnaire about postoperative signs and symptoms. Five biopsies from each side (control and tested) were collected at 7, 14, and 45 days of healing, which were histomorphometrically analyzed for relative volume density of the connective tissue in the different components and in the epithelium/connective tissue interface.
A significant decrease was found in vertical graft dimension during the first 30 days, with little variation from then on up to 90 days. This decrease was more significant in the control side. Probing depth and attachment level at probing showed statistically significant decrease in control and tested sides between preoperative recordings and those at 90 days. Fibrin glue grafts showed better clinical appearance and tissue organization on histological examination during the first 14 days postoperative. This is probably why patients chose these sites as the best healing areas. Morphometrical observation showed that the control side presented a statistically higher density of inflammatory cells at 7 days and a tendency towards a lower density of collagen fibers, and less development of the epithelium/connective tissue interface.
This fibrin glue is suitable for use in free gingival grafts, presenting outcomes comparable to conventional sutures, with the following advantages: ease of application, smaller graft dimensional change, better postoperative healing, and tendency to faster repair. The use of this material deserves further studies for possible applications in periodontal therapy.
KEY WORDS: fibrin glue, periodontal surgery, gingival graft, snake venom.
M. D. B. de Oliveira - Avenida Antônio Carlos Magalhães, 585, Centro Odonto-Médico Itaigara, Edf. Pierre Fauchard, Sala 902, Itaigara, 41825-000, Salvador, BA. Phone: 55 71 3532178 / Fax: 55 71 3594312 / Mobile: 55 71 99814312
Publication in this collection
16 Sept 2002
Date of issue