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BACKGROUND: The aim of this systematic review and network meta-analysis (NMA) was to assess the efficacy of different wound-healing agents for palatal donor area management after soft tissue graft harvesting. METHODS: Electronic searches in six databases were conducted for publications up to October 2023. Studies with data from patients undergoing therapeutic approaches using agents for palatal healing after gingival graft harvesting were included. Data about postoperative pain, wound-healing and postoperative complications reported for each agent were extracted. Three different tools were used for the risk of bias within studies evaluation (Murad tool for case series and case report, RoB 2.0 tool for randomized studies and ROBINS-I tool for non-randomized studies). A Bayesian random effects NMA was conducted for postoperative pain levels and wound healing. RESULTS: Eighty-four publications were included in the systematic review (qualitative analysis), with 14 of these subjected to NMA (quantitative analysis). The summarized results from the qualitative and quantitative analysis showed that all wound-healing agents evaluated promoted better pain control and wound healing compared to spontaneous healing and hemostatic sponges alone. The NMA outcomes reveal that leucocyte- and platelet-rich fibrin (L-PRF) was the most effective agent in reducing postoperative pain in all analyzed periods. Moreover, the L-PRF seems to accelerate wound healing and reduce postoperative complications compared to other agents. CONCLUSION: In conclusion, the L-PRF was the most effective agent in reducing postoperative pain, accelerating wound healing and reducing postoperative complications after harvesting soft tissue grafts from the palatal area.

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Abstract Introduction The maintenance of oral health in inpatients is essential, particularly to avoid complications arising from periodontal disease, which not only affect oral health but can also exacerbate systemic issues during hospitalization. Objective: This study aimed to assess nursing staff's knowledge regarding the management of periodontal disease and its association with systemic diseases. Material and method This cross-sectional observational study was conducted in a general referral hospital of the Brazilian National Health System (SUS). A total of 504 nursing professionals completed a self-administered 24-item questionnaire on relating to oral care procedures and the importance of oral health in hospitalized patients. Data were analyzed using descriptive analysis and the chi-squared test (α = 0.05). Result Most respondents (97.8%) believed that oral infections can affect a patient's general health and that oral hygiene is important during hospitalization. However, knowledge deficits were identified. The oral effect of periodontal disease was considered moderate by 49.3% of the participants, and 74.6% believed that sugar was the most common cause of periodontal disease. Conclusion Nursing professionals are aware of the importance of maintaining oral hygiene and the relationship between periodontal and systemic diseases. However, their dental hygiene practice knowledge is limited. A training program on oral healthcare for inpatients and the inclusion of oral hygiene topics in the curricula of nursing professionals are recommended.

Resumo Introdução A manutenção da saúde bucal em pacientes internados é essencial, especialmente para evitar complicações decorrentes da doença periodontal, que não apenas afetam a saúde bucal, mas também podem agravar problemas sistêmicos durante a hospitalização. Objetivo: Este estudo teve como objetivo avaliar o conhecimento da equipe de enfermagem em relação ao manejo da doença periodontal e sua associação com doenças sistêmicas. Material e método Este estudo observacional transversal foi conduzido em um hospital geral de referência do Sistema Único de Saúde (SUS) do Brasil. Um total de 504 profissionais de enfermagem completaram um questionário autoaplicável com 24 questões, abordando procedimentos de cuidados bucais e a importância da saúde bucal em pacientes hospitalizados. Os dados foram analisados por meio de análise descritiva e teste qui-quadrado (α = 0,05). Resultado A maioria dos entrevistados (97,8%) acreditava que infecções bucais podem afetar a saúde geral do paciente e que a higiene bucal é importante durante a hospitalização. No entanto, foram identificados déficits de conhecimento. O efeito oral da doença periodontal foi considerado moderado por 49,3% dos participantes, e 74,6% acreditavam que o açúcar era a causa mais comum da doença periodontal. Conclusão Profissionais de enfermagem reconhecem a importância da manutenção da higiene bucal e a relação entre doença periodontal e doenças sistêmicas. No entanto, seu conhecimento prático em higiene bucal é limitado. Recomenda-se um programa de treinamento em cuidados bucais para pacientes internados e a inclusão de tópicos de higiene bucal nos currículos dos profissionais de enfermagem.

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Objective: This study evaluated the use of autogenous blood concentrate (injectable platelet-rich fibrin) [i-PRF] for promoting soft tissue healing in osteoradionecrosis (ORN) lesions in patients who underwent head and neck radiotherapy. Material and Methods: This study included five ORN lesions in four patients who were treated with i-PRF (applied weekly for 4 weeks to the lesions). Soft tissue features were evaluated through clinical analysis at baseline and at 7, 15, 30, 60, and 90 days after the first session of i-PRF. Extension of the bone lesions was evaluated radiographically. Patient-centered related outcomes were evaluated using quality-of-life questionnaires at baseline and 90 days after the first treatment session. Quality of life data were analyzed using descriptive and frequency statistics and the Wilcoxon test. Results: Of the 5 treated lesions, 1 was completely closed and 3 remained open. The open lesions showed increased necrotic tissue exposure. No changes were observed in the radiographic appearance of the lesions. There was also no impact on the patient's quality of life. Conclusion: The results suggest that the majority of ORN lesions remained stable after the application of i-PRF, with a slight improvement in the quality of the mucosa around the lesions. Furthermore, it was observed that i-PRF did not compromise the quality of life of patients during treatment.(AU)

Objetivo: Este estudo avaliou o uso de concentrado de sangue autógeno (fibrina rica em plaquetas injetável) [i-PRF] para promover a cicatrização de tecidos moles em lesões de osteorradionecrose (ORN) em pacientes submetidos a radioterapia de cabeça e pescoço. Material e Métodos: Este estudo incluiu cinco lesões de ORN em quatro pacientes tratados com i-PRF (aplicado semanalmente por 4 semanas nas lesões). As características do tecido mole foram avaliadas por meio de análises clínicas no início e aos 7, 15, 30, 60 e 90 dias após a primeira sessão de i-PRF. A extensão das lesões ósseas foi avaliada radiograficamente. Os resultados centrados no paciente foram avaliados usando questionários de qualidade de vida no início e 90 dias após a primeira sessão de tratamento. Os dados de qualidade de vida foram analisados usando estatísticas descritivas e de frequência, além do teste de Wilcoxon. Resultados: Das 5 lesões tratadas, 1 foi completamente fechada e 3 permaneceram abertas. As lesões abertas mostraram aumento na exposição de tecido necrótico. Não foram observadas mudanças na aparência radiográfica das lesões. Também não houve impacto na qualidade de vida do paciente. Conclusão: Os resultados sugerem que a maioria das lesões de ORN permaneceu estável após a aplicação de i-PRF, com uma discreta melhora na qualidade da mucosa ao redor das lesões. Além disso, observou-se que a i-PRF não comprometeu a qualidade de vida dos pacientes durante o tratamento.(AU)

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