牙科麻醉水膠敷料於拔牙傷口之活體評估

In Vivo Evaluation of a Dental Anesthetic Hydrogel Dressing in post-extraction Sockets

羅怡君(Yi-June Lo) ； 李勝揚(Sheng-Yang Lee) ； 陳建中(Chien-Chung Chen) ； 許明照(Ming-Thau Sheu) ； 黃豪銘(Haw-Ming Huang) ； 施永勳(Yung-Hsun Shin) ； 楊正昌(Jen-Chang Yang)

《中華牙醫學雜誌（中文版）》 25卷2期 (2006/06) Pp. 79-89

https://doi.org/10.7106/CJD.200606.0079

摘要

新型牙科麻醉水膠(dental anesthetic hydrogel, DAH)敷料，係利用其置入拔牙傷口後吸水後膨賬並同時緩慢釋出利度卡因(lidocaine)麻醉劑，以舒緩病患在拔牙後或乾性齒槽炎之疼痛不適。本研究之目的是應用米格魯犬之動物試驗模式，活體評估DAH之利度卡因藥物釋出動力學，及組織學傷口癒合效果。在利度卡因藥物釋出方面，拔牙後分別於不同的傷口置放DAH敷料，並於10、30、60、90、120、150或180分鐘時取出DAH以分析殘餘的利度卡因重量並計算釋放出之利度卡因之百分比。在拔牙傷口癒合方面，五隻米格魯犬，其上或下顎每顎各拔三顆門齒，隨機分成三組：不放任何敷料之控制組、放商品止血敷料Spongostan(上標 ®)之對照組、及放DAH敷料之試驗組，之後分別於時問點2天、1、2、4及12週作傷口癒合之組織學觀察。結果顯示DAH月中的利度卡因在10分鐘時已有釋出，2~3小時約可釋放出40~50%，而在組織學觀察中DAH在2週內就完全降解，對組織沒有明顯不良反應發生，在組織內具可接受兀相容性，放置DAH和Spongostan(上標 ®)傷口癒合在2和4週時較不放敷料的控制組為延遲，但是在12週時三組之問的癒合則沒有明顯差別。

關鍵字

水膠 ； 敷料 ； 拔牙齒槽 ； 組織學 ； 傷口癒合

並列摘要

A novel dental anesthetic hydrogel (DAH) dressing can absorb water then slowly release lidocaine, an anesthetic agent, to relieve the pain after an extraction or a dry socket. The purpose of this in vivo study was to evaluate the DAH's release pharmacokinetics of lidocaine, and histological wound healing in post-extraction sockets. Adult beagles were used as the animal model. To establish the lidocaine release profile, DAHs were first placed in extraction sockets, then removed at various time intervals of 10, 30, 60, 90, 120, 150, or 180 minutes. The residual lidocaine in the DAH was analyzed and calculated at each time interval. To examine the healing process of the extraction site, 3 incisors in each arch were selected for extraction in 5 beagles. Post-extraction sockets were randomized for each treatment modality: extraction site without dressing control group, Spongostan(superscript ®) dressing control group, and DAH dressing experimental group. The above animals were sacrificed later at the time interval of 2 days, and 1, 2, 4, and 12 weeks for further histological evaluations. The results showed that lidocaine in DAH began to be released within 10 minutes, and up to 40%~50% had been released at 2~3 hours. DAH was degraded within 2 weeks; the biocompatibility of residual DAH was quite good with no adverse reaction noted in histological tissue sections. The wound healing of sockets treated with the DAH or Spongostan(superscript ®) dressing was slightly delayed for up to 2 and 4 weeks, respectively, but no significant differences were observed at 12 weeks within the 3 groups.

並列關鍵字

hydrogel ； dressing ； extraction socket ； histology ； wound healing