Effects of StellaLife Oral Care Recovery Kit on Palatal Wound Healing After Free Gingival Graft

This study looks to compare the clinical effects of StellaLife VEGA Oral Care Kit with chlorhexidine mouth-rinse on patient comfort, wound healing, wound epithelialization, bacterial levels, and colonization of the wounds.

A total of 60 participants will be recruited from those needing and have been treatment planned for a free gingival graft surgery to increase keratinized gum. The study subjects will be randomly allocated to either negative control group (NC), chlorhexidine group (C) or StellaLife group (S) by randomization done using a computer-generated table. The NC group is provided normal saline mouth-rinse to rinse 2 times per day along with placebo gel to be applied 2 times and placebo oral spray. The S group will use StellaLife Oral Care mouth-rinse, gel and spray 2 times per day. The C group will use chlorhexidine mouth-rinse and placebo gel and spray 2 times per day. All groups beginning the same day and continuing for the duration of two weeks. All patients will receive a protective splint. Following this, subjective and objective measurements on the success of the mouthwash and oral care kit will be measured. Patients will be evaluated post operatively following surgery as mentioned below: Wound Healing Assessment and Epithelization Assessment: Postoperative Days 1, 5, 14, 21 and 28 Oral Health Impact Profile-14 and Functional Pain Scale: Starting on the day of the surgery and Postoperative Days 1, 5, 14, 21 and 28 Wound Exudate assessment: Samples collected on Postoperative Days 1, 5, 14, 21 and 28 Wound Plaque assessment: Starting on the day of the surgery and Postoperative Days 1, 5, 14, 21 and 28

Parallel model: Patient will receive either normal saline mouth-rinse to rinse, or Chlorhexidine mouth-rinse with placebo gel and placebo oral spray or Stellalife Oral Care Kit with mouthrinse, gel and oral spray.

This group is provided normal saline mouth-rinse to rinse 2 times per day along with placebo gel to be applied 2 times and placebo oral spray.

This procedure is done to increase the width of keratinized gingiva around teeth or dental implant. The healing of the palatal wound at the donor site will be recorded.

Clinical photographs of the donor site will be taken at baseline, immediately after surgery, and at each follow-up visit, to record the appearance A sterile paper measuring tape in millimeters will be placed on the length and width of the wound at the time getting the picture, then with use of the image analysis software the size (area in sq millimeter) and wound healing estimation will be made. The images will be analyzed with ImageJ software to determine area.

A wound epithelization test will be done with hydrogen peroxide on each follow-up visits to record epithelization. The wound will be dried with gentle air flow and 3% hydrogen peroxide will be sprayed with a syringe. The appearance of bubbles will be considered as indication for incomplete epithelialization and will be dichotomously recorded (yes/no).

The wound exudate sample will be collected using a sterile durapore membrane. The membrane would be held on the surface of the wound for 30 seconds to absorb the wound exudate and then transferred to 2ml plastic vial. All samples will be at -40 degree centigrade till further analysis. Expression of cytokine biomarkers and metabolomes will be analyzed in picogram/mL

Plaque samples over the wound will be collected using sterile Q tips. The Q-tips will be transferred into plastic vials containing 50 ul RNA latter. All samples will be at -40 degree centigrade till further analysis. The de-identified plaque samples would be sent to the lab for DNA isolation and high through output sequencing of bacterial genomes to measure the relative abundance of different bacterial phyla and classes

The oral health-related quality of life will be assessed by the Oral Health Impact Profile scale (OHIP-14). Participants will be asked how frequently they had experienced the impact on each category in OHIP-14 with a 5-point scale (from 0 to 4). The total score of OHIP-14 will be calculated by adding the sum of each category from 14 questions (total score ranges from 0 to 56 points). Higher scores imply a poorer oral health quality of life, whereas lower scores indicate a better one.

The patient experienced pain and discomfort will be assessed and by the Functional Pain Scale. Participants will be asked to rate their pain on a scale of 0 to 5. The scale will also be used to assess pain and questions related to analgesic use and postoperative discomfort and complications experienced. Highest score of 5 is intolerable pain and score of 0 is no pain.

Inclusion Criteria: Adults aged ≥18 years, No history of medication affecting periodontal status in the last 6 months, No history of allergy to study medication or material, No use of tobacco, No history of pregnancy or lactation or contraceptive medication Good oral hygiene. Exclusion Criteria: Previous palatal surgery Patient on anticoagulant therapy Uncontrolled diabetes, Rheumatoid arthritis, Osteoporosis.