A Comparative Evaluation of Chitosan Hydrogel and Concentrated Growth Factor on Alveolar Bone Healing- a Randomized Clinical Trial

The healing process is a dynamic procedure, characterised by a sequence of phases and accompanied by some classical symptoms of inflammation such as redness, swelling, pain, and loss of function. Chitosan is soluble in an acidic environment and exhibits excellent tissue affinity, and consequently it could be used in hydrogel forms. The aim of the study was to evaluate and compare the effect of chitosan hydrogel and concentrated growth factor on alveolar bone healing after third molar extractions. This experimental pilot study is a split-mouth design carried out among 16 patients with bilaterally impacted mandibular third molars indicated for surgical extraction. The subjects were randomly assigned to 2 groups. Group 1: Chitosan hydrogel mixed with concentrated growth factor. Group 2: Platelet-rich fibrin. After extracting the tooth, the socket was filled with chitosan on the right side, and on the left side PRF was placed. The clinical outcome variables were pain, swelling, maximum mouth opening, and pocket depth, which were measured using a 10-point visual analog scale, suture thread, Vernier caliper, and William's periodontal probe, respectively. Periapical radiographs were obtained at 7 days, and 4 and 6 months postoperatively. Pain, swelling, and trismus were less in the chitosan mixed with CGF group when compared to PRF. Some classic signs of inflammation were observed in a short period of time where the chitosan acted. In these cases, a decrease in pain and an absence of bleeding were observed. Both groups showed a significant reduction in pocket depth over the 6-month period. The evaluation of bone density at the extraction site by radiological assessment showed higher grey level values on the 7th day, and 4th and 6th months in the chitosan group when compared to PRF. Within the limits of this study, there was significant improvement in pain, swelling, and trismus in the chitosan group. PD was observed to be the same on the third molar sites. The bone regenerative property of chitosan was significantly better than PRF. Keywords: chitosan, alveolar bone healing, growth factor