Gingival enlargement leads to unaesthetic appearance, increased susceptibility to
periodontal disease and halitosis by making it difficult to control plaque, and chewing
and speech disorders by affecting functional function. Gingivectomy and gingivoplasty are
used for the excision of diseased gingiva or gingival enlargement to create a natural
anatomical form of the gingiva and improve aesthetics. After gingivectomy and
gingivoplasty surgery, secondary healing occurs at the wound site. Bleeding and pain as a
result of secondary healing negatively affect the patient's quality of life. Many
different treatment methods such as ozone therapy, laser therapy, antiseptic agents,
platelet concentrate, and herbal products are applied to reduce postoperative
complications and increase patient comfort after gingivectomy and gingivoplasty. Since
ozone gas increases growth factors, activates local antioxidant mechanisms, and supports
tissue repair, its application to the wound site prevents postoperative infection and may
accelerate wound healing. Topical application of ozone gas has been reported to be
effective in the early stages of wound healing by increasing the amount of vascular
endothelial growth factor expression. In a systematic review aiming to evaluate the
effectiveness of ozone therapy in reducing the symptoms of oral diseases, especially oral
mucositis, which is a serious complication of cancer treatment, it was confirmed that
ozone has analgesic, anti-inflammatory, antimicrobial, and regenerative properties. In a
study, it was found that the application of ozone therapy after gingivectomy and
gingivoplasty reduced the pain levels of patients and positively affected their quality
of life. To compare the healing potential of the wound surface following gingivectomy and
gingivoplasty surgery applied to the maxillary anterior regions with the application of
classical periodontal paste (Coe-pak) using activated oxygen (Cure 09 Active Oxygen) and
with the application of classical periodontal paste (Coe-pak) alone.
The study will include 48 systemically healthy, systemically healthy patients older than
18 years of age, with gingival enlargement in the maxillary anterior region, requiring
gingivectomy and gingivoplasty surgery, who applied to Kütahya University of Health
Sciences, Faculty of Dentistry, Department of Periodontology and İzmir Democracy
University, Faculty of Dentistry, Department of Periodontology. All patients will be
called for re-evaluation 4 weeks after phase 1 periodontal treatment and surgical
treatment will be planned. Clinical measurements (plaque index, gingival index, pocket
depth, bleeding index on probing, and gingival overgrowth index) and oral health impact
profile-14 questionnaire will be recorded and standard photographs will be taken before
surgery. After local anesthesia, the incision line will be determined with a marking
press or periodontal probe according to the amount of gingival enlargement. An external
beveled incision will be made along the determined incision line with a No. 15 scalpel.
Once the incision is complete, the surrounding tissues will be cleaned using
microsurgical scissors. Following this, gingivoplasty will be performed. Patients will be
randomly assigned to either the test group or the control group. In the test group,
periodontal paste (Coe-Pak) will be applied to the area designated for secondary healing
after ozone therapy (Cure 09 Active Oxygen). In the control group, only periodontal paste
(Coe-Pak) will be applied. Postoperatively, the patient will record the bleeding status,
daily analgesic use, and pain and burning with a visual analog scale for the first 7
days. Standard photographs will be taken in the postoperative period, immediately after
the placement of the patch and on the 7th, 14th and 21st days. In addition, clinical
evaluations (healing index, inflammation, modified manchester scar scale, surgical Area
Plaque index, re-epithelialisation evaluation, and only on the 7th day, plaque
accumulation in the periodontal paste) will be recorded from the patients on the 7th,
14th, and 21st days.
