Journal of Mazandaran University of Medical Sciences (Jun 2024)
Evaluation of the Effects of Zinc Sulfate Gel on the Healing Process of Intraoral Ulcers in Rats and Comparing it with Triamcinolone Gel
Abstract
Background and purpose: A wound is a break in the skin. Oral wounds are among the most common reasons for patients to visit a dental clinic, manifesting as lesions with clear boundaries, often slightly sunken, accompanied by or with complete loss of epithelium, covered by a fibrinoleukocytic membrane. Various factors can cause developing wound lesions, including trauma, infection, disease, medication, malignancy, and non-specific causes. Zinc plays a role in cell proliferation, protein synthesis, and wound healing following injury. Given the contradictions and potentials of zinc, and the lack of a study on the effect of zinc on oral wounds, conducting such a study became necessary. This study aimed to investigate the effect of zinc sulfate gel on the healing process of intraoral wounds in rats and compare it with triamcinolone. Materials and methods: This experimental study was conducted in the animal laboratory of the Oral and Dental Diseases Research Center of Kerman University of Medical Sciences. In this study, rats with an approximately 2 x 2 mm wound created using a 2-mm punch in the hard palate were used. The animals were randomly divided into 3 groups (14 rats in each group). Group A (0.1% triamcinolone acetonide gel), Group B (5% zinc sulfate gel), and Group C (placebo) received the respective treatments. Each group was divided into two subgroups based on microscopic evaluation of wound healing: A1, B1, and C1 for one week, and A2, B2, and C2 for two weeks of treatment. The wound sizes were measured along the largest diameter on days 1, 3, 7, and 14 using a Williams periodontal probe. Histological samples were prepared on days 7 and 14 and sent to the pathology laboratory for evaluation. The histopathological criterion for the wounds was based on tissue inflammation. The wounds were also divided into grades 1-5 for re-epithelialization. Finally, the data were analyzed using SPSS 20 software. Results: Regarding the severity of inflammation in the three study groups on days 7 and 14, there was no significant difference (P=0.538). Evaluation of the extent of re-epithelialization in the three study groups on days 7 and 14 showed that the mean extent of re-epithelialization was not significantly different between the triamcinolone and zinc sulfate groups (P=0.18), but the mean extent of re-epithelialization in the triamcinolone group was significantly greater than the placebo group (P=0.001). Also, in terms of wound size on days 1, 3, 7, and 14, the trend of wound size change was the same in the groups, and the mean wound size in the triamcinolone and zinc sulfate groups was less than the placebo group, although the mean of the triamcinolone group was slightly lower, the difference was not significant (P=0.118), indicating that the zinc sulfate group performed as well as the triamcinolone group. Conclusion: The use of zinc sulfate gel resulted in a decrease in inflammation, an increase in re-epithelialization, and a decrease in wound size. Although the triamcinolone gel performed better in reducing inflammation, increasing re-epithelialization, and decreasing wound size, the difference was not significant. The prolonged use of triamcinolone can lead to adverse effects in some oral ulcers, such as candidiasis and hyperpigmentation. Additionally, zinc supplementation has fewer undesirable effects. Therefore, further research is needed to consider replacing triamcinolone with zinc sulfate.
