Clinical evaluation of amniotic membrane used as soft tissue graft material in oral surgical procedures with laser doppler

Introduction: The clinical use of the amniotic membrane as a graft material in secondary surgical areas in patients with vestibuloplasty and white lesions draws attention. The aim of this study; the effects of the amniotic membrane, which is used as a graft material on the wound surfaces that are left for secondary healing after vestibuloplasty and biopsy in patients with white lesions, on the mucoperiosteal blood flow with laser doppler and the effects of the amniotic membrane in terms of ease of application, hemostatic status, pain, epithelialization, wound size, nutritional status, and scar contracture. Comparative clinical evaluation with the control group was done. In our study, blood flow was evaluated preoperatively, at the end of the first week and at the end of the second week, and these values were compared with the preoperative blood flow values. By creating a clinical observation form, the clinical effects of the membrane were evaluated over 7 parameters. We had no case of complete or partial graft necrosis. Materials and Methods: A total of 40 patients whose amniotic membrane was used in surgical procedures, ranging in age from 35 to 70 of patients who will undergo vestibuloplasty and those who will undergo biopsy in white lesions, were clinically evaluated. The study was evaluated in terms of changes in blood flow, epithelialization, scar size and pain by selecting 20 patients from each group. The study was designed as 2 groups, with 20 patients from each group. In the first group, the patient group in which the amniotic membrane was applied as the graft material, and in the second group, the patients who were left for secondary healing without the use of grafts were examined. In each group, the mucoperiosteal blood flow of the flap was measured from 5 different points of the mucoperiosteal flap from 5 different points on the 7th day and 2nd week preoperatively and postoperatively, with a laser Doppler flowmeter (LDF) for 30 seconds for each point. The obtained data were transferred to the computer environment and recorded by the program (PeriSoft for Windows, Perimed) and the obtained data were evaluated statistically. Results: In the preoperative and postoperative 7th day and 2nd week mucoperiosteal measurements, for all measurement points in the perfusion unit (PU) values, the mean change of the measurements of the group with amniotic membrane applied in the postoperative period was statistically higher than the mean of the measurements of the control group (p<0.05) . It was statistically determined that all the patients in the patient group with amniotic membrane had good epithelialization and no pain at all times. In scar size measurements, patients with amniotic membrane were found to have a statistically significant decrease over time compared to the control group. (p<0.05) Conclusion: Amniotic membrane as a biological dressing graft material is viable and reliable for repairing of post-surgical oral mucosal defects and prevent secondary contraction after vestibuloplasty. Since tissue perfusion, epithelization and scar contracture size can be a good predictor for healing, Amnion membrane was found to be more successful during the healing period of the exposed periosteum and any exposed layer of mucosa.