Clinical evaluation of the efficacy of purified bioactive peptides from Spirulina Platensis algae in healing wounds caused by periodontal flap surgery (double-blinded split-mouth clinical trial)

Abstract

Introduction Surgery is a common therapeutic method for the treatment of periodontal diseases in various cases, such as the ineffectiveness of mechanical treatments in removing calculus and plaques. The use of naturally derived pharmaceutical agents after surgery can provide relative relief of postoperative pain, improvement of inflammatory symptoms, and accelerated tissue reconstruction with fewer side effects. The aim of this study was to clinically evaluate the effectiveness of bioactive peptides derived from Spirulina platensis algae in the healing of wounds resulting from periodontal flap surgery.

Materials and Methods In this clinical trial, a split-mouth design was employed, involving 20 patients referred to the Periodontics department of dentistry faculty in Tabriz university of medical sciences for periodontal flap surgery in two oral regions. Before suturing in one side of the patient's mouth, a gel containing Spirulina-derived compounds was applied under the flap, while on the other side, no compounds were used. Soft tissue swelling, gum color, probing depth, Bleeding Index, and Plaque Index were evaluated at 1, 4, and 8 weeks postoperatively. Additionally, patients responded to a questionnaire during the first 7 days after surgery regarding pain levels, the number of analgesics used, postoperative bleeding, facial swelling, and surgical site swelling. Data were analyzed using SPSS 20 software and statistical tests such as Wilcoxon, Kruskal-Wallis, Chi-squared, and Mann-Whitney U test.

Results The use of bioactive peptides from Spirulina resulted in a significant reduction in Probing Depth, Bleeding Index, and Plaque Index at 4 weeks postoperatively compared to the control group (P<.05). At 8 weeks postoperatively, BI and PI values were significantly lower in the intervention group than the control group (P<.05), leading to a reduction in PD in the intervention group compared to the control group, although this difference was not significant. According to clinical examinations, the level of gum redness in the first follow-up (one week after surgery) was significantly lower in the intervention group than the control group (P<.05). However, in the follow-ups at 4 and 8 weeks, although this level was reported lower in the intervention group, it was not statistically significant. Moreover, no significant difference in the reduction of surgical site swelling intensity was observed in follow-ups at 1, 4, and 8 weeks after surgery in both groups. The reduction in facial swelling and postoperative bleeding in the intervention group showed slightly better improvement, but this difference was not significant. The level of pain during the first 7 days after surgery was significantly lower in the intervention group than the control group, and a reduction in analgesic consumption was observed in the intervention group compared to the control group (P<.05).

Conclusion In conclusion, the use of a gel containing bioactive peptides derived from biocompatible Spirulina platensis algae showed greater improvement in Probing Depth, Bleeding Index, Plaque Index, gum redness after surgery, and a reduction in pain and analgesic consumption after surgery in the group exposed to Spirulina gel compared to the control group.