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Three commercial periodontal dressings were tested for antibacterial activity against salivary microorganisms after having been stored dry or in liquid for 1 and 2 days. Inhibition of growth of mixed salivary flora was evaluated on blood agar dishes. Also, the ability of Strep. mutans to colonize the surface of the dressings was tested. The surface contact test indicated antibacterial activity against salivary microorganisms by freshly made Coe-pak and Wondrpak. Some activity could also be observed after 2 days' storage in about half the experiments. The initial bacteriostatic effect of Peripac was limited to the setting phase. The plaque accumulation test revealed single cells only on the surfaces of Coe-pak and Wondrpak whereas Peripac seemed to be colonized by the test bacteria.
The cytotoxicity of three periodontal dressings was evaluated by two in vitro cell culture techniques. Fresh and stored materials were found to be cytotoxic by both techniques and it appeared that the mechanism of cytotoxicity was different for the three dressing materials tested.
A detailed review of periodontal dressings is presented, covering physical, chemical and biological aspects. Areas requiring further research are outlined, particularly in the physico-chemical sphere; and some contra-indications to particular substances are described. It is concluded that there is a definite place for dressings, but that more knowledge is required before optimal properties can be developed.
The sensitizing potential of three periodontal dressing materials was evaluated by the guinea pig maximization test. The results indicated a difference in the sensitization rate of the three materials.
The linear dimensional changes of three commercial periodontal dressings were measured during 24 hours. The dressings revealed different degrees of dimensional changes, which may indicate that exhibit variations in adaptation to wound surfaces.
Three different methods were used to determine working and setting times of periodontal dressings. The Gillmore needle and the rheometer employed were not suitable for recording setting reactions. A penetration test was found applicable for determination of working and setting times for all three dressings although they exhibited different setting characteristics.
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Forty-one patients requiring gingivectomy in one or more areas were used for a clinical evaluation of three different periodontal dressings. Sixty-five operations were performed. Whenever possible different dressings were tested in the same patient. The type of dressing was chosen randomly, applied by one operator and left in place for 1 week. The patients were supplied with analgetic tablets. At day 7 the condition of the dressing was evaluated before removal. The patients' subjective experiences of pain, swelling, bleeding and fever, as well as use of pain relieving tablets, were recorded. The wound was evaluated with regard to the degree of epithelialization, presence of denuded bone and granulation tissue. The tendency to bleeding and the sensitivity of the teeth to a water spray (15 degrees C) were tested. At day 14 and 21 the same evaluation procedure was repeated. In addition the presence of plaque in the operated area was assessed. One of the dressings more frequently induced pain and swelling than the others. Tablet consumption was also higher when this dressing had been used. No statistically significant differences were found in the clinical assessment of wound healing, tendency to bleeding and the sensitivity of teeth.