Prospective of chitosan crosslinked collagen for postgingivectomy wound healing in fixed orthodontic treatment patient: A narrative review

Fixed orthodontic appliance is used by patients with malocclusion. The prevalence of malocclusion in Indonesia reached 80%. Malocclusion patient treated with fixed orthodontic appliances that cannot maintain oral hygiene can lead to dental plaque accumulation in the orthodontic appliance. The dental plaque accumulation may cause gingivitis or gingival enlargement. gingivectomy can be an option to treat gingival enlargement. Post gingivectomy treatment, the wound healing in the gingiva will take place. Within this process, collagen is required to form a new connective tissue. Collagen is a highly thrombogenic biomaterial and it has an ability to maintain hemostasis. Collagen plays an important role in wound healing especially in remodeling phase. Chitosan contains chitin which is a non-toxic and biocompatible material. In the healing process, collagen induces platelet adhesion and aggregation as well as activation of intrinsic factor of blood coagulation. Chitosan plays a role in the formation of granular tissues with angiogenesis. In this process, chitosan works by stimulating growth factor and cytokine that involved in angiogenesis and fibroblast proliferation. Collagen and chitosan must be crosslinked to be biodegradable. The use of chitosan crosslinked collagen may have potential ability in wound healing post gingivectomy in patients with fixed orthodontic appliance.