JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Experimental assessment of an elderberry-enriched carboxymethyl chitosan gel in a rat gingival defect model: local and systemic tolerance with histological findings
Abstract
Aims: The local and systemic effects of an elderberry-enriched carboxymethyl chitosan (CMCht-E) gel formulation were evaluated in an experimental rat gingival defect model.
Methods: Twenty-one male Wistar rats were randomly assigned to three experimental groups, including a sham group, a CMCht gel group, and a CMCht-E gel group, with seven animals in each group. Standardized gingival defects measuring 3 mm in diameter were surgically created in the mandibular incisor region. Sham defects were irrigated with normal saline only, whereas experimental defects were treated with CMCht or CMCht-E gel. Local tissue responses were evaluated by macroscopic and histological analyses, and systemic effects were assessed using hematological and serum biochemical parameters.
Results: Histological analysis revealed a significant intergroup difference in epithelial thickness (p0.05). Hematological and biochemical parameters showed no significant intergroup differences (p>0.05).
Conclusion: The elderberry-enriched CMCht gel showed favorable histological healing without inflammatory infiltration or systemic adverse effects, supporting its potential as a locally well-tolerated topical biomaterial with anti-inflammatory properties for gingival wound applications.

Keywords : Elderberry extract, carboxymethyl chitosan, gingival defect, topical gel, rat, histological evaluation

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1. Zhang T, Yuan M, Hao X, et al. Innovative biomaterials in promoting intraoral wound healing: mechanisms, applications, and challenges. Mater Today Bio. 2025;35:102470. doi:10.1016/j.mtbio.2025.102470
2. Tavelli L, Barootchi S, Stefanini M, Zucchelli G, Giannobile WV, Wang H. Wound healing dynamics, morbidity, and complications of palatal soft-tissue harvesting. Periodontol 2000. 2023;92(1):90-119. doi:10.1111/prd.12466
3. Feng M, Zeng X, Lin Q, et al. Characterization of chitosan-gallic acid graft copolymer for periodontal dressing hydrogel application. Adv Healthc Mater. 2024;13(7):e2302877. doi:10.1002/adhm.202302877
4. Zhu T, Park HC, Son KM, Yang HC. Effects of dimethyloxalylglycine on wound healing of palatal mucosa in a rat model. BMC Oral Health. 2015; 15(1):60. doi:10.1186/s12903-015-0047-1
5. Toma AI, Fuller JM, Willett NJ, Goudy SL. Oral wound healing models and emerging regenerative therapies. Transl Res. 2021;236:17-34. doi:10. 1016/j.trsl.2021.06.003
6. Torres-Rosas R, Torres-Gómez N, Moreno-Rodríguez A, García-Contreras R, Argueta-Figueroa L. Anti-inflammatory and antibacterial activity of the chitosan/chlorhexidine gel commercial preparation for postexodontia treatment: an in vitro study. Eur J Dent. 2020;14(3):397-403. doi:10.1055/s-0040-1714453
7. Chang G, Dang Q, Liu C, et al. Carboxymethyl chitosan and carboxymethyl cellulose based self-healing hydrogel for accelerating diabetic wound healing. Carbohydr Polym. 2022;292:119687. doi:10.1016/ j.carbpol.2022.119687
8. Geng Y, Xue H, Zhang Z, et al. Recent advances in carboxymethyl chitosan-based materials for biomedical applications. Carbohydr Polym. 2023;305:120555. doi:10.1016/j.carbpol.2023.120555
9. Yin K, Divakar P, Wegst UGK. Plant-derived nanocellulose as structural and mechanical reinforcement of freeze-cast chitosan scaffolds for biomedical applications. Biomacromolecules. 2019;20(10):3733-3745. doi:10.1021/acs.biomac.9b00784
10. Osman AG, Avula B, Katragunta K, Ali Z, Chittiboyina AG, Khan IA. Elderberry extracts: characterization of the polyphenolic chemical composition, quality consistency, safety, adulteration, and attenuation of oxidative stress- and inflammation-induced health disorders. Molecules. 2023;28(7):3148. doi:10.3390/molecules28073148
11. Safta DA, Vlase AM, Pop A, et al. Optimized Sambucus nigra L., Epilobium hirsutum L., and Lythrum salicaria L. Extracts: biological effects supporting their potential in wound care. Antioxidants. 2025; 14(5):521. doi:10.3390/antiox14050521
12. Baysan G, Yilmaz PA, Husemoglu RB, Albayrak AZ, Sisman AR, Havitcioglu H. Elderberry (Sambucus nigra) and hawthorn (Crataegus oxyacantha) extract additives in carboxymethyl chitosan scaffolds for osteochondral tissue engineering applications. J Appl Polym Sci. 2024; 141(28). doi:10.1002/app.55637
13. Uzun Saylan BC, Baysan G, Yılmaz O, et al. In vivo biocompatibility of elderberry-enriched carboxymethyl chitosan in soft tissue and calvaria bone defects. BMC Oral Health. 2025;25(1):1582. doi:10.1186/s12903-025-06991-3
14. Yang L, Han Z, Chen C, et al. Novel probiotic-bound oxidized Bletilla striata polysaccharide-chitosan composite hydrogel. Mater Sci Engineering: C. 2020;117:111265. doi:10.1016/j.msec.2020.111265
15. Zelga PJ, Górnicz MM, Gluszkiewicz JM, Piasecka-Zelga J. Outcomes of acute dermal irritation and sensitisation tests on active dressings for chronic wounds: a comparative study. J Wound Care. 2016;25(12):722-729. doi:10.12968/jowc.2016.25.12.722
16. Baysan G, Husemoglu B, Havitcioglu H. Cytotoxic effects of hawthorn and elderberry extracts on 3t3 fibroblast cell line. J Med Innovation Technol. 2020;2(1):85-91.
17. Uzun Saylan BC, Baysan G, Yılmaz O, Aktaş S, Havıtçıoğlu H. In vitro evaluation of pore size and weight changes of elderberry-enriched carboxymethyl chitosan in various biological fluids. J Mater Mechatronics: A. 2025;6(2):353-365. doi:10.55546/jmm.1717116
18. Giridhar VU. Role of nutrition in oral and maxillofacial surgery patients. Natl J Maxillofac Surg. 2016;7(1):3. doi:10.4103/0975-5950.196146
19. Hatipoglu F, Cunusova A, Kadiraliyeva N, et al. Safety assessment of repeated oral administration of tolfenamic acid in Japanese quails: haematological, biochemical and histopathological evaluations. Vet Med Sci. 2026;12(1):e70770. doi:10.1002/vms3.70770
20. Lasisi TJ, Shittu ST, Oguntokun MM, Tiamiyu NA. Aging affects morphology but not stimulated secretion of saliva in rats. Ann Ib Postgrad Med. 2014;12(2):109-114.
21. Ali J, Chiang M, Lee JB, et al. Is rat a good model for assessment of particulate-based taste-masked formulations? Eur J Pharm Biopharm. 2020;146:1-9. doi:10.1016/j.ejpb.2019.11.001
22. Li X, Yang R, Lu M, et al. Effects of sodium bicarbonate solution on tongue coating and oral hygiene in patients with heart failure: a randomized controlled trial. BMC Oral Health. 2025;25(1):1569. doi:10. 1186/s12903-025-06836-z
23. Chandel S, Khan M, Singh N, Agrawal A, Khare V. The effect of sodium bicarbonate oral rinse on salivary pH and oral microflora: a prospective cohort study. Natl J Maxillofac Surg. 2017;8(2):106. doi:10.4103/njms.NJMS_36_17
24. Lakraj A, Moghimi N, Jabbari B. Sialorrhea: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins. Toxins (Basel). 2013;5(5):1010-1031. doi:10.3390/toxins5051010
25. Li L, Xu J, Ye C, et al. Biomaterials-based strategy for dental-oral tissue regeneration: current clinical application, laboratory development, and future direction. Biomaterials. 2026;326:123714. doi:10.1016/j.biomaterials.2025.123714
26. Shariatinia Z. Carboxymethyl chitosan: properties and biomedical applications. Int J Biol Macromol. 2018;120(Pt B):1406-1419. doi:10. 1016/j.ijbiomac.2018.09.131
27. Ho GTT, Wangensteen H, Barsett H. Elderberry and elderflower extracts, phenolic compounds, and metabolites and their effect on complement, RAW 264.7 macrophages and dendritic cells. Int J Mol Sci. 2017;18(3):584. doi:10.3390/ijms18030584
28. Osman AG, Avula B, Katragunta K, Ali Z, Chittiboyina AG, Khan IA. Elderberry extracts: characterization of the polyphenolic chemical composition, quality consistency, safety, adulteration, and attenuation of oxidative stress- and inflammation-induced health disorders. Molecules. 2023;28(7):3148. doi:10.3390/molecules28073148
Article available in :
Volume 7, Issue 2, 2026
Page : 297-306
https://doi.org/10.47582/jompac.1867014
Article Information
Received : 19 Oca 2026
Accepted : 28 Şub 2026
Published : 27 Mar 2026
Corresponding Author :

Bilge Cansu Uzun Saylan: Department of Periodontology, Faculty of Dentistry, Dokuz Eylül University, İzmir, Turkiye

[email protected]
Citation : Uzun Saylan BC, Yılmaz O, Ziylan A, et al. Experimental assessment of an elderberry-enriched carboxymethyl chitosan gel in a rat gingival defect model: local and systemic tolerance with histological findings. J Med Palliat Care. 2026;7(2):297-306. doi:10.47582/jompac.1867014

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