## 4 Discussion
Subgroup C patients underwent diode laser excision of oral benign neoplasms without stitches (average diameter of the surgical areas was 20 mm) and were treated with Aminogam(r) (three applications per day) until the complete healing of the covering mucosa. With the exclusion of subgroup A patients who had an in-patient comparison, an equivalent number of patients were selected as control cases for B and C experimental subgroups. Overall, a reduction of the elapsed time between surgery and stitches removal and between surgery and healing time were obtained in all experimental groups. In the current study, we enrolled a total of 580 cases (290 for experimental subgroups, 290 for control subgroups) subdivided according to the type of the surgical procedures as follows: teeth extractions--group A; teeth extraction in patients considered at risk of MRONJ development--group B; MRONJ treatment--group C; endosseous implants--group D; laser excision of soft tissues lesions--group E; laser photocoagulation of slow flow vascular malformations--group F; surgical removal of bone lesions--group G.  
After surgery, cases of the experimental subgroups were treated with Aminogam(r) at least five times a day until the soft tissue healed completely. In all the experimental subgroups we found a statistically significant reduction (\(p<0.05\)) of the wound HT, evaluable as 26% less regardless of the kind of surgery, along with reduction of infective complications (infections and post-surgical pain). These data as obtained on a large sample confirm and improve our previously published results as showing an additional reduction of the HT, assuredly related to the increased number of Aminogam(r) applications used in the current study. Furthermore, in the present study, we also introduced four new groups of patients which required additional considerations. Oncologic patients of B group receiving intravenous BPs were considered as at high risk of MRONJ in accordance with the well-recognized side effects of antiresorptive therapy both in oncologic and osteoporortic patients which is described in the literature [19]; for such reasons, faster wound healing without infective complications is certainly useful to avoid osteogenesis development. Moreover, BPs are life-saving drugs for oncologic patients and, therefore, faster wound healing is also useful for reducing the drug suspension period. Patients of C group were affected by MRONJ. In these cases, the reduction of wound HT is very important to reduce risk of infection and other complications, especially wound dehiscence after large surgical incision, and to reduce the aforementioned life-saving drug suspension time in oncologic patients. Patients of F group were affected by slow flow vascular malformations of oral mucosa and were treated by diode laser photocoagulation. In these cases, Aminogam(r) gel, by reducing the risk of ulceration and superinfection, provided a double effect both as mechanical protection for the wound and by accelerating the healing process. Patients of G group were affected by bone lesions. In these cases, Aminogam(r) gel was applied both on the covering mucosa, to obtain a faster healing of surgical incision and to reduce the risk of wound dehiscence, and in the residual cavity in the jaw. As it has been postulated, if Aminogam(r) gel stimulates soft tissues healing, it could play a role in bone regeneration too [20]; the latter could be the object of future studies. The effectiveness of Aminogam(r) gel in wound healing processes has been confirmed by histopathological analysis of specimens (gingival tissues) obtained during exposition of implants in D group patients. In fact, both traditional and CLSM examination highlighted the presence of abundant mature collagen and minor blood vessel density and inflammatory infiltrate in tissues receiving gel after surgery.