\documentclass[twocolumn,twoside]{article}
\makeatletter\if@twocolumn\PassOptionsToPackage{switch}{lineno}\else\fi\makeatother

\usepackage{amsfonts,amssymb,amsbsy,latexsym,amsmath,tabulary,graphicx,times,xcolor}

%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
% Following additional macros are required to function some 
% functions which are not available in the class used.
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\usepackage{url,multirow,morefloats,floatflt,cancel,tfrupee}
\makeatletter


\AtBeginDocument{\@ifpackageloaded{textcomp}{}{\usepackage{textcomp}}}
\makeatother
\usepackage{colortbl}
\usepackage{xcolor}
\usepackage{pifont}
\usepackage[nointegrals]{wasysym}
\urlstyle{rm}
\makeatletter

%%%For Table column width calculation.
\def\mcWidth#1{\csname TY@F#1\endcsname+\tabcolsep}

%%Hacking center and right align for table
\def\cAlignHack{\rightskip\@flushglue\leftskip\@flushglue\parindent\z@\parfillskip\z@skip}
\def\rAlignHack{\rightskip\z@skip\leftskip\@flushglue \parindent\z@\parfillskip\z@skip}

%Etal definition in references
\@ifundefined{etal}{\def\etal{\textit{et~al}}}{}


%\if@twocolumn\usepackage{dblfloatfix}\fi
\usepackage{ifxetex}
\ifxetex\else\if@twocolumn\@ifpackageloaded{stfloats}{}{\usepackage{dblfloatfix}}\fi\fi

\AtBeginDocument{
\expandafter\ifx\csname eqalign\endcsname\relax
\def\eqalign#1{\null\vcenter{\def\\{\cr}\openup\jot\m@th
  \ialign{\strut$\displaystyle{##}$\hfil&$\displaystyle{{}##}$\hfil
      \crcr#1\crcr}}\,}
\fi
}

%For fixing hardfail when unicode letters appear inside table with endfloat
\AtBeginDocument{%
  \@ifpackageloaded{endfloat}%
   {\renewcommand\efloat@iwrite[1]{\immediate\expandafter\protected@write\csname efloat@post#1\endcsname{}}}{\newif\ifefloat@tables}%
}%

\def\BreakURLText#1{\@tfor\brk@tempa:=#1\do{\brk@tempa\hskip0pt}}
\let\lt=<
\let\gt=>
\def\processVert{\ifmmode|\else\textbar\fi}
\let\processvert\processVert

\@ifundefined{subparagraph}{
\def\subparagraph{\@startsection{paragraph}{5}{2\parindent}{0ex plus 0.1ex minus 0.1ex}%
{0ex}{\normalfont\small\itshape}}%
}{}

% These are now gobbled, so won't appear in the PDF.
\newcommand\role[1]{\unskip}
\newcommand\aucollab[1]{\unskip}
  
\@ifundefined{tsGraphicsScaleX}{\gdef\tsGraphicsScaleX{1}}{}
\@ifundefined{tsGraphicsScaleY}{\gdef\tsGraphicsScaleY{.9}}{}
% To automatically resize figures to fit inside the text area
\def\checkGraphicsWidth{\ifdim\Gin@nat@width>\linewidth
	\tsGraphicsScaleX\linewidth\else\Gin@nat@width\fi}

\def\checkGraphicsHeight{\ifdim\Gin@nat@height>.9\textheight
	\tsGraphicsScaleY\textheight\else\Gin@nat@height\fi}

\def\fixFloatSize#1{}%\@ifundefined{processdelayedfloats}{\setbox0=\hbox{\includegraphics{#1}}\ifnum\wd0<\columnwidth\relax\renewenvironment{figure*}{\begin{figure}}{\end{figure}}\fi}{}}
\let\ts@includegraphics\includegraphics

\def\inlinegraphic[#1]#2{{\edef\@tempa{#1}\edef\baseline@shift{\ifx\@tempa\@empty0\else#1\fi}\edef\tempZ{\the\numexpr(\numexpr(\baseline@shift*\f@size/100))}\protect\raisebox{\tempZ pt}{\ts@includegraphics{#2}}}}

%\renewcommand{\includegraphics}[1]{\ts@includegraphics[width=\checkGraphicsWidth]{#1}}
\AtBeginDocument{\def\includegraphics{\@ifnextchar[{\ts@includegraphics}{\ts@includegraphics[width=\checkGraphicsWidth,height=\checkGraphicsHeight,keepaspectratio]}}}

\DeclareMathAlphabet{\mathpzc}{OT1}{pzc}{m}{it}

\def\URL#1#2{\@ifundefined{href}{#2}{\href{#1}{#2}}}

%%For url break
\def\UrlOrds{\do\*\do\-\do\~\do\'\do\"\do\-}%
\g@addto@macro{\UrlBreaks}{\UrlOrds}



\edef\fntEncoding{\f@encoding}
\def\EUoneEnc{EU1}
\makeatother
\def\floatpagefraction{0.8} 
\def\dblfloatpagefraction{0.8}
\def\style#1#2{#2}
\def\xxxguillemotleft{\fontencoding{T1}\selectfont\guillemotleft}
\def\xxxguillemotright{\fontencoding{T1}\selectfont\guillemotright}

\newif\ifmultipleabstract\multipleabstractfalse%
\newenvironment{typesetAbstractGroup}{}{}%

%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%

\usepackage[authoryear]{natbib}



\newif\ifnokeywords\nokeywordsfalse

\makeatletter\input{size10-pointfive.clo}\makeatother%
\definecolor{kwdboxcolor}{RGB}{242,242,242}
\usepackage[hidelinks,colorlinks=true,allcolors=blue]{hyperref}
\linespread{1}                 
\def\floatpagefraction{0.8}

\usepackage[paperheight=11.69in,paperwidth=8.26in,top=1in,bottom=1in,left=1in,right=.75in,headsep=24pt]{geometry}

\usepackage{multirow-custom}

\makeatletter

\def\hlinewd#1{%
  \noalign{\ifnum0=`}\fi\hrule \@height #1%
  \futurelet\reserved@a\@xhline}
\def\tbltoprule{\hlinewd{1pt}\\[-14pt]}
\def\tblbottomrule{\noalign{\vspace*{6pt}}\hline\noalign{\vspace*{2pt}}}
\def\tblmidrule{\hline\noalign{\vspace*{2pt}}}



\let\@articleType\@empty
\let\@journalDoi\@empty
\let\@journalVolume\@empty
\let\@journalIssue\@empty
\let\@crossMarkLink\@empty
\let\@receivedDate\@empty
\let\@acceptedDate\@empty
\let\@revisedDate\@empty
\let\@publishedDate\@empty
\let\@copyrightYear\@empty
\let\@firstPage\@empty
\def\articleType#1{\gdef\@articleType{#1}}
\def\journalDoi#1{\gdef\@journalDoi{#1}}
\def\crossMarkLink#1{\gdef\@crossMarkLink{#1}}
\def\receivedDate#1{\gdef\@receivedDate{#1}}
\def\acceptedDate#1{\gdef\@acceptedDate{#1}}
\def\revisedDate#1{\gdef\@revisedDate{#1}}
\def\publishedDate#1{\gdef\@publishedDate{#1}}
\def\copyrightYear#1{\gdef\@copyrightYear{#1}}
\def\journalVolume#1{\gdef\@journalVolume{#1}}
\def\journalIssue#1{\gdef\@journalIssue{#1}}
\def\firstPage#1{\gdef\@firstPage{#1}}
\let\@issuelogo\@empty%
\let\@issuelogoex\@empty%
\def\issuelogo#1{\gdef\@issuelogo{#1}}
\def\issuelogoex#1{\gdef\@issuelogoex{#1}}


\def\author#1{%
  \gdef\@author{%
    \hskip-\dimexpr(\tabcolsep)\hskip5pt%
    \parbox{\dimexpr\textwidth-1pt}%
    {\fontsize{11}{13}\selectfont\raggedright #1}%
  }%
}


\usepackage{pharmascope-abs}
\usepackage{caption}
\usepackage{lastpage}
\usepackage{fancyhdr}
\usepackage[noindentafter,explicit]{titlesec}
\usepackage{fontspec}

\setmainfont[%
BoldFont=cambriab.ttf,%
ItalicFont=CAMBRIAI.TTF,%
BoldItalicFont=CAMBRIAZ.TTF]{Cambria.ttf}
\lefthyphenmin = 3

\def\title#1{%
  \gdef\@title{%
      \vspace*{-40pt}%
       \ifx\@articleType\@empty\else{\fontsize{10}{12}\scshape\selectfont\hspace{8pt}\@articleType\hfill\mbox{}\par\vspace{2pt}}\fi%
       \minipage{\linewidth}
         \hrulefill\\[-0.7pt]%%{\includegraphics[width=75pt,height=50pt]{ijrps_logo.png}}\hfill
         \mbox{~}\hspace{5pt}\parbox{.1\linewidth}{\IfFileExists{images/\@issuelogo.\@issuelogoex}{\includegraphics[width=79pt,height=61pt]{images/\@issuelogo.\@issuelogoex}}{\includegraphics[width=75pt,height=50pt]{ijrps_logo.png}}}\hfill
         \fcolorbox{kwdboxcolor}{kwdboxcolor}{\parbox{.792\linewidth}{%
          \begin{center}\fontsize{17}{17}\selectfont\scshape\vskip-7pt International Journal of Research in Pharmaceutical Sciences\hfill\end{center}%
          \vspace*{-10pt}\hspace*{4pt}{\fontsize{8}{9}\selectfont Published by JK Welfare \& Pharmascope Foundation\hfill  Journal Home Page: \href{www.ijrps.com}{\color{blue}\underline{\smash{www.ijrps.com}}}}\hspace*{4pt}\mbox{}}}%
       \par\vspace*{-1pt}\rule{\linewidth}{1.3pt}%
       \endminipage%
    \par\vspace*{9.2pt}\parbox{.98\linewidth}{\linespread{.9}\raggedright\fontsize{14}{17}\selectfont #1}%
    \vspace*{-8pt}%
  }
}


\setlength{\parindent}{0pt}
\setlength{\parskip}{0.4pc plus 1pt minus 1pt}

\def\abbrvJournalTitle{Int. J. Res. Pharm. Sci.}

\fancypagestyle{headings}{%
  \renewcommand{\headrulewidth}{0pt}%
  \renewcommand{\footrulewidth}{0.3pt}
  \fancyhf{}%
  \fancyhead[R]{%
    \fontsize{9.12}{11}\selectfont\RunningAuthor,\ \abbrvJournalTitle,\ \ifx\@journalVolume\@empty X\else\@journalVolume\fi%
    \ifx\@journalIssue\@empty\else(\@journalIssue)\fi%
    ,\ \ifx\@firstPage\@empty 1\else\@firstPage\fi-\pageref*{LastPage}%
  }%
  \fancyfoot[LO,RE]{\fontsize{9.12}{11}\selectfont\textcopyright\ International Journal of Research in Pharmaceutical Sciences}%
  \fancyfoot[RO,LE]{\fontsize{9.12}{11}\selectfont\thepage}
}\pagestyle{headings}

                                                         
\fancypagestyle{plain}{%
  \renewcommand{\headrulewidth}{0pt}%
  \renewcommand{\footrulewidth}{0.3pt}%
  \fancyhf{}%
  \fancyhead[R]{%
    \fontsize{9.12}{11}\selectfont\RunningAuthor,\ \abbrvJournalTitle,\ \ifx\@journalVolume\@empty X\else\@journalVolume\fi%
    \ifx\@journalIssue\@empty\else(\@journalIssue)\fi%
    ,\ \ifx\@firstPage\@empty 1\else\@firstPage\fi-\pageref*{LastPage}%
  }%
  \fancyfoot[LO,RE]{\fontsize{9.12}{11}\selectfont\textcopyright\ International Journal of Research in Pharmaceutical Sciences}%
  \fancyfoot[RO,LE]{\fontsize{9.12}{11}\selectfont\thepage}
  \ifx\@firstPage\@empty\else\setcounter{page}{\@firstPage}\fi
}


\def\NormalBaseline{\def\baselinestretch{1.1}}
\usepackage{textcase}
\setcounter{secnumdepth}{0}

\titleformat{\section}[block]{\bfseries\boldmath\NormalBaseline\filright\fontsize{10.5}{13}\selectfont}
{\thesection}
{6pt}
{\MakeTextUppercase{#1}}
[]
\titleformat{\subsection}[block]{\bfseries\boldmath\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubsection}
{6pt}
{#1}
[]
\titleformat{\subsubsection}[block]{\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubsubsection}
{6pt}
{#1}
[]
\titleformat{\paragraph}[block]{\NormalBaseline\filright\fontsize{10.5}{10}\selectfont}
{\theparagraph}
{6pt}
{#1}
[]
\titleformat{\subparagraph}[block]{\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubparagraph}
{6pt}
{#1}
[]

\titlespacing{\section}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subsection}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subsubsection}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\paragraph}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subparagraph}{0pt}{.5\baselineskip}{.5\baselineskip}

\captionsetup[figure]{skip=1.4pt,font=bf,labelsep=colon,justification=raggedright,singlelinecheck=false}
\captionsetup[table]{skip=1.4pt,font=bf,labelsep=colon,justification=raggedright,singlelinecheck=false}

\def\bibyear#1{#1}
%\def\bibjtitle#1{#1}   %%Publisher request
\def\bibauand{}
\setlength\bibsep{3pt}
\setlength\bibhang{8pt}

\makeatother
\date{}


\usepackage{float}

\begin{document}


\def\RunningAuthor{Subhashini Ramasubbu et al.}
\firstPage{1179}
\articleType{Original Article}
\receivedDate{20 Aug 2020}
\acceptedDate{24 Sep 2020}
\revisedDate{23 Sep 2020}
\journalVolume{2020, 11 (SPL4)}
\journalDoi{ijrps.v11iSPL4.4261}
\copyrightYear{2020}
\def\authorCount{4}
\def\affCount{1}

\def\journalTitle{International Journal of Research in Pharmaceutical Sciences}

\title{Efficacy of L-Ascorbic acid in the healing of extraction site after trans alveolar extraction of third molar teeth}
\author{Subhashini~Ramasubbu\textsuperscript{*},  
            Shivangi~Gaur,  
            Abdul~Wahab~~P~U, 
            Madhulaxmi~Marimuthu~\\[5pt]{Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai-600 077, Tamil Nadu, India}}

\begin{abstract}
Wound healing monitoring after every surgery is the most vital concern to deal with. The surgical removal of the teeth involves guttering of overlying bone, splitting the tooth (odontectomy), delivery of the tooth, irrigation of the socket, achieving haemostasis and closure of the soft tissue flap. This leads to big surgical insults resulting in post-operative inflammatory response like pain and swelling, difficulty in mouth opening, fever, etc. In some cases, other rare complications, including infection, nerve damage, have also been reported. The objective of this study is to evaluate the effects of submucosal injection of vitamin c (L-Ascorbic Acid) in wound healing after trans alveolar extraction of teeth. Thirty patients requiring trans alveolar extraction of teeth were included in this study. Patients were divided into two groups, Group S (Vit c) and Group B (Control). Healing of extraction socket was observed on 3\ensuremath{^{rd}} and 7\ensuremath{^{th}} post-operative days. The study group (Vitamin C) had better healing indices than the controls at 7\ensuremath{^{th}} post-op day. There was no significant difference in 3\ensuremath{^{rd}} post-op day. There was no significant reduction in pain on 3\ensuremath{^{rd}} and 7\ensuremath{^{th}} post-operative days. L-Ascorbic acid injection provides satisfactory post-operative healing following trans alveolar extraction of teeth. But it does not decrease the post-operative pain following surgery. 
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Trans alveolar extraction,\newline Vitamin C,\newline Wound healing
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Subhashini~Ramasubbu~\\ Phone:\ 9999286618~\\  Email:\ meetsubha07@gmail.com
        \par}\vspace*{-11pt}\hrulefill\par{\fontsize{12}{14}\selectfont ISSN: 0975-7538}\par% 
        \textsc{DOI:}\ \href{https://doi.org/10.26452/\@journalDoi}{\textcolor{blue}{\underline{\smash{https://doi.org/10.26452/\@journalDoi}}}}\par%
        \vspace*{-11pt}\hrulefill\\{\fontsize{9.12}{10.12}\selectfont Production and Hosted by}\par{IJRPS |~\href{www.ijrps.com}{www.ijrps.com}}\par%
        \vspace*{-2pt}{\fontsize{9.12}{10.12}\selectfont\textcopyright\ \@copyrightYear\ $|$ All rights reserved.}\par%
        \vspace*{-11pt}\rule{\linewidth}{1.2pt}
        \makeatother
        
    
\section{Introduction}
Wound healing monitoring after every surgery is the most vital concern to deal with. The surgical removal of the teeth involves guttering of overlying bone, splitting the tooth (odontectomy), delivery of the tooth, irrigation of the socket, achieving haemostasis and closure of the soft tissue flap \unskip~\citep{900000:20470808}. This leads to big surgical insults resulting in post-operative inflammatory response like pain and swelling, difficulty in mouth opening, fever, etc. In some cases, other rare complications, including infection, nerve damage, have also been reported. In addition to this, the residual bony defect takes several weeks to months even a year to slowly fill with blood and gradually with bone and to reossify \unskip~\citep{900000:20470812}.

Vitamin C involves many physiologic functions in the human body, and it has an important role in collagen formation \unskip~\citep{900000:20470804}. Because of its role in collagen formation, it helps in wound healing \unskip~\citep{900000:20470801}. Ascorbic acid is a cofactor in the hydroxylation of proline and lysine, which is a necessary step in collagen formation \unskip~\citep{900000:20470813}. The objective of this study is to evaluate the submucosal injection of vitamin C (L-Ascorbic acid) in wound healing of extraction site after trans alveolar extraction of teeth.

\textbf{Aim}

To evaluate the clinical efficacy of Vitamin C injection in soft tissue healing following trans alveolar extractions of teeth.

\textbf{Objective}

To evaluate the soft tissue wound healing at the extraction site on 3\ensuremath{^{rd}} and 7\ensuremath{^{th}} post-operative day. 

To compare post-operative pain using a standard scale.
    
\section{Materials and Methods}
The study was conducted in 30 patients who were reported to the Oral Surgery clinic for the trans alveolar extraction of teeth. The patients were randomly allocated into two groups. Group S, who received intra mucosal Vitamin injection 200mg and control group Group C received placebo. Trans alveolar surgical extraction of teeth was carried out in all patients. Patients in Group S were given an intramucosal injection of Vitamin C (l-ascorbic acid) 200mg after the closure of the mucoperiosteal flap. Healing is measured by \unskip~\cite{900000:20470802}  (Figure~\ref{f-94321640c283}) on 3\ensuremath{^{rd}} and 7\ensuremath{^{th}} post-operative day.


\bgroup
\fixFloatSize{images/4234fafb-8b8f-415a-bd15-8d2dd21e45ed-upicture1.png}
\begin{figure*}[!htbp]
\centering \makeatletter\IfFileExists{images/4234fafb-8b8f-415a-bd15-8d2dd21e45ed-upicture1.png}{\includegraphics{images/4234fafb-8b8f-415a-bd15-8d2dd21e45ed-upicture1.png}}{}
\makeatother 
\caption{\boldmath {Healing index Score}}
\label{f-94321640c283}
\end{figure*}
\egroup

    
\section{Results}
The healing was measured by Landry et al. index. Table~\ref{tw-d8c4a024477e} represents the mean index of the study group on 3\ensuremath{^{rd}} and 7\ensuremath{^{th}} post-operative day was 2.86 and 4.93, respectively. The mean index of the control group on group 3\ensuremath{^{rd}} and 7\ensuremath{^{th}} post-operative day was 2.30 and 3.03 respectively Study group had satisfactory healing indices than the controls on the 7th post-op day. There was no satisfactory difference on 3\ensuremath{^{rd}} post-op day. There was no significant difference in accordance with pain between the groups. A VAS scale measured the pain. 


\begin{table*}[!htbp]
\caption{\boldmath {Mean healing index} }
\label{tw-d8c4a024477e}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.1704\linewidth-2\tabcolsep}p{\dimexpr.4132\linewidth-2\tabcolsep}p{\dimexpr.4164\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Groups & 3\ensuremath{^{rd}} Post-Operative Day & 7\ensuremath{^{th}} Post-Operative Day\\
\tblmidrule 
Group S &
  2.86 &
  4.93\\
Group C &
  2.30 &
  3.03\\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

    
\section{Discussion}
Vitamin C involves many physiologic functions in the human body, and it has an important role in collagen formation \unskip~\citep{900000:20470805}. Because of its role in collagen formation, it helps in wound healing. Ascorbic acid is a cofactor in the hydroxylation of proline and lysine, which is a necessary step in collagen formation. To stabilise the triple helix structure of collagen, hydroxyproline and hydroxylysine is needed \unskip~\citep{900000:20470807}. In the absence of this stabilisation, the structure disintegrates \unskip~\citep{900000:20470807}. Vitamin C or Ascorbic acid provides tensile strength to the newly formed collagen, which is essential for stretching without tearing. For ulcer healing tensile strength is important. If it fails to stretch the healed ulcer may face a future breakdown. For the functioning of a proper immune system, this Vitamin C is important especially in the patients with open wounds \unskip~\citep{900000:20470811,900000:20470809}.

Vitamin C has Other essential functions also which include:


  
  \begin{enumerate}
  \item \relax First, it is an antioxidant. It inhibits damage to body cells
  \item \relax It is an anti-inflammatory agent which helps in reducing post-operative inflammatory sequelae
  \item \relax Carnitine which is essential for the transport of fat to mitochondria is synthesised with the help of Vitamin C
  \item \relax It also plays a vital role in the synthesis of Norepinephrine, a neurotransmitter
  \item \relax It inhibits the oxidation of iron in the intestine and promotes the absorption of iron.
  \item \relax It also inhibits the oxidation of Vitamin E in the blood.
  \end{enumerate}
  In spontaneous healing after an extraction, the socket is immediately filled by the blood, which is usually completely replaced gradually by increasing granulation tissue density within 2-7 days. Epithelialization starts within 24 hours, and it gets completed after 1-4 weeks \unskip~\citep{900000:20470806,900000:20470810}.

In this study, Vitamin C was injected submucosally of the teeth to be extracted. The total numerical index was evaluated, resulting in an average value per each patient. This analysis indicates a 100\% reduction in gingival inflammation from the average baseline value over a week to one month. The evaluated per cent indicated a significant reduction in the gingival inflammation to the surgical site. It is mandatory to handle soft tissues, especially the thinner ones, more carefully to avoid necrosis. Improvement of the tissue colour and consistency was carefully observed in the recall visits on 3\ensuremath{^{rd}} and 7\ensuremath{^{th}} POD.

Other significant changes which were observed after Vitamin-C (L-Ascorbic acid) administration were in accordance with Nusgens et al. \unskip~\citep{900000:20470803,900000:20470808}. An elevated number of fibroblasts was detected, forming more collagen fibres which could be seen clinically. Many newly formed minute blood capillaries were also detected clinically. These changes are consistent in the formation of new connective tissue in a healing wound. 

This is because Vitamin C plays a vital role as a cofactor for collagen formation. It is the main component of the connective tissue that forms the framework around which the new tissue is built. Collagen is an essential component in the wall of blood vessels. That is why, despite the increase in the number of blood vessels, redness and bleeding tendency markedly decreased clinically. These vessels provide more nutritional and enough oxygen supply to chronically irritated, damaged mucosal areas, thereby it improves their healing.
    
\section{Conclusion}
Submucosal Vitamin C improves post- operative wound healing following Transalveolar extraction of teeth. But it does not decrease the post-operative pain or swelling associated with the surgery.

\textbf{Conflict of Interest}

The authors declare that there is no conflict of interest for this study.

\textbf{Funding Support}

The authors declare that they have no funding support for this study.
    

\bibliographystyle{pharmascope_apa-custom}

\bibliography{\jobname}
\end{document}
