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Vela OC, Boariu M, Rusu D, Iorio-Siciliano V, Ramaglia L, Boia S, Radulescu V, Ilyes I, Stratul SI. Healing of Periodontal Suprabony Defects following Treatment with Open Flap Debridement with or without Hyaluronic Acid (HA) Application. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:829. [PMID: 38793012 PMCID: PMC11122748 DOI: 10.3390/medicina60050829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/09/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: This randomized, double-arm, multicentric clinical trial aims to compare the clinical outcomes following the treatment of suprabony periodontal defects using open flap debridement (OFD) with or without the application of hyaluronic acid (HA). Materials and Methods: Sixty systemically healthy patients with at least two teeth presenting suprabony periodontal defects were randomly assigned with a 1:1 allocation ratio using computer-generated tables into a test (OFD + HA) or control group (OFD). The main outcome variable was clinical attachment level (CAL). The secondary outcome variables were changes in mean probing pocket depth (PPD), gingival recession (GR), full-mouth plaque score (FMPS), and full-mouth bleeding score (FMBS). All clinical measurements were carried out at baseline and 12 months. Results: Sixty patients, thirty in each group, were available for statistical analysis. The mean CAL gain was statistically significantly different (p < 0.001) in the test group compared with the control group (3.06 ± 1.13 mm vs. 1.44 ± 1.07 mm). PPD reduction of test group measurements (3.28 ± 1.14 mm) versus the control group measurements (2.61 ± 1.22 mm) were statistically significant (p = 0.032). GR changes were statistically significant only in the test group 0.74 ± 1.03 mm (p < 0.001). FMBS and FMPS revealed a statistically significant improvement mostly in the test group. Conclusions: Suprabony periodontal defects could benefit from the additional application of HA in conjunction with OFD in terms of improvement of the clinical parameters compared with OFD alone.
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Affiliation(s)
- Octavia Carolina Vela
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.C.V.); (D.R.); (S.B.); (V.R.); (I.I.); (S.-I.S.)
| | - Marius Boariu
- Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.C.V.); (D.R.); (S.B.); (V.R.); (I.I.); (S.-I.S.)
| | - Vincenzo Iorio-Siciliano
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, 80138 Naples, Italy; (V.I.-S.); (L.R.)
| | - Luca Ramaglia
- Department of Periodontology, School of Dental Medicine, University of Naples Federico II, 80138 Naples, Italy; (V.I.-S.); (L.R.)
| | - Simina Boia
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.C.V.); (D.R.); (S.B.); (V.R.); (I.I.); (S.-I.S.)
| | - Viorelia Radulescu
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.C.V.); (D.R.); (S.B.); (V.R.); (I.I.); (S.-I.S.)
| | - Ioana Ilyes
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.C.V.); (D.R.); (S.B.); (V.R.); (I.I.); (S.-I.S.)
| | - Stefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.C.V.); (D.R.); (S.B.); (V.R.); (I.I.); (S.-I.S.)
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De Lauretis A, Øvrebø Ø, Romandini M, Lyngstadaas SP, Rossi F, Haugen HJ. From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308848. [PMID: 38380549 PMCID: PMC11077667 DOI: 10.1002/advs.202308848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/23/2024] [Indexed: 02/22/2024]
Abstract
Periodontitis is a dysbiosis-driven inflammatory disease affecting the tooth-supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step-wise therapeutic approach is employed for periodontitis. After an initial behavioral and non-surgical phase, intra-bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra-bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.
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Affiliation(s)
- Angela De Lauretis
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Øystein Øvrebø
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Mario Romandini
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
| | - Ståle Petter Lyngstadaas
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
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Basudan AM, Abas I, Shaheen MY, Alghamdi HS. Effectiveness of Topical Oxygen Therapy in Gingivitis and Periodontitis: Clinical Case Reports and Review of the Literature. J Clin Med 2024; 13:1451. [PMID: 38592268 PMCID: PMC10932006 DOI: 10.3390/jcm13051451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/22/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Gingivitis and periodontitis are common oral pathological conditions. Several optional adjunctive local therapies are used clinically. While antibiotics and chlorhexidine are the most common agents of choice, their long-term use is associated with several adverse effects. Some of these include staining of teeth and restorations, cellular cytotoxicity and hypersensitivity. Topical oxygen therapy has been recently introduced and could be clinically capable of inhibiting plaque bacterial biofilm growth. Available as a mouthwash, toothpaste and oral gel, this formulation comprises cellulose, glycerol and sodium peroxoborate, and releases topical oxygen in a controlled manner. Moreover, it releases topical oxygen, in a controlled manner, and lactoferrin, which are capable of antibacterial action and stimulation of bone cells, respectively. The aim of this paper is to report a case of gingivitis and another case of periodontitis, both of which were successfully treated clinically with adjunctive local oxygen therapy (blue®m). Additionally, this paper aims to review the relevant literature in terms of adjunct topical or local therapies used in the treatment of gingivitis and periodontitis, in order to understand how local therapies are helpful and to know if local oxygen therapy is a suitable clinical alternative.
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Affiliation(s)
- Amani M. Basudan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (M.Y.S.); (H.S.A.)
| | - Irfan Abas
- Department of Oral Implantology and Restorative Dentistry, Academy and Private Practice, Herenstraat 37, 1404 HC Bussum, The Netherlands;
| | - Marwa Y. Shaheen
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (M.Y.S.); (H.S.A.)
| | - Hamdan S. Alghamdi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (M.Y.S.); (H.S.A.)
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Levrini L, Rossini M, Truppello E, Sevi S, Fiorini E, Benedicenti S, Pasquale C, Farronato D. Evaluation of Sterify Gel as an Adjunctive Treatment to Scaling and Root Planing in Promoting Healing of Periodontal Pockets: A Split-Mouth Randomized Controlled Trial. Int J Dent 2024; 2024:3113479. [PMID: 38213553 PMCID: PMC10783987 DOI: 10.1155/2024/3113479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/22/2023] [Accepted: 12/07/2023] [Indexed: 01/13/2024] Open
Abstract
Background Periodontal disease is a common infectious disease that leads to the destruction of tooth-supporting structures. Current treatments, such as scaling and root planing (SRP), have limitations in deep and complex pockets, and antibiotic use carries the risk of resistance. Sterify Gel, a medical device composed of polyvinyl polymers, hydroxytyrosol, nisin, and magnesium ascorbyl phosphate, offers a new approach to periodontal care. This study aims to evaluate the safety and efficacy of Sterify Gel as an adjunctive treatment to SRP in promoting the healing of periodontal pockets. Methods The study includes 34 patients with moderate to advanced chronic periodontal disease. Randomization assigned one site for SRP alone (control) and the other site for SRP with Sterify Gel (treatment). Periodontal parameters were evaluated at baseline, 1, 2, and 3 months after treatment bacterial contamination was assessed through quantitative PCR at baseline and 3 months after treatment. Statistical analysis was conducted using ANOVA and Wilcoxon test. Results Treatment with Sterify Gel and SRP demonstrated significant improvements in pocket depth, gingival recession, and clinical attachment level compared with SRP alone. Bleeding and plaque indexes, pain perception, tooth mobility, and furcations showed no significant differences between the two groups. The treatment group showed a reduction in bacterial contamination at 3 months. Conclusions Sterify Gel in combination with SRP shows the potential for improving periodontal health by promoting healing and reducing periodontal pockets. It may offer benefits in preventing bacterial recolonization and reducing reliance on antibiotics.
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Affiliation(s)
- Luca Levrini
- Department of Human Sciences, Innovation and Territory, Postgraduate School of Orthodontic, University of Insubria, 21100, Varese, Italy
| | - Michela Rossini
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
| | - Elisa Truppello
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
| | - Simone Sevi
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
| | - Enrico Fiorini
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132, Genoa, Italy
| | - Claudio Pasquale
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132, Genoa, Italy
| | - Davide Farronato
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
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Yakout BK, Kamel FR, Khadr MAEAA, Heikal LAH, El-Kimary GI. Efficacy of hyaluronic acid gel and photobiomodulation therapy on wound healing after surgical gingivectomy: a randomized controlled clinical trial. BMC Oral Health 2023; 23:805. [PMID: 37891549 PMCID: PMC10612174 DOI: 10.1186/s12903-023-03519-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Surgical gingivectomy can be considered the gold standard treatment for gingival enlargement. The healing of wound site after gingivectomy occurs slowly by secondary intention. To accelerate the wound healing process, several studies have been conducted evaluating the effect of various treatment modalities. Photobiomodulation therapy (PBMT) was proposed to provide minimally invasive and painless treatment as well as to decrease discomfort of the patient following the surgical process. Another factor that is expected to improve the healing after surgery is topical application of chemotherapeutic agents such as Hyaluronic acid (HA). This study aims to assess the effect of topically applied HA gel after PBMT on the healing of wound site after surgical gingivectomy. METHODS This randomized controlled clinical trial included twenty-six surgical gingivectomy wound sites, equally divided into two groups, Group-I (test group): the surgical sites after gingivectomy were irradiated with a diode laser (980 nm, 0.2 W) then covered by 2% HA gel loaded in a special custom-made soft transparent tissue guard appliance for each patient. Group II (control group): the surgical sites were irradiated with a diode laser (980 nm, 0.2 W) only. Wound healing was assessed subjectively by Landry healing index on the 3rd, 7th, 14th and 21st days after surgery, and pain perception was assessed by the patients using visual analog scale (VAS) throughout the 21 days of the follow up period. Comparisons between the two study groups were performed using Mann-Whitney U test, while comparisons between different time points were performed using Friedman test. Significance was inferred at p value < 0.05. RESULTS By the end of the follow-up period, surgical sites of the test group showed excellent healing compared to the control group. There were no significant differences in VAS scores between both groups (p > 0.05). CONCLUSIONS Application of 2% HA gel as an adjunctive to PBMT was found to have significant clinical effects and higher power of repair among test group when compared to that achieved by PBMT alone in control group. TRIAL REGISTRATION This study was retrospectively registered on ClinicalTrials.gov and first posted on 28th of March 2023 with an identifier number: NCT05787912.
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Affiliation(s)
- Basma Khalil Yakout
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt.
| | - Fatma Ramzy Kamel
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
| | - Maha Abd El-Aziz Abou Khadr
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
| | | | - Gillan Ibrahim El-Kimary
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt
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Ostos-Aguilar BI, Pinheiro Furquim C, Muniz FWMG, Faveri M, Meza-Mauricio J. Clinical efficacy of hyaluronic acid in the treatment of periodontal intrabony defect: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:1923-1935. [PMID: 36598601 DOI: 10.1007/s00784-022-04855-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This systematic review aimed to evaluate the effects of hyaluronic acid (HA) alone or in combination with any bone substitute for the treatment of intrabony defects (IBDs). MATERIAL AND METHODS Six databases were searched up to April 2022 to find randomized clinical trials comparing the clinical effects of open flap debridement (OFD) + HA versus OFD alone (first group) or OFD + HA + bone substitutes versus OFD + bone substitutes (second group) in the treatment of IBDs with a follow-up of at least 3 months. Random effects models of mean differences were used to determine the clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic bone fill (RBF). RESULTS Of the 276 studies identified, 6 were included in the qualitative synthesis, and 5 in the meta-analyses. The meta-analyses in the first group showed a statistically significant differences for CAL gain (mean difference [MD]:1.00; 95% confidence interval [CI]:0.65 - 1.35; n = 2) and PD reduction (MD: 0.76; 95%CI: 0.34 - 1.17; n = 2) favoring HA + OFD at 6 months. However, in the second group, the meta-analyses did no show additional effect of HA in association with bone substitute was demonstrated for either CAL gain (MD: 0.57; 95%CI: - 0.30 - 1.43; n = 2) or PD reduction (MD: 1.05; 95%CI: - 0.38 - 2.47; n = 2) but did show significant differences for RBF (MD: 0.57; 95%CI: 0.15 - 0.99; n = 2) at 12 months. CONCLUSION Compared with OFD alone, local application of HA in the treatment of IBDs provided a significant CAL gain and PD reduction at 6 months. However, its combination with bone substitutes showed no statistically significant differences at 12 months. CLINICAL RELEVANCE The use of OFD + HA improves the CAL and PD in the treatment of IBDs compared to OFD only after 6 months of follow-up. These results are not maintained after 12 months.
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Affiliation(s)
- Bertha Inés Ostos-Aguilar
- Department of Periodontology, School of Dentistry, Universidad Cientifica del Sur, Calle Cantuarias 398, 15048, Miraflores, Lima, Peru
| | - Camila Pinheiro Furquim
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil
| | | | - Marcelo Faveri
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil
| | - Jonathan Meza-Mauricio
- Department of Periodontology, School of Dentistry, Universidad Cientifica del Sur, Calle Cantuarias 398, 15048, Miraflores, Lima, Peru.
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Efficiency of Hyaluronic Acid in Infrabony Defects: A Systematic Review of Human Clinical Trials. Medicina (B Aires) 2022; 58:medicina58050580. [PMID: 35629997 PMCID: PMC9143907 DOI: 10.3390/medicina58050580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/19/2022] [Accepted: 04/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background and objectives: The aim of this systematic review was to assess the electronic literature about the benefits of using hyaluronic acid (HA) in the surgical periodontal treatment of infrabony defects. Materials and methods: This review was conducted under the PRISMA guidelines. The electronic search was conducted on PubMed, Scopus, Web of Science, and Cochrane databases until February 2022. The inclusion criteria consisted of human clinical trials that reported the use of HA in open-flap debridement (OFD) for infrabony defects. The assessment of risk of bias was performed using the Cochrane risk of bias tool. Statistical analysis was performed using Review Manager. Results: Overall, three RCTs were found eligible for the statistical analysis. Probing depth (PD) reduction and clinical attachment level (CAL) gain in the HA test group presented WMs of −1.11 mm (95% CI −2.38 to 0.16 mm; p = 0.09) and −1.38 mm (95% CI −2.26 to −0.49 mm; p = 0.002), respectively. However, the heterogeneity of the RCTs was high, and the risk of bias, in general, was low. Conclusions: The use of hyaluronic acid seems to have beneficial effects in periodontal surgery using OFD, in terms of PD and CAL. To draw a clear conclusion, more adapted and well-designed clinical trials are needed to assess the advantage of this product in comparison with other products.
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Lee JH, Lee KE, Nam OH, Chae YK, Lee MH, Kweon DK, Kim MS, Lee HS, Choi SC. Orodispersible hyaluronic acid film delivery for oral wound healing in rats. J Dent Sci 2022; 17:1595-1603. [PMID: 36299335 PMCID: PMC9588893 DOI: 10.1016/j.jds.2022.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/07/2022] [Indexed: 11/30/2022] Open
Abstract
Background/purpose Oral wound healing undergoes a dynamic process of oral environment. This study aimed to investigate the effects of hyaluronic acid (HA) film on oral wound healing in a rat model. Materials and methods A total of 60 rats with tongue wounds (5 mm in diameter) were randomly divided into control (n = 20), HA gel (n = 20), and HA film groups (n = 20). The animals were sacrificed on either 3 or 7 days after the experiment. Clinical, histological, and quantitative reverse transcriptase-polymerase chain reaction analysis were performed to evaluate the healing rate, inflammation, re-epithelialization, and gene expression of wound healing biomarkers. Results The healing rates of HA gel (84.4 ± 9.2%) and HA film (74.0 ± 15.0%) were significantly higher than that of the control (51.7 ± 16.9%) on day 7 (P < 0.001 and P = 0.002, respectively). Histological analysis revealed no significant differences between the groups on day 3. On day 7, only the HA film showed significant improvement in inflammation (P = 0.038) and re-epithelialization (P = 0.011) compared to the control. Regarding wound healing biomarkers, both HA gel and HA film groups showed lower level of COL1α1 expression on day 3 compared to the control. Conclusion Within the limits of this study, HA film was found to be effective for oral wound healing, particularly for re-epithelialization. This finding suggests that HA film delivery can be beneficial not only for clinical convenience but also for promoting oral wound healing.
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Affiliation(s)
- Jeong Hyun Lee
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Ko Eun Lee
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Ok Hyung Nam
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
- Corresponding author. Department of Pediatric Dentistry, Kyung Hee University School of Dentistry, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea.
| | - Yong Kwon Chae
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | | | | | - Mi Sun Kim
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, South Korea
| | - Hyo-Seol Lee
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Sung Chul Choi
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, South Korea
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Khan MA, Sivaraj LD, Nahar P, Kollata VRS, Prakash M, Vaderhobli RM. Efficacy of the Use of Adjunctives in Periodontal Surgeries: An Evidenced-based Summary. J Long Term Eff Med Implants 2022; 32:63-82. [DOI: 10.1615/jlongtermeffmedimplants.2022043326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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El-Rashidy AA, El Moshy S, Radwan IA, Rady D, Abbass MMS, Dörfer CE, Fawzy El-Sayed KM. Effect of Polymeric Matrix Stiffness on Osteogenic Differentiation of Mesenchymal Stem/Progenitor Cells: Concise Review. Polymers (Basel) 2021; 13:2950. [PMID: 34502988 PMCID: PMC8434088 DOI: 10.3390/polym13172950] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 01/23/2023] Open
Abstract
Mesenchymal stem/progenitor cells (MSCs) have a multi-differentiation potential into specialized cell types, with remarkable regenerative and therapeutic results. Several factors could trigger the differentiation of MSCs into specific lineages, among them the biophysical and chemical characteristics of the extracellular matrix (ECM), including its stiffness, composition, topography, and mechanical properties. MSCs can sense and assess the stiffness of extracellular substrates through the process of mechanotransduction. Through this process, the extracellular matrix can govern and direct MSCs' lineage commitment through complex intracellular pathways. Hence, various biomimetic natural and synthetic polymeric matrices of tunable stiffness were developed and further investigated to mimic the MSCs' native tissues. Customizing scaffold materials to mimic cells' natural environment is of utmost importance during the process of tissue engineering. This review aims to highlight the regulatory role of matrix stiffness in directing the osteogenic differentiation of MSCs, addressing how MSCs sense and respond to their ECM, in addition to listing different polymeric biomaterials and methods used to alter their stiffness to dictate MSCs' differentiation towards the osteogenic lineage.
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Affiliation(s)
- Aiah A. El-Rashidy
- Biomaterials Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt;
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (S.E.M.); (I.A.R.); (D.R.); (M.M.S.A.)
| | - Sara El Moshy
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (S.E.M.); (I.A.R.); (D.R.); (M.M.S.A.)
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt
| | - Israa Ahmed Radwan
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (S.E.M.); (I.A.R.); (D.R.); (M.M.S.A.)
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt
| | - Dina Rady
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (S.E.M.); (I.A.R.); (D.R.); (M.M.S.A.)
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt
| | - Marwa M. S. Abbass
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (S.E.M.); (I.A.R.); (D.R.); (M.M.S.A.)
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, 24105 Kiel, Germany;
| | - Karim M. Fawzy El-Sayed
- Stem Cells and Tissue Engineering Research Group, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt; (S.E.M.); (I.A.R.); (D.R.); (M.M.S.A.)
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, 24105 Kiel, Germany;
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo 11562, Egypt
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Clinical Comparison of MEBO and Hyaluronic Acid Gel in the Management of Pain after Free Gingival Graft Harvesting: A Randomized Clinical Trial. Int J Dent 2021; 2021:2548665. [PMID: 34426739 PMCID: PMC8380183 DOI: 10.1155/2021/2548665] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022] Open
Abstract
Aim This study aimed to compare the effect of MEBO versus 0.2% hyaluronic acid gel (Gengigel®) applied to the palatal donor site on postoperative pain reduction and wound healing after free gingival graft harvesting. Methodology. Thirty-nine patients with different mucogingival defects were included in this study for harvesting a free gingival graft (FGG) for soft tissue augmentation. Patients were randomly assigned into three equal groups: group I (MEBO), group II (0.2% HA Gengigel®), and group III (control). Postoperative pain was recorded by using the Visual Analogue Scale (VAS). Analgesic consumption was recorded for 7 days postoperatively. Wound size was measured at baseline and on days 3, 7, 14, and 21. Postoperative healing of the palatal wound was assessed by the VAS score for color match on days 3, 7, 14, 21, and 42. Results Results of this study showed significant postoperative pain reduction for the three groups; MEBO showed statistically significant less VAS score compared to the other two groups, while HA showed statistically significant less VAS score compared to the control group. Both MEBO and HA showed statistically significant less total analgesic consumption. No statistically significant difference was observed between groups for wound size. MEBO showed statistically significant higher VAS for color match. Conclusions Both treatment modalities could reduce postoperative pain following harvesting of FGG and improve the palatal wound healing. However, MEBO showed better outcomes in terms of postoperative pain and color match.
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Mamajiwala AS, Sethi KS, Raut CP, Karde PA, Mamajiwala BS. Clinical and radiographic evaluation of 0.8% hyaluronic acid as an adjunct to open flap debridement in the treatment of periodontal intrabony defects: randomized controlled clinical trial. Clin Oral Investig 2021; 25:5257-5271. [PMID: 33598778 DOI: 10.1007/s00784-021-03834-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/08/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Present study aimed to evaluate and compare the clinical and radiographic efficacy of 0.8% hyaluronic acid (HA) gel as an adjunct to open flap debridement (OFD) versus open flap debridement (OFD) alone in the treatment of periodontal intrabony defects. MATERIALS AND METHODS This randomized, controlled, split-mouth, clinical trial included 20 chronic periodontitis (stage II or III (grades A to B)) patients, having at least two contralateral intrabony defects. Forty bilateral intrabony defects (20 in each group) were randomly divided into test (0.8% HA gel + OFD) and control (OFD + placebo) groups. Clinical parameters evaluated at baseline, 6-months, and 12-months were plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and gingival recession (GR). Using cone beam computed tomography (CBCT), radiographic parameters were evaluated at baseline and 12 months. This included bone defect fill (DF), alveolar crest changes (ACC), and defect resolution (DR). CAL served as the primary outcome variable. RESULTS After 12 months, the test group showed significantly greater CAL gain (5.1 ± 1.2 versus 4.05 ± 1.19 mm) and bone defect fill (DF) (5.67 ± 2.01 versus 4.49 ± 1.78 mm) compared to the control group. Mean PD reduction in the test group (5.3 ± 1.2 versus 4.35 ± 0.81 mm) was statistically significant compared to the control group at 12-month period. The control group showed statistically significant increase in GR (1.2 ± 0.76 versus 0.7 ± 0.73 mm) compared to the test group after 12 months. CONCLUSION Application of hyaluronic acid gel in conjunction with open flap debridement resulted in enhanced clinical and radiographic outcomes compared to open flap debridement alone. CLINICAL RELEVANCE Adjunctive application of HA gel in open flap debridement may improve clinical and radiographic outcomes. CLINICAL TRIAL REGISTERED NUMBER CTRI/2018/03/012334.
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Affiliation(s)
- Alefiya S Mamajiwala
- Department of Periodontology and Oral Implantology, Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik, Maharashtra, India
| | - Kunal S Sethi
- Department of Periodontology and Oral Implantology, Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik, Maharashtra, India
| | - Chetan P Raut
- Department of Periodontology and Oral Implantology, Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik, Maharashtra, India.
| | - Prerna A Karde
- Department of Periodontology and Oral Implantology, Karmaveer Bhausaheb Hiray Dental College and Hospital, Nashik, Maharashtra, India
| | - Batul S Mamajiwala
- Department of Public Health Dentistry, Government Dental College and Hospital, Mumbai, India
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13
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Shirakata Y, Nakamura T, Kawakami Y, Imafuji T, Shinohara Y, Noguchi K, Sculean A. Healing of buccal gingival recessions following treatment with coronally advanced flap alone or combined with a cross-linked hyaluronic acid gel. An experimental study in dogs. J Clin Periodontol 2021; 48:570-580. [PMID: 33513277 PMCID: PMC8248173 DOI: 10.1111/jcpe.13433] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/14/2020] [Accepted: 01/22/2021] [Indexed: 01/13/2023]
Abstract
Aim To clinically and histologically evaluate in dogs the healing of gingival recessions treated with coronally advanced flap (CAF) with or without cross‐linked hyaluronic acid (HA). Materials and methods Gingival recession defects were surgically created on the vestibular side of both maxillary canines in 8 dogs. After 8 weeks of plaque accumulation, the 16 chronic defects were randomly treated with either CAF alone or CAF and HA‐gel (CAF/HA). Clinical and histological outcomes were evaluated at 10 weeks post‐surgically. Results Compared to baseline, the clinical measurements at 10 weeks revealed a statistically significant decrease in gingival recession for both CAF (p < 0.01) and CAF/HA (p < 0.001) groups. Statistically significant differences were found in clinical attachment level (p < 0.05) and width of gingival recession (p < 0.01) favouring the CAF/HA group. Bone formation was statistically significantly greater in the CAF/HA group than in the CAF group (1.84 ± 1.16 mm vs., 0.72 ± 0.62 mm, respectively, p < 0.05). Formation of cementum and connective tissue attachment were statistically significantly higher in the CAF/HA group compared with the CAF group (i.e. 4.31 ± 1.78 mm versus 2.40 ± 1.35 mm and 1.69 ± 0.98 mm versus 0.74 ± 0.68 mm, respectively (p < 0.05)). Conclusions The present data have for the first time provided histologic evidence for periodontal regeneration of gingival recession defects following treatment with CAF and HA. Clinical relevance The use of HA in conjunction with CAF may represent a novel modality for treating gingival recession defects.
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Affiliation(s)
- Yoshinori Shirakata
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Toshiaki Nakamura
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yoshiko Kawakami
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takatomo Imafuji
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yukiya Shinohara
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kazuyuki Noguchi
- Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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14
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Lobato JCRF, Dos Santos Vilhena MA, Izidoro C, Alves RC, Proença L. Single application of 0.8% hyaluronic acid as a coadjuvant of nonsurgical treatment in nonsmoking patients with periodontitis: A split-mouth, randomized, controlled pilot clinical trial. J Indian Soc Periodontol 2019; 23:545-548. [PMID: 31849400 PMCID: PMC6906898 DOI: 10.4103/jisp.jisp_674_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background: Topical coadjuvants might be indicated to increase the results of nonsurgical periodontal treatment and overcome some of its limitations. The aim of this study was to evaluate the clinical benefits of a single topical application of 0.8% hyaluronic acid (HA) as a coadjuvant to scaling and root planing (SRP) in periodontal patients. Materials and Methods: Sixteen patients diagnosed with periodontitis were recruited to participate in this split-mouth randomized controlled trial. At baseline, oral hygiene instructions, prophylaxis, and SRP were performed in both sides; additionally, a subgingival application of HA at 0.8% was made in the test side. Several clinical parameters were assessed at baseline, 6, and 12 weeks later: full mouth plaque score, gingival score, bleeding on probing (BoP), probing depth (PD), and clinical attachment level (CAL). Results: At the end of 12 weeks, there was a overall improvement in all periodontal parameters in both sides (P < 0.05). Test sides showed less BoP when compared to the control sides (9.4 ± 4.0 vs. 14.9 ± 8.9, P < 0.05). Other periodontal parameters such as PD and CAL showed a slight improvement in comparison with the control sides, but the difference was not statistically significant (P > 0.05). Conclusion: Results from this study indicate that a single subgingival application of 0.8% HA seems to reduce gingival inflammation and improve clinical parameters, particularly BoP. Further studies are needed to evaluate the effect of repeated application of HA and long-term results.
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Affiliation(s)
| | | | | | - Ricardo Castro Alves
- Department of Periodontology, Almada, Portugal.,Egas Moniz Clinical Research Unit, Almada, Portugal
| | - Luís Proença
- Egas Moniz Clinical Research Unit, Almada, Portugal
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15
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Yıldırım S, Özener HÖ, Doğan B, Kuru B. Effect of topically applied hyaluronic acid on pain and palatal epithelial wound healing: An examiner-masked, randomized, controlled clinical trial. J Periodontol 2019; 89:36-45. [PMID: 28914592 DOI: 10.1902/jop.2017.170105] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 08/22/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aims to evaluate the effects of two different concentrations of topical hyaluronic acid (HA) on postoperative patient discomfort and wound healing of palatal donor sites after free gingival graft (FGG) surgery. METHODS Thirty-six patients requiring FGG were randomly assigned into three groups in an examiner-masked, randomized, controlled clinical trial. After harvesting palatal grafts, 0.2% and 0.8% HA gels were used in test groups 1 and 2, respectively. Gels were applied on donor sites and protected with periodontal dressing in the test groups, whereas the wound was covered only with periodontal dressing in the control group. On days 3, 7, 14, and 21, pain and burning sensation were recorded using a visual analog scale (VAS) as well as other parameters such as complete epithelization (CE) and color match on days 3, 7, 14, 21, and 42. RESULTS Test groups experienced less pain than the control group on days 3 and 7 (P <0.001 and P <0.001, respectively). Mean VAS score for burning sensation was higher in the control group on day 3 compared with test groups 1 and 2 (P = 0.03 and P = 0.02, respectively). CE in all patients was achieved on day 21 in both test groups, whereas it was achieved on day 42 in the control group. The test groups showed higher color match scores than the control group on days 21 (P <0.001 and P <0.001, respectively) and 42 (P = 0.004 and P = 0.002, respectively). CONCLUSION Topical application of HA exhibits positive impact on postoperative pain and burning sensation, and accelerates palatal wound healing in terms of epithelization and color match.
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Affiliation(s)
- Selin Yıldırım
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Hafize Öztürk Özener
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Başak Doğan
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Bahar Kuru
- Department of Periodontology, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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16
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Eliezer M, Imber JC, Sculean A, Pandis N, Teich S. Hyaluronic acid as adjunctive to non-surgical and surgical periodontal therapy: a systematic review and meta-analysis. Clin Oral Investig 2019; 23:3423-3435. [PMID: 31338632 DOI: 10.1007/s00784-019-03012-w] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 07/04/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate the potential added benefit of the topical application of hyaluronic acid (HA) on the clinical outcomes following non-surgical or surgical periodontal therapy. MATERIALS AND METHODS A systematic search was performed in Medline, Embase, Cochrane, Web of Science, Scopus and Grey literature databases. The literature search was preformed according to PRISMA guidelines. The Cochrane risk of bias tool was used in order to assess the methodology of the included trials. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) between the treatment and controls were estimated using the random-effect model for amount of bleeding on probing (BOP), probing depth (PD) reduction and clinical attachment level (CAL) gain. In order to minimize the bias and to perform meta-analysis, only randomized clinical studies (RCTs) were selected. RESULTS Thirteen RCTs were included: 11 on non-surgical periodontal treatment and two on surgical periodontal treatment. Overall analysis of PD reduction, CAL gain and BOP reduction in non-surgical therapy with adjunctive HA presented WMD of - 0.36 mm (95% CI - 0.54 to - 0.19 mm; p < 0.0001), 0.73 mm (95% CI 0.28 to 1.17 mm; p < 0.0001) and - 15% (95% CI - 22 to - 8%; p < 0.001) respectively, favouring the application of HA. The overall analysis on PD and CAL gain in surgical therapy with adjunctive HA presented WMD of - 0.89 mm (95% CI - 1.42 to - 0.36 mm; p < 0.0001) for PD reduction and 0.85 mm (95% CI 0.08 to 1.62 mm; p < 0.0001) for CAL gain after 6-24 months favouring the treatment with HA. However, comparison presented considerable heterogeneity between the non-surgical studies and a high risk of bias in general. CONCLUSIONS Within their limits, the present data indicate that the topical application of HA may lead to additional clinical benefits when used as an adjunctive to non-surgical and surgical periodontal therapy. However, due to the high risk of bias and heterogeneity, there is a need for further well-designed RCTs to evaluate this material in various clinical scenarios. CLINICAL RELEVANCE The adjunctive use of HA may improve the clinical outcomes when used in conjunction with non-surgical and surgical periodontal therapy.
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Affiliation(s)
- Meizi Eliezer
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontology and Operative Dentistry, University of Mainz, Mainz, Germany
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland.
| | - Nikolas Pandis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Sorin Teich
- Medical University of South Carolina, James B. Edwards College of Dental Medicine, Charleston, South Carolina, USA
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17
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Fawzy El-Sayed KM, Dörfer CE. Animal Models for Periodontal Tissue Engineering: A Knowledge-Generating Process. Tissue Eng Part C Methods 2017; 23:900-925. [DOI: 10.1089/ten.tec.2017.0130] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Karim M. Fawzy El-Sayed
- Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
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18
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Fujioka-Kobayashi M, Müller HD, Mueller A, Lussi A, Sculean A, Schmidlin PR, Miron RJ. In vitro effects of hyaluronic acid on human periodontal ligament cells. BMC Oral Health 2017; 17:44. [PMID: 28093072 PMCID: PMC5240222 DOI: 10.1186/s12903-017-0341-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/11/2017] [Indexed: 12/12/2022] Open
Abstract
Background Hyaluronic acid (HA) has been reported to have a positive effect on periodontal wound healing following nonsurgical and surgical therapy. However, to date, a few basic in vitro studies have been reported to investigating the potential of HA on human periodontal ligament (PDL) cell regeneration. Therefore, the aim of this study was to investigate the effect of HA on PDL cell compatibility, proliferation, and differentiation in vitro. Methods Either non-cross-linked (HA_ncl) or cross-linked (HA_cl) HA was investigated. Human PDL cells were seeded in 7 conditions as follows (1) Control tissue culture plastic (TCP) (2) dilution of HA_ncl (1:100), (3) dilution of HA_ncl (1:10), 4) HA_ncl directly coated onto TCP, (5) dilution of HA_cl (1:100), 6) dilution of HA_cl (1:10) and (7) HA_cl directly coated onto TCP. Samples were then investigated for cell viability using a live/dead assay, an inflammatory reaction using real-time PCR and ELISA for MMP2, IL-1 and cell proliferation via an MTS assay. Furthermore, the osteogenic potential of PDL cells was assessed by alkaline phosphatase(ALP) activity, collagen1(COL1) and osteocalcin(OCN) immunostaining, alizarin red staining, and real-time PCR for genes encoding Runx2, COL1, ALP, and OCN. Results Both HA_ncl and HA_cl showed high PDL cell viability (greater than 90%) irrespective of the culturing conditions. Furthermore, no significant difference in both mRNA and protein levels of proinflammatory cytokines, including MMP2 and IL-1 expression was observed. Both diluted HA_ncl and HA_cl significantly increased cell numbers compared to the controlled TCP samples at 3 and 5 days. HA_ncl and HA_cl in standard cell growth media significantly decreased ALP staining, COL1 immunostaining and down-regulated early osteogenic differentiation, including Runx2, COL1, and OCN mRNA levels when compared to control samples. When osteogenic differentiation medium (ODM) was added, interestingly, the expression of early osteogenic markers increased by demonstrating higher levels of COL1 and ALP expression; especially in HA 1:10 diluted condition. Late stage osteogenic markers remained inhibited. Conclusions Both non-cross-linked and cross-linked HA maintained high PDL cell viability, increased proliferation, and early osteogenic differentiation. However, HA was consistently associated with a significant decrease in late osteogenic differentiation of primary human PDL cells. Future in vitro and animal research is necessary to further characterize the effect of HA on periodontal regeneration.
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Affiliation(s)
- Masako Fujioka-Kobayashi
- Department of Cranio-Maxillofacial Surgery, Bern University Hospital, Inselspital, Bern, Switzerland.,Department of Oral Surgery, Institute of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Heinz-Dieter Müller
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Mueller
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Adrian Lussi
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Patrick R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Richard J Miron
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland. .,Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA. .,Cell Therapy Institute, Center for Collaborative Research, Nova Southeastern University, Fort Lauderdale, FL, USA. .,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
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19
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Silva ECE, Omonte SV, Martins AGV, de Castro HHO, Gomes HE, Zenóbio ÉG, de Oliveira PAD, Horta MCR, Souza PEA. Hyaluronic acid on collagen membranes: An experimental study in rats. Arch Oral Biol 2016; 73:214-222. [PMID: 27776288 DOI: 10.1016/j.archoralbio.2016.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 08/17/2016] [Accepted: 10/14/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of hyaluronic acid (HA) in the structure and degradation patterns of BioGide® and OsseoGuard™ collagen membranes. HA mediates inflammation and acts in cell migration, adhesion, and differentiation, benefitting tissue remodeling and vascularization. These are desirable effects in guided regeneration procedures, but it is still unknown whether HA alters the barrier properties of absorbable membranes. DESIGN Bone defects were created in the calvaria of rats, which were treated with HA gel 1% (HA group) or simply filled with blood clot (control group), and covered with BioGide® or OsseoGuard™. The animals were euthanized after 1, 30, and 60days, and their calvarias were processed for histological analysis. RESULTS BioGide®, in both HA and control groups, showed vascularization, intense cell colonization, bone formation, and tissue integration at 30 and 60days. In contrast, Osseoguard™ presented minimal cellular colonization, and inflammatory reaction associated to foreign body reaction in both time points and groups. The HA group of BioGide® showed higher cell colonization (574.9±137.6) than the control group (269.1±70.83) at 60days (p<0.05). Despite this finding, the structure and degradation pattern were similar for BioGide® and Osseoguard™ in the HA and control groups. CONCLUSION The results suggest that HA did not interfere with tissue integration and structural degradation of BioGide® and Osseoguard™ membranes.
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Affiliation(s)
- Edson Costa E Silva
- Graduate Program in Dentistry, Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil.
| | - Sheyla Viana Omonte
- Graduate Program in Dentistry, Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Hayder Egg Gomes
- Undergraduate course, Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Élton Gonçalves Zenóbio
- Graduate Program in Dentistry, Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Paulo Eduardo Alencar Souza
- Graduate Program in Dentistry, Department of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
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20
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Casale M, Moffa A, Vella P, Sabatino L, Capuano F, Salvinelli B, Lopez MA, Carinci F, Salvinelli F. Hyaluronic acid: Perspectives in dentistry. A systematic review. Int J Immunopathol Pharmacol 2016; 29:572-582. [PMID: 27280412 DOI: 10.1177/0394632016652906] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/03/2016] [Indexed: 11/16/2022] Open
Abstract
To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the soft periodontal tissue, gingiva, and periodontal ligament as well as to the hard tissue such as alveolar bone and cementum. Topical hyaluronic acid (HA) has recently been recognized as an adjuvant treatment for chronic inflammatory disease in addition to its use to improve healing after dental procedures. The aim of our work was to systematically review the published literature about potential effects of HA as an adjuvant treatment for chronic inflammatory disease, in addition to its use to improve healing after common dental procedures. Relevant published studies were found in PubMed, Google Scholar, and Ovid using a combined keyword search or medical subject headings. At the end of our study selection process, 25 relevant publications were included, three of them regarding gingivitis, 13 of them relating to chronic periodontitis, seven of them relating to dental surgery, including implant and sinus lift procedures, and the remaining three articles describing oral ulcers. Not only does topical administration of HA play a pivotal key role in the postoperative care of patients undergoing dental procedures, but positive results were also generally observed in all patients with chronic inflammatory gingival and periodontal disease and in patients with oral ulcers.
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Affiliation(s)
- Manuele Casale
- Unit of Otolaryngology, University Campus Bio-Medico, Rome, Italy
| | - Antonio Moffa
- Unit of Otolaryngology, University Campus Bio-Medico, Rome, Italy
| | - Paola Vella
- Unit of Otolaryngology, University Campus Bio-Medico, Rome, Italy
| | - Lorenzo Sabatino
- Unit of Otolaryngology, University Campus Bio-Medico, Rome, Italy
| | | | | | | | - Francesco Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Zhao N, Wang X, Qin L, Zhai M, Yuan J, Chen J, Li D. Effect of hyaluronic acid in bone formation and its applications in dentistry. J Biomed Mater Res A 2016; 104:1560-9. [PMID: 27007721 DOI: 10.1002/jbm.a.35681] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 01/20/2023]
Affiliation(s)
- Ningbo Zhao
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Xin Wang
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Lei Qin
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Min Zhai
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Jing Yuan
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Ji Chen
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
| | - Dehua Li
- State Key Laboratory of Military Stomatology; Department of Oral Implants; School of Stomatology; Fourth Military Medical University; No. 145 Changle West Road Xi'an Shaanxi 710032 People's Republic of China
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22
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Shah SA, Vijayakar HN, Rodrigues SV, Mehta CJ, Mitra DK, Shah RA. To compare the effect of the local delivery of hyaluronan as an adjunct to scaling and root planing versus scaling and root planing alone in the treatment of chronic periodontitis. J Indian Soc Periodontol 2016; 20:549-556. [PMID: 29242692 PMCID: PMC5676338 DOI: 10.4103/0972-124x.201695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Hyaluronan is a critical component of the extracellular matrix and contributes significantly to tissue hydrodynamics and cell migration and proliferation. Studies have demonstrated its anti-inflammatory, antibacterial, and regenerative effects. The present study aimed to assess the clinical effects of the subgingival application of 0.8% hyaluronic acid gel as an adjunct to scaling and root planing (SRP) in the treatment of generalized chronic periodontitis. Materials and Methods: Patients with chronic periodontitis were recruited to participate in a study with a split-mouth design and provided informed consent. One hundred sites were included in the study and divided into fifty test sites and fifty control sites. These were assessed for plaque index (PI), gingival index (GI), pocket probing depths, and relative attachment level (RAL) at-pretreatment (baseline), 4, and 12 weeks posttreatment. The patients received full-mouth SRP. A 0.8% hyaluronan gel was administered subgingivally in the test sites at baseline and after 1 week. Significant differences between test and control were evaluated using the t-test, analysis of variance (test) followed by Bonferroni post hoc test. Results: A significant reduction in PI and GI was observed in both groups at 12 weeks (P < 0.05). Significant reduction in the pocket probing depths and gain RAL was observed in both the groups as compared to baseline (P < 0.05). The hyaluronan group compared to control at 12 weeks showed statistically significant reduction in the probing pocket depth and gain in RAL (P < 0.05). Conclusion: The subgingival application of 0.8% hyaluronan gel in conjunction with SRP may have a beneficial effect on periodontal health in patients with chronic periodontitis.
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Affiliation(s)
- Srishti Anil Shah
- Department of Periodontology, TPCT's Terna Dental College, Navi Mumbai, Maharashtra, India
| | | | | | | | - Dipika Kalyan Mitra
- Department of Periodontology, TPCT's Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Rohit Ajay Shah
- Department of Periodontology, TPCT's Terna Dental College, Navi Mumbai, Maharashtra, India
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Sandhu GK, Khinda PK, Gill AS, Kalra HS. Surgical re-entry evaluation of regenerative efficacy of bioactive Gengigel(®) and platelet-rich fibrin in the treatment of grade II furcation: A novel approach. Contemp Clin Dent 2015; 6:570-3. [PMID: 26681869 PMCID: PMC4678562 DOI: 10.4103/0976-237x.169855] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The furcation area creates situations in which routine periodontal procedures are somewhat limited, and surgical procedures are generally required. The introduction of bioactive agents, such as platelet concentrates, enamel matrix derivatives, bone morphogenic proteins, and matrix macromolecules such as hyaluronic acid has expanded the scope for better outcomes in furcation treatment. Hyaluronic acid is a naturally occurring nonsulfated high molecular weight glycosaminoglycan that forms a critical component of the extracellular matrix and contributes significantly to tissue hydrodynamics, cell migration, and proliferation. Platelet-rich fibrin (PRF) is an immune and platelet concentrate containing all the constituents of a blood sample, which are favorable for healing and immunity. The purpose of the present case report was to assess through surgical re-entry, the regenerative capacity of Gengigel® in conjunction with PRF in a patient with grade II furcation defect. It was observed that the combined approach resulted in significant furcation defect fill on re-evaluation at 6 months.
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Affiliation(s)
- Gurkirat Kaur Sandhu
- Department of Periodontology and Oral Implantology, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Paramjit Kaur Khinda
- Department of Periodontology and Oral Implantology, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Amarjit Singh Gill
- Department of Periodontology and Oral Implantology, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Harveen Singh Kalra
- Department of Periodontology and Oral Implantology, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
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24
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Miranda DG, Malmonge SM, Campos DM, Attik NG, Grosgogeat B, Gritsch K. A chitosan-hyaluronic acid hydrogel scaffold for periodontal tissue engineering. J Biomed Mater Res B Appl Biomater 2015; 104:1691-1702. [PMID: 26344054 DOI: 10.1002/jbm.b.33516] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 07/31/2015] [Accepted: 08/23/2015] [Indexed: 11/11/2022]
Abstract
The current challenge in treating periodontitis is regenerating the periodontium. This motivates tissue-engineering researchers to develop scaffolds as artificial matrices that give mechanical support for osteoblasts, cementoblasts, gingival and periodontal ligament fibroblast cells. In this study, modified hyaluronic acid (HA) and chitosan (CS) were employed to create a hybrid CS-HA hydrogel scaffold for periodontal regeneration. CS, HA, and CS-HA scaffolds were obtained by freeze-drying technique, resulting in porous structures suitable for use in tissue engineering. Scaffolds were submitted to gamma and UV-sterilization without significant morphology changes. The ATR-FTIR spectra of CS-HA hydrogels showed peaks at 377 cm-1 , 1566 cm-1 , and 1614 cm-1 , representing secondary amide, primary amine, and carboxyl acid respectively, and it was also observed the emergence of peaks at 886 cm-1 , which probably represents the Schiff base formed in the case of hybrid CS-HA hydrogels. The scaffolds presented a high rate of PBS uptake, reaching values higher than 95%. Thermal degradation of HA scaffolds was around 225°C and CS was around 285°C. The ATR-FTIR spectra and swelling degree were slightly disturbed mainly after gamma sterilization, but degradation temperature did not change after sterilization. The performance of the CS-HA hydrogel scaffolds for in vitro cell culture was tested using NIH3T3 and MG63 cell lines. The Alamar Blue test showed a significant increase in cellular viability and high CD44 expression, suggesting that the cells migrated more when seeded onto the scaffolds. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1691-1702, 2016.
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Affiliation(s)
- Diego G Miranda
- Laboratoire des Multimatériaux et Interfaces CNRS (UMR 5615), Université Lyon 1, Villeurbanne, France.,UFR d'Odontologie, Université Lyon 1, Lyon, France
| | - Sônia M Malmonge
- Center of Engineering, Modeling and Applied Social Sciences, Federal University of ABC, Santo André, Sao Paulo, Brazil.
| | - Doris M Campos
- Laboratoire des Multimatériaux et Interfaces CNRS (UMR 5615), Université Lyon 1, Villeurbanne, France
| | - Nina G Attik
- Laboratoire des Multimatériaux et Interfaces CNRS (UMR 5615), Université Lyon 1, Villeurbanne, France
| | - Brigitte Grosgogeat
- Laboratoire des Multimatériaux et Interfaces CNRS (UMR 5615), Université Lyon 1, Villeurbanne, France.,UFR d'Odontologie, Université Lyon 1, Lyon, France.,Service de Consultations et de Traitements Dentaires (U.F. Santé Publique), Hospices Civils de Lyon, Lyon, France
| | - Kerstin Gritsch
- Laboratoire des Multimatériaux et Interfaces CNRS (UMR 5615), Université Lyon 1, Villeurbanne, France.,UFR d'Odontologie, Université Lyon 1, Lyon, France.,Service de Consultations et de Traitements Dentaires (U.F. Parodontologie), Hospices Civils de Lyon, Lyon, France
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25
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Fawzy El-Sayed KM, Mekhemar MK, Beck-Broichsitter BE, Bähr T, Hegab M, Receveur J, Heneweer C, Becker ST, Wiltfang J, Dörfer CE. Periodontal regeneration employing gingival margin-derived stem/progenitor cells in conjunction with IL-1ra-hydrogel synthetic extracellular matrix. J Clin Periodontol 2015; 42:448-57. [DOI: 10.1111/jcpe.12401] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2015] [Indexed: 12/27/2022]
Affiliation(s)
- Karim M. Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology; School of Dental Medicine; Christian Albrechts University; Kiel Germany
- Oral Medicine and Periodontology Department; Faculty of Oral and Dental Medicine; Cairo University; Cairo Egypt
| | - Mohamed K. Mekhemar
- Clinic for Conservative Dentistry and Periodontology; School of Dental Medicine; Christian Albrechts University; Kiel Germany
| | | | - Telse Bähr
- Animal Experiment Division; Clinic for Heart- and Vascular-Surgery; University Hospital Schleswig-Holstein; Kiel Germany
| | - Marwa Hegab
- Clinic for Conservative Dentistry and Periodontology; School of Dental Medicine; Christian Albrechts University; Kiel Germany
| | - Jan Receveur
- Clinic for Conservative Dentistry and Periodontology; School of Dental Medicine; Christian Albrechts University; Kiel Germany
| | - Carola Heneweer
- Clinic of Radiology and Neuroradiology; University Hospital Schleswig-Holstein; Kiel Germany
| | - Stephan T. Becker
- Department of Oral and Maxillofacial Surgery; Christian Albrechts University; Kiel Germany
| | - Joerg Wiltfang
- Department of Oral and Maxillofacial Surgery; Christian Albrechts University; Kiel Germany
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology; School of Dental Medicine; Christian Albrechts University; Kiel Germany
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26
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Polepalle T, Srinivas M, Swamy N, Aluru S, Chakrapani S, Chowdary BA. Local delivery of hyaluronan 0.8% as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A clinical and microbiological study. J Indian Soc Periodontol 2015; 19:37-42. [PMID: 25810591 PMCID: PMC4365154 DOI: 10.4103/0972-124x.145807] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 04/23/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the clinical and microbiological effects of the local and sub-gingival application of a hyaluronan gel on scaling and root planing (SRP) in the treatment of moderate generalized chronic periodontitis. MATERIALS AND METHODS In this split mouth study, 72 teeth in 18 patients with generalized chronic periodontitis with moderate severity were chosen for the study. Plaque samples were obtained by paper points at required intervals. Contra-lateral pairs of premolars and canine teeth in the maxilla or the mandible were selected to receive test treatment or serve as controls. Experimental jaw quadrants received sub-gingival administration of 0.2-ml 0.8% hyaluronan gel into selected sites following SRP and 1-week later. Clinical parameters were assessed at baseline, 1(st), 4(th), and 12(th) week. Colony-forming units (CFU) per milliliter were assessed at baseline, after SRP and after 2 weeks of drug insertion Student t-test and repeated measure ANOVA (RMANOVA) were used in this study. RMANOVA was used to find the significance in bleeding on probing (BOP) and plaque index (PI) and t-test for probing pocket depth (PPD) and clinical attachment level (CAL). RESULTS The results revealed that there was a significant reduction in BOP (P < 0.001) PI (P < 0.001), PPD (P < 0.001) and CAL (P < 0.001) were also observed in experimental jaw quadrant following SRP and insertion of 0.8% hyaluronan when compared with the control group. A statistically significant reduction of CFUs was also found (P < 0.001) in the experimental site when compared with the control site. CONCLUSION Sub-gingival placement of 0.2-ml of 0.8% hyaluronan along with SRP resulted in a significant improvement in both clinical and microbiological parameters when compared with the control site.
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Affiliation(s)
- Tejaswin Polepalle
- Department of Periodontology, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India
| | - Moogala Srinivas
- Department of Periodontology, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India
| | - Narasimha Swamy
- Department of Periodontology, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India
| | - Sudheer Aluru
- Department of Anthropology, Division of Human Genetics, S.V. University, Tirupati, Andhra Prdaesh, India
| | - Swarna Chakrapani
- Department of Periodontology, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, India
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Bertl K, Bruckmann C, Isberg PE, Klinge B, Gotfredsen K, Stavropoulos A. Hyaluronan in non-surgical and surgical periodontal therapy: a systematic review. J Clin Periodontol 2015; 42:236-46. [DOI: 10.1111/jcpe.12371] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Kristina Bertl
- Department of Periodontology; Faculty of Odontology; University of Malmö; Malmö Sweden
- Division of Oral Surgery; Bernhard Gottlieb School of Dentistry; Medical University of Vienna; Vienna Austria
| | - Corinna Bruckmann
- Division of Conservative Dentistry and Periodontology; Bernhard Gottlieb School of Dentistry; Medical University of Vienna; Vienna Austria
| | - Per-Erik Isberg
- Department of Statistics; Lund University School of Economics and Management; Lund University; Lund Sweden
| | - Björn Klinge
- Department of Periodontology; Faculty of Odontology; University of Malmö; Malmö Sweden
| | - Klaus Gotfredsen
- Department of Oral Rehabilitation; School of Dentistry; Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Andreas Stavropoulos
- Department of Periodontology; Faculty of Odontology; University of Malmö; Malmö Sweden
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28
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Chauhan AS, Bains VK, Gupta V, Singh GP, Patil SS. Comparative analysis of hyaluronan gel and xanthan-based chlorhexidine gel, as adjunct to scaling and root planing with scaling and root planing alone in the treatment of chronic periodontitis: A preliminary study. Contemp Clin Dent 2013; 4:54-61. [PMID: 23853453 PMCID: PMC3703695 DOI: 10.4103/0976-237x.111619] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study was to evaluate the effects of hyaluronan (HA) and chlorhexidine (CHX) gels as adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. MATERIALS AND METHODS Sixty patients within the age group of 30-65 years recruited to participate in the study were randomly equally divided into three groups. Complete SRP and subgingival debridement were performed within 6 h in all the patients. For control (Group I) patients, SRP was the only treatment modality given; for Group II and III patients, at least 8 teeth with 4-8 mm probing pocket depth (PPD) were selected for subgingival application of HA gel and CHX gel, respectively. Clinical periodontal parameters such as gingival index, PPD, and clinical attachment level (CAL) were recorded at baseline and 3 months, whereas plaque index was recorded at baseline, 1 month, and 3 months. For measuring systemic/hematological parameters, blood samples for laboratory tests for total leucocyte count (TLC), differential leucocyte count (DLC), and C-reactive protein (CRP) were obtained using standard 2-mL syringe from each subject in all the three groups at baseline, 24 h, and on the 1 month and 3 months post-baseline. RESULTS In all the three groups, a significant reduction in PPD and gain in CAL were observed between baseline and 3 months follow-up (P< 0.05); however, at 3 months, change in PPD and CAL was more in Group II than Group III, but the difference was non-significant, and Group I (control) showed less changes in PPD and CAL than both experimental groups. Only one patient revealed positive value for CRP at baseline only, and hence could not be statistically analyzed. In all the three groups, the peak values for TLC count were observed at 24 h. At 1-month and 3-month intervals, a significant improvement in TLC and DLC counts was observed among the experimental (HA gel/SRP and Xan-CHX gel) groups as compared to control group (SRP alone).
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Affiliation(s)
- Avinash Singh Chauhan
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
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29
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Dahiya P, Kamal R. Hyaluronic Acid: a boon in periodontal therapy. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2013; 5:309-15. [PMID: 23814761 PMCID: PMC3690787 DOI: 10.4103/1947-2714.112473] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hyaluronic acid is a naturally occurring linear polysaccharide of the extracellular matrix of connective tissue, synovial fluid, and other tissues. Its use in the treatment of the inflammatory process is established in medical areas such as orthopedics, dermatology, and ophthalmology. The Pubmed/Medline database was searched for keywords “Hyaluronic acid and periodontal disease” and “Hyaluronic acid and gingivitis” which resulted in 89 and 22 articles respectively. Only highly relevant articles from electronic and manual search in English literature were selected for the present review article. In the field of dentistry, hyaluronic acid has shown anti-inflammatory and anti-bacterial effects in the treatment of periodontal diseases. Due to its tissue healing properties, it could be used as an adjunct to mechanical therapy in the treatment of periodontitis. Further studies are required to determine the clinical efficacy of hyaluronic acid in healing of periodontal lesion. The aim of the present review, article is to discuss the role of hyaluronic acid in periodontal therapy.
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Affiliation(s)
- Parveen Dahiya
- Department of Periodontics and Implantology, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour, India
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30
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Eick S, Renatus A, Heinicke M, Pfister W, Stratul SI, Jentsch H. Hyaluronic Acid as an Adjunct After Scaling and Root Planing: A Prospective Randomized Clinical Trial. J Periodontol 2013; 84:941-9. [DOI: 10.1902/jop.2012.120269] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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