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Zhu X, Sculean A, Eick S. In-vitro effects of different hyaluronic acids on periodontal biofilm-immune cell interaction. Front Cell Infect Microbiol 2024; 14:1414861. [PMID: 38938883 PMCID: PMC11208323 DOI: 10.3389/fcimb.2024.1414861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/20/2024] [Indexed: 06/29/2024] Open
Abstract
Introduction Recent studies have demonstrated a positive role of hyaluronic acid (HA) on periodontal clinical outcomes. This in-vitro study aimed to investigate the impact of four different HAs on interactions between periodontal biofilm and immune cells. Methods The four HAs included: high-molecular-weight HA (HHA, non-cross-linked), low-molecular-weight HA (LHA), oligomers HA (OHA), and cross-linked high-molecular-weight HA (CHA). Serial experiments were conducted to verify the influence of HAs on: (i) 12-species periodontal biofilm (formation and pre-existing); (ii) expression of inflammatory cytokines and HA receptors in monocytic (MONO-MAC-6) cells and periodontal ligament fibroblasts (PDLF) with or without exposure to periodontal biofilms; (iii) generation of reactive oxygen species (ROS) in MONO-MAC-6 cells and PDLF with presence of biofilm and HA. Results The results indicated that HHA and CHA reduced the bacterial counts in a newly formed (4-h) biofilm and in a pre-existing five-day-old biofilm. Without biofilm challenge, OHA triggered inflammatory reaction by increasing IL-1β and IL-10 levels in MONO-MAC cells and IL-8 in PDLF in a time-dependent manner, whereas CHA suppressed this response by inhibiting the expression of IL-10 in MONO-MAC cells and IL-8 in PDLF. Under biofilm challenge, HA decreased the expression of IL-1β (most decreasing HHA) and increased IL-10 levels in MONO-MAC-6 cells in a molecular weight dependent manner (most increasing CHA). The interaction between HA and both cells may occur via ICAM-1 receptor. Biofilm stimulus increased ROS levels in MONO-MAC-6 cells and PDLF, but only HHA slightly suppressed the high generation of ROS induced by biofilm stimulation in both cells. Conclusion Overall, these results indicate that OHA induces inflammation, while HHA and CHA exhibit anti-biofilm, primarily anti-inflammatory, and antioxidant properties in the periodontal environment.
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Affiliation(s)
- Xilei Zhu
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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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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Bertl K, Vlachou S, Pandis N, Zampelis A, Stavropoulos A. Repeated local delivery of hyaluronic acid gel as adjunctive treatment of residual pockets in periodontitis patients undergoing supportive periodontal care. A randomized controlled clinical trial. Clin Oral Investig 2024; 28:158. [PMID: 38376596 PMCID: PMC10879318 DOI: 10.1007/s00784-024-05505-9] [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: 11/19/2023] [Accepted: 01/09/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVES To assess the effect of hyaluronic acid (HyA) application as adjunct to re-instrumentation of residual pockets in patients undergoing regular supportive periodontal care (SPC). METHODS Chronic periodontitis patients (stage III and IV, grade B and C) with 4 interproximal residual pockets were randomly assigned to the test (HyA gel) or control (saline) group. After subgingival instrumentation, test or control substance was applied subgingivally, then daily supragingivally for 3 months, and if required a second time after subgingival re-instrumentation after 3 months. Clinical and patient reported outcome parameters were recorded every 3 months for 12 months. Pocket closure [probing pocket depth (PPD) ≤ 4mm with absence of bleeding on probing (BoP) at PPD = 4mm] was the main outcome parameter. RESULTS Fifty-six patients (221 experimental sites) were analysed. Pocket closure was achieved in 56.8 and 46.6% of the experimental sites in the test and control group, respectively (p > 0.05), while median PPD and PPD distribution (< 5mm/5mm/ > 5mm) differed significantly between groups in favour of the test group, at 12 months. Further, significantly fewer sites in the HyA group required re-instrumentation at 3 months, and sites in the HyA group showed a tendency for lower odds to remain diseased compared to the control group (OR 0.48, 95%CI 0.22-1.06). The odds for a site to remain diseased after 12 months increased significantly in the presence of plaque (OR 7.94, 95%CI 4.12-15.28), but in general, decreased significantly over time (OR 0.48, 95%CI 0.28-0.81). CONCLUSION Re-instrumentation of residual pockets in SPC patients, per se, leads to a significant increase in pocket closure over time; this was impeded by poor plaque control. Repeated local application of HyA results in fewer sites requiring re-instrumentation and might slightly improve the rate of pocket closure. (clinicaltrials.gov registration nr. NCT04792541). CLINICAL RELEVANCE HyA gel is easy to apply, well accepted by patients, and may have some positive effect in terms of fewer sites requiring re-instrumentation at 3 months and higher pocket closure rate at 12 months.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Dental Clinic, Faculty of Medicine, Sigmund Freud University Vienna, Freudplatz 3, 1020, Vienna, Austria
- Department of Periodontology, Blekinge Hospital, Hälsovägen, Byggnad 13, 371 41, Karlskrona, Sweden
| | - Stefania Vlachou
- Division of Regenerative Dental Medicine and Periodontology, CUMD, University of Geneva, Rue Michel-Servet 1, 1211, Genève 4, Switzerland
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Antonios Zampelis
- Private Practice, Drottninggatan 27, 652 25, Karlstad, Sweden
- Specialist Clinic for Endodontics and Periodontology, Public Dental Service, Värmland, Hagagatan 6, 652 20, Karlstad, Sweden
| | - Andreas Stavropoulos
- Department of Periodontology, Blekinge Hospital, Hälsovägen, Byggnad 13, 371 41, Karlskrona, Sweden.
- Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs väg 34, 205 06, Malmö, Sweden.
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, 3010, Switzerland.
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Torres-Carrillo AJS, Assis HC, Salazar-Gamarra RE, Teodosio LM, Silva-Sousa AC, Mazzi-Chaves JF, Ferreira-Soares PB, Sousa-Neto MD, Lopes-Olhê FC. Evaluation of Different Techniques and Materials for Filling in 3-dimensional Printed Teeth Replicas with Perforating Internal Resorption by Means of Micro-Computed Tomography. J Endod 2024; 50:205-212. [PMID: 37918796 DOI: 10.1016/j.joen.2023.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the filling ability of 2 obturation techniques in 3-dimensional (3D) printed teeth with perforating internal resorption (PIR). METHODS A maxillary central incisor was instrumented and scanned by micro-computed tomographic (micro-CT) imaging. The 3D model was exported in the stereolithographic format and, with the aid of OrtogOnBlender software (Cícero Moraes, Sinop, SP, Brazil), a PIR in the middle third of the root canal was designed. Thirty-two replicas were printed in surgical resin and distributed into 4 groups (n = 8) according to the obturation technique and the material used: 2 groups used the hybrid technique, 1 with Bio-C Sealer (BCS; Angelus, Londrina, PR, Brazil)/gutta-percha (GP; VDW GmbH, Munich, Germany) + Bio-C Repair (BCR; Angelus, Londrina, PR, Brazil) and the other with BioRoot (BR; Septodont, Saint Maur des Fosses, France)/gutta-percha (GP) + Biodentine (BD; Septodont, Saint Maur des Fosses, France), and 2 groups used the incremental technique, 1 with BCR and the other with BD. Postobturation micro-CT imaging was performed to measure the percentage volume of voids and laser confocal microscopy to measure the surface roughness (μm) of the repair cements. Data were compared using analysis of variance and Kruskal-Wallis tests. RESULTS Regarding the filling volume in the apical third, the BCS/GP + BCR (89.70 ± 5.15), BR/GP + BD (87.70 ± 8.43), and BCR (84.20 ± 9.00) groups showed the highest percentages compared with the BD group (69.70 ± 6.88) (P < .05). In the area of internal resorption, the BCS/GP + BCR (96.00 ± 2.64) and BCR (95.30 ± 2.93) groups showed the highest percentages compared with the BR/GP + BD group (91.50 ± 1.35) (P < .05). The BD group showed intermediate values that were sometimes similar to the BCS/GP + BCR and BCR groups and similar to the BR/GP + BD group (P > .05). Regarding the quality of the filling in the perforation area, the BCR group showed better results compared with the BD group (P < .001). Regarding roughness, the BCR group (1.66 ± 0.65) showed lower surface roughness compared with the BD group (2.51 ± 0.89) (P < .05). CONCLUSIONS The capacity and quality of the filling in teeth with PIR were superior with the incremental technique with BCR and the hybrid technique with BCS/GP + BCR.
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Affiliation(s)
- Angelo J S Torres-Carrillo
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Helena C Assis
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Rodrigo E Salazar-Gamarra
- Faculty of Sciences of Life and Health, School of Dentistry, Digital Dentistry Lab, Universidad Científica del Sur, Lima, Peru
| | - Leonardo Moreira Teodosio
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Alice C Silva-Sousa
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Jardel F Mazzi-Chaves
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Fabiane C Lopes-Olhê
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
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Hakki SS, Bozkurt SB, Sculean A, Božić D. Hyaluronic acid enhances cell migration, viability, and mineralized tissue-specific genes in cementoblasts. J Periodontal Res 2024; 59:63-73. [PMID: 38069670 DOI: 10.1111/jre.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND/OBJECTIVES It has been repeatedly demonstrated that cementum formation is a crucial step in periodontal regeneration. Hyaluronic acid (HA) is an important component of the extracellular matrix which regulates cells functions and cell-cell communication. Hyaluronic acid/derivatives have been used in regenerative periodontal therapy, but the cellular effects of HA are still unknown. To investigate the effects of HA on cementoblast functions, cell viability, migration, mineralization, differentiation, and mineralized tissue-associated genes and cementoblast-specific markers of the cementoblasts were tested. MATERIALS AND METHODS Cementoblasts (OCCM-30) were treated with various dilutions (0, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64, 1:128) of HA and examined for cell viability, migration, mineralization, and gene expressions. The mRNA expressions of osteocalcin (OCN), runt-related transcription factor 2 (Runx2), bone sialoprotein (BSP), collagen type I (COL-I), alkaline phosphatase (ALP), cementum protein-1 (CEMP-1), cementum attachment protein (CAP), and small mothers against decapentaplegic (Smad) -1, 2, 3, 6, 7, β-catenin (Ctnnb1) were performed with real-time polymerase chain reaction (RT-PCR). Total RNA was isolated on days 3 and 8, and cell viability was determined using MTT assay on days 1 and 3. The cell mineralization was evaluated by von Kossa staining on day 8. Cell migration was assessed 2, 4, 6, and 24 hours following exposure to HA dilutions using an in vitro wound healing assay (0, 1:2, 1:4, 1:8). RESULTS At dilution of 1:2 to 1:128, HA importantly increased cell viability (p < .01). HA at a dilution of 1/2 increased wound healing rates after 4 h compared to the other dilutions and the untreated control group. Increased numbers of mineralized nodules were determined at dilutions of 1:2, 1:4, and 1:8 compared with control group. mRNA expressions of mineralized tissue marker including COL-I, BSP, RunX2, ALP, and OCN significantly improved by HA treatments compared with control group both on 3 days and on 8 days (p < .01). Smad 2, Smad 3, Smad 7, and β-catenin (Ctnnb1) mRNAs were up-regulated, while Smad1 and Smad 6 were not affected by HA administration. Additionally, HA at dilutions of 1:2, 1:4, and 1:8 remarkably enhanced CEMP-1 and CAP expressions in a dilution- and time-dependent manner (p < .01). CONCLUSIONS The present results have demonstrated that HA affected the expression of both mineralized tissue markers and cementoblast-specific genes. Positive effects of HA on the cementoblast functions demonstrated that HA application may play a key role in cementum regeneration.
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Affiliation(s)
- Sema S Hakki
- Department of Periodontology, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - Serife Buket Bozkurt
- Department of Biochemistry, Faculty of Medicine, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Darko Božić
- Department of Periodontology, School of Dental Medicine, University Clinical hospital, Zagreb, Croatia
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Zhu X, von Werdt L, Zappalà G, Sculean A, Eick S, Stähli A. In vitro activity of hyaluronic acid and human serum on periodontal biofilm and periodontal ligament fibroblasts. Clin Oral Investig 2023; 27:5021-5029. [PMID: 37380794 PMCID: PMC10492760 DOI: 10.1007/s00784-023-05121-z] [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: 01/31/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES A beneficial effect of cross-linked hyaluronic acid (cHA) on periodontal wound healing and regeneration has recently been demonstrated. The present in vitro study was designed to obtain deeper knowledge on the effect of cHA when applied in the gingival sulcus (serum-rich environment) during non-surgical periodontal therapy. MATERIALS AND METHODS The influence of cHA, human serum (HS), and cHA/HS on (i) a 12-species biofilm formation, (ii) the adhesion of periodontal ligament fibroblasts (PDLF) to dentine surface, (iii) the expression and secretion of interleukin-8, and (iv) the expression of receptors of HA in PDLF and gingival fibroblasts (GF) were evaluated. RESULTS At 4 h of biofilm formation, cHA and HS in combination (cHA/HS) slightly decreased the colony-forming unit counts in biofilm whereas the metabolic activity of biofilm was reduced in all test groups (cHA, HS, cHA/HS) vs. control. At 24 h, the quantity of biofilm was reduced in all test groups vs. untreated control. The test substances did not affect adhesion of PDLF to dentin. HS increased the expression of IL-8 by PDLF and GF which was partially downregulated by cHA. HS and/or cHA promoted the expression of the HA receptor RHAMM in GF but not in PDLF. CONCLUSIONS In summary, the present data indicate that serum neither negatively affect the activity of cHA against periodontal biofilm nor had any unwanted influence on the activity of PDLF. CLINICAL RELEVANCE These findings lend additional support for the positive effects of cHA on cells involved in periodontal wound healing, thus pointing to its potential use in non-surgical periodontal therapy.
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Affiliation(s)
- Xilei Zhu
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Livia von Werdt
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Graziano Zappalà
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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Felemban BK. Enhancing attachment of human gingival fibroblasts to periodontally compromised teeth: A comparative analysis of hyaluronic acid, EDTA, enamel matrix derivatives. Saudi Dent J 2023; 35:547-552. [PMID: 37520595 PMCID: PMC10373072 DOI: 10.1016/j.sdentj.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/04/2023] [Accepted: 05/07/2023] [Indexed: 08/01/2023] Open
Abstract
Background Gingival recession is a characteristic indicator of periodontitis and one of the factors that contributes to increased tooth clinical crown length. Patients with root exposure frequently undergo periodontal surgical procedures in addition to adjunctive therapy to increase root coverage area and soft tissue stability. Purpose This study aimed to evaluate fibroblast-root surface adhesion and determine whether periodontitis-damaged root surface microstructure can be restored using ethylenediaminetetraacetic acid (EDTA) and an enamel matrix derivative (EMD), individually or in combination. Material and methods Teeth extracted from patients with periodontal disease were used to create 60 samples, with each group containing six specimens. The test groups were provided root planing or root condition-specific materials (hyaluronic acid [HA], 24% EDTA, EMD, or EDTA/EMD) for varying treatment time periods. In contrast, the control group did not undergo any surface modifications. The samples and fibroblast cells were incubated for 72 h. The number of living cells on the root surface in each group was calculated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay (cell viability assessment). Results The control, root planing, and EMD groups showed that the root surfaces treated with EDTA for 4 min had significantly better cell adhesion. Surface EDTA treatment for 2 min significantly promoted cell attachment compared to root planing treatment. The root surfaces modified with EDTA/EMD for 2 and 4 min showed significantly improved cellular migration and adhesion compared to the root surface treated with root planing. Conclusion EDTA and EDTA/EMD substantially affected the root surface, which was related to the length of the treatment process. This effect shifts the surface properties, alters fibroblast interactions with the root surface, and recruits more cells to cover a larger area.
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Affiliation(s)
- Baher Khaled Felemban
- At: Department of Basic and Clinical Oral Sciences, Division of Periodontology, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
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Diehl D, Friedmann A, Liedloff P, Jung RM, Sculean A, Bilhan H. Adjunctive Application of Hyaluronic Acid in Combination with a Sodium Hypochlorite Gel for Non-Surgical Treatment of Residual Pockets Reduces the Need for Periodontal Surgery-Retrospective Analysis of a Clinical Case Series. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6508. [PMID: 36233855 PMCID: PMC9571901 DOI: 10.3390/ma15196508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
The comprehensive treatment of periodontitis stage 2 to 4 aims at the resolution of periodontal inflammation and “pocket closure”, which implies a residual probing depth of ≤4 mm and a negative BoP. However, supportive periodontal therapy (SPT) regularly leaves behind persistent periodontal pockets with 5 or more mm in residual PPD and sites that often re-colonize and re-infect. Various adjunctive options for subgingival instrumentation have been proposed to enhance the antimicrobial effects to better control the re-infection of these residual sites. The locally applied adjuncts, based on their anti-inflammatory effect, are sodium hypochlorite antiseptic cleaning gel and cross-linked hyaluronic acid (xHyA). Both recently moved into the focus of clinical research on non-surgical and surgical therapy for periodontitis. The surgical use of xHyA indicates regenerative potential, supporting periodontal regeneration. This case series retrospectively analyzes the clinical benefits of the consecutive flapless application of sodium-hypochlorite-based cleaning gel and xHyA at the SPT to achieve pocket closure, thereby reducing the need for periodontal surgery. In 29 patients, 111 sites received the treatment sequence. At 6-month re-evaluation, an overall PPD reduction exceeding 2 mm was achieved, associated with a similar CAL gain (2.02 mm); the bleeding tendency (BoP) was reduced by >60%. Pocket closure occurred in almost 25% of all the sites. Within their limits, the present data suggest that the proposed combined adjunctive treatment of residual active periodontal sites yielded significant improvement in the clinical parameters. Further studies in RCT format are required to confirm these observations.
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Affiliation(s)
- Daniel Diehl
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
- Institute of Pharmacology and Toxicology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Anton Friedmann
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Pheline Liedloff
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Rico Marvin Jung
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
| | - Hakan Bilhan
- Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
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Ramenzoni LL, Annasohn L, Miron RJ, Attin T, Schmidlin PR. Combination of enamel matrix derivative and hyaluronic acid inhibits lipopolysaccharide-induced inflammatory response on human epithelial and bone cells. Clin Oral Investig 2021; 26:1773-1783. [PMID: 34460002 PMCID: PMC8816768 DOI: 10.1007/s00784-021-04152-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/16/2021] [Indexed: 12/01/2022]
Abstract
Objectives The aim of this study was to evaluate the in vitro effect of enamel matrix derivative (EMD) and hyaluronic acid (HA) and their synergistic combination on lipopolysaccharides (LPS)-induced inflammation in human keratinocytes and osteoblasts. Material and methods Cells were challenged with LPS (1 μg/ml) and cultured in the following treatment groups with EMD (30 mg/ml) and HA (30 mg/ml): LPS, EMD, HA, EMD + HA, EMD + LPS, HA + LPS, and EMD + HA + LPS. Cell viability, inflammatory cytokine expression, and cell migration were determined using colorimetric assay, quantitative real-time polymerase chain reaction (qPCR), and scratch wound healing assay, respectively. Results Cell viability was decreased when exposed to LPS compared to the controls. Overall, LPS treatment expressed upregulation on inflammatory cytokine tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6). EMD and HA reduced up to 3.0-fold the cytokine expression caused by LPS (p < 0.05). EMD and HA statistically induced higher migration in osteoblasts and keratinocytes, respectively. Migration was impaired by LPS, whereas it significantly increased after addition of EMD and HA. Conclusions EMD and HA are advantageous biomaterials that individually generate strong directional migratory keratinocyte and osteoblast response. Their combination also enhances cell viability, and anti-inflammatory and migratory abilities to promote healing specially under LPS inflammatory stimulus. Future in vivo and animal research is necessary to further characterize the effect of EMD and HA on periodontal regeneration. Clinical relevance The use of EMD in conjunction with HA resulted in a reduction of inflammation and improvement of tissue healing at wound sites. Both biomaterials combined may potentially improve the effectiveness of bone regeneration in periodontal bone defects, pointing to the potential clinical relevance of both materials in regenerative periodontal surgery.
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Affiliation(s)
- Liza L Ramenzoni
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland. .,Laboratory of Applied Periodontal and Peri-Implantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - Laura Annasohn
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Laboratory of Applied Periodontal and Peri-Implantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Laboratory of Applied Periodontal and Peri-Implantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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10
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Babgi W, Alhajaji M, Al-Mehmadi L, Elbaqli R, Khayat N, Aldahlawi S, Youssef AR. Effect of root conditioning agents hyaluronic acid, EDTA and chlorhexidine on the attachment of human gingival fibroblasts to healthy root surface. Saudi Dent J 2021; 33:342-347. [PMID: 34434037 PMCID: PMC8376665 DOI: 10.1016/j.sdentj.2020.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 12/16/2022] Open
Abstract
Background The gold standard treatment of periodontal diseases is scaling and root planing (SRP). Different adjunctive root conditioning agents such as hyaluronic acid (HA), ethylenediaminetetraacetic acid (EDTA), and chlorhexidine (CHX) have been used with SRP to improve the smear layer removal and the healing of periodontal tissues. The aim of this study was to compare the effect of manual scaling with or without HA, EDTA, or CHX root conditioning on the attachment and viability of human gingival fibroblasts (GF). Methods Fifteen healthy single rooted teeth were co llected and divided randomly into a scaled (n = 12) and non-scaled control group (n = 3). The scaled roots were subdivided equally into four groups; the first group did not receive any chemical treatment, while the remaining groups were treated with the conditioning agents HA or 17% EDTA or 0.2% CHX gel. Gingival fibroblasts were seeded on the top of each root and incubated for 48 h to allow attachment to the roots. The viability of fibroblasts attached to the root surface was assessed using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cell viability assay. Results The cell viability was the highest in the scaled only group (p = 0.0001) while the lowest was in the scaled with EDTA group (p > 0.05). The scaled group was the highest followed by the HA and CHX groups, while the EDTA group showed the lowest mean value. Conclusion SRP remains the superior method for regaining cell attachment to the root surface, leading to better periodontal health, and adjunctive therapies did not enhance the GF attachment to the root surface beyond the effect of SRP. Further studies are needed to investigate the effect of root conditioning agents on periodontally diseased teeth in vitro and compare them in vivo.
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Affiliation(s)
- Walaa Babgi
- Dental Intern, Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Mashael Alhajaji
- Dental Intern, Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Lujain Al-Mehmadi
- Dental Intern, Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Rokaia Elbaqli
- Dental Intern, Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Noha Khayat
- Dental Intern, Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Salwa Aldahlawi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Abdel-Rahman Youssef
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia.,Department of Microbiology, Faculty of Medicine, Suez Canal University, Egypt
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11
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Abstract
Recently, consumers have become invested in more natural and sustainable ingredients contained in personal care products. Unfortunately, cationic surfactants are still heavily relied on as primary conditioning agents in products such as conditioning shampoos because of their ability to cling well to the negatively charged surface of hair follicles. Additionally, sulfates are utilized as cleansing agents because they are highly effective and low cost. The objective of this study is to find a more sustainable formulation for a conditioning shampoo without compromising the desired wet combing, rheological, and surface activity properties. The systems which were investigated contained hyaluronic acid (HA) at a variety of molecular weights and concentrations, in combination with a surfactant, either acidic sophorolipid (ASL) or alkyl polyglucoside (APG), and varying the presence of sodium chloride. A Dia-stron was utilized to test the wet combing force, a rheometer recorded the viscosity at various shear rates, and a tensiometer measured the surface tension of the samples before a visual foaming study was conducted. Molecular weight and concentration seemed to have a large impact on wet combing force, as well as rheology, with the largest molecular weight and concentration producing the lowest friction coefficient and desired rheological profile. The addition of a surfactant significantly aids in the reduction in surface tension and increased foamability. Therefore, the optimal system to achieve the largest reduction in wet combing force, large viscosity with shear-thinning behavior, and relatively low surface tension with decent foaming is composed of 1% HA at 800 kDa, 10% ASL and 1% NaCl. This system shows a viable sulfate-free and silicone-free option that can achieve both conditioning and cleansing.
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12
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Pilloni A, Zeza B, Kuis D, Vrazic D, Domic T, Olszewska-Czyz I, Popova C, Kotsilkov K, Firkova E, Dermendzieva Y, Tasheva A, Orrù G, Sculean A, Prpić J. Treatment of Residual Periodontal Pockets Using a Hyaluronic Acid-Based Gel: A 12 Month Multicenter Randomized Triple-Blinded Clinical Trial. Antibiotics (Basel) 2021; 10:antibiotics10080924. [PMID: 34438976 PMCID: PMC8388804 DOI: 10.3390/antibiotics10080924] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 12/11/2022] Open
Abstract
The aim of the present study was to evaluate the adjunctive effect of hyaluronic acid (HA) gel in the treatment of residual periodontal pockets over a 12-month period. Periodontal patients presenting at least one residual periodontal pocket 5-9 mm of depth in the anterior area were recruited from six university-based centers. Each patient was randomly assigned to subgingival instrumentation (SI) with the local adjunctive use of HA for test treatment or adjunctive use of local placebo for control treatment at baseline and after 3 months. Clinical parameters ( )probing depth (PD), bleeding on probing (BoP), plaque index (PI), recession (REC), clinical attachment level (CAL)) and microbiological samples for the investigation of the total bacterial count (TBC) and presence of specific bacterial species (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum) were taken at baseline and every 3 months, until study termination. PD was determined as the primary outcome variable. From a total of 144 enrolled, 126 participants (53 males, 73 females) completed the entire protocol. Both treatments resulted in statistically significant clinical and microbiological improvements compared to baseline. Although the local application of HA showed a tendency for better results, there was a lack of statistically significant differences between the groups.
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Affiliation(s)
- Andrea Pilloni
- Department of Dental and Maxillo-Facial Sciences, Section of Periodontology, Sapienza University of Rome, 00161 Rome, Italy;
| | - Blerina Zeza
- Department of Dental and Maxillo-Facial Sciences, Section of Periodontology, Sapienza University of Rome, 00161 Rome, Italy;
- Correspondence: ; Tel.: +39-06-4991-8152; Fax: +39-06-4423-0812
| | - Davor Kuis
- Department of Periodontology, School of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.K.); (J.P.)
| | - Domagoj Vrazic
- Department of Periodontology, University of Zagreb, 10000 Zagreb, Croatia;
| | - Tomislav Domic
- Dental Polyclinic Zagreb, Perkovceva 3, 10000 Zagreb, Croatia;
| | - Iwona Olszewska-Czyz
- Department of Periodontology, Jagiellonian University Medical College, ul.Montelupich 4, 31-155 Krakow, Poland;
| | - Christina Popova
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria; (C.P.); (K.K.)
| | - Kamen Kotsilkov
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria; (C.P.); (K.K.)
| | - Elena Firkova
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, 4004 Plovdiv, Bulgaria; (E.F.); (Y.D.); (A.T.)
| | - Yana Dermendzieva
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, 4004 Plovdiv, Bulgaria; (E.F.); (Y.D.); (A.T.)
| | - Angelina Tasheva
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, 4004 Plovdiv, Bulgaria; (E.F.); (Y.D.); (A.T.)
| | - Germano Orrù
- Oral Biotechnology Laboratory (OBL), Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland;
| | - Jelena Prpić
- Department of Periodontology, School of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia; (D.K.); (J.P.)
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13
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Taskan MM, Balci Yuce H, Karatas O, Gevrek F, Isiker Kara G, Celt M, Sirma Taskan E. Hyaluronic acid with antioxidants improve wound healing in rats. Biotech Histochem 2020; 96:536-545. [PMID: 33047988 DOI: 10.1080/10520295.2020.1832255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Hyaluronic acid (HA) is found in connective tissue and participates in wound healing. We investigated the efficacy of a HA gel (2% hyaluronic acid; 1% antioxidants, coenzyme Q10 and vitamin E; and 5% benzocaine) on healing of palatal wounds in rats. We established two groups of rats: a control group treated with vehicle and an HA group treated with HA gel. The control group was divided into five subgroups and the HA group was divided into four subgroups according to the day on which animals were sacrificed. Wounds were created by elevating 5 mm diameter full thickness flaps. Healed and unhealed wound areas were measured using photographs. Transforming growth factor (TGF)-β, insulin-like growth factor (IGF), and collagen I and III expressions were determined using immunohistochemistry. The number of fibroblasts increased and inflammatory cells decreased from day 0 to 21 in both groups. The HA group exhibited more fibroblasts by day 7 compared to controls; (TGF)-β and IGF levels were similar between HA and control groups. HA groups exhibited fewer inflammatory cells than controls on days 3 and 7. We found significant differences in TGF-β and IGF levels among HA groups between days 3 and 21, and among control groups between days 0 and 21. Collagen I and III levels were greater for the day 3 HA group compared to controls. We observed improved wound healing in HA treated rats within 7 days.
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Affiliation(s)
- Mehmet Murat Taskan
- Department of Periodontology, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Hatice Balci Yuce
- Department of Periodontology, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Ozkan Karatas
- Department of Periodontology, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Fikret Gevrek
- Department of Histology and Embryology, Faculty of Medicine, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Gozde Isiker Kara
- Department of Periodontology, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Melike Celt
- Department of Periodontology, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey
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14
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Zhang Y, Hong G, Zhang Y, Sasaki K, Wu H. Minimally invasive procedures for deficient interdental papillae: A review. J ESTHET RESTOR DENT 2020; 32:463-471. [PMID: 32519508 DOI: 10.1111/jerd.12608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/11/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Deficient interdental papillae cause a series of problems, including food impaction, phonetic difficulties, and esthetic concerns. The purpose of this article is to provide valid clinical recommendations for clinicians to address these problems in a predictable and less invasive way. OVERVIEW Numerous treatments are available for interdental papillae reconstruction, but most of them involve surgery and yield unpredictable outcomes. Minimally invasive treatments have the advantages of being effective, predictable, and involving only slight injury as compared to surgical treatments. We included 66 studies obtained after searching for relevant papers in PubMed and Web of Science. The etiology and classification of deficient interdental papillae are explained and minimally invasive procedures for deficient interdental papillae reconstruction are summarized. CONCLUSIONS Minimally invasive procedures are promising ways to reconstruct deficient interdental papillae, and have the advantages of slight pain and rapid recovery. It should be noticed that some of the minimally invasive treatments still require further long-term observation to confirm their efficacy. CLINICAL SIGNIFICANCE Familiarity with etiology and classification of deficient interdental papillae can help clinicians to choose the appropriate minimally invasive approach as well as help with case collection to enhance esthetics status in patients with deficient interdental papillae.
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Affiliation(s)
- Yiding Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hosepital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China.,Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Guang Hong
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Yifan Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hosepital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China.,Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Hongkun Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hosepital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China
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15
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Zarra T, Lambrianidis T, Vasiliadis L, Gogos C. Effect of curing conditions on physical and chemical properties of MTA+. Int Endod J 2018; 51:1279-1291. [DOI: 10.1111/iej.12938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 04/04/2018] [Indexed: 12/27/2022]
Affiliation(s)
- T. Zarra
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - T. Lambrianidis
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - L. Vasiliadis
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - C. Gogos
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki Greece
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16
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Cvikl B, Hess SC, Miron RJ, Agis H, Bosshardt D, Attin T, Schmidlin PR, Lussi A. Response of human dental pulp cells to a silver-containing PLGA/TCP-nanofabric as a potential antibacterial regenerative pulp-capping material. BMC Oral Health 2017; 17:57. [PMID: 28241819 PMCID: PMC5327548 DOI: 10.1186/s12903-017-0348-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 02/14/2017] [Indexed: 12/11/2022] Open
Abstract
Background Damage or exposure of the dental pulp requires immediate therapeutic intervention. Methods This study assessed the biocompatibility of a silver-containing PLGA/TCP-nanofabric scaffold (PLGA/Ag-TCP) in two in vitro models, i.e. the material adapted on pre-cultured cells and cells directly cultured on the material, respectively. Collagen saffolds with and without hyaluronan acid (Coll-HA; Coll) using both cell culturing methods and cells growing on culture plates served as reference. Cell viability and proliferation were assessed after 24, 48, and 72 h based on formazan formation and BrdU incorporation. Scaffolds were harvested. Gene expression of interleukin(IL)-6, tumor necrosis factor (TNF)-alpha, and alkaline phosphatase (AP) was assessed 24 h after stimulation. Results In both models formazan formation and BrdU incorporation was reduced by PLGA/Ag-TCP on dental pulp cells, while no significant reduction was found in cells with Coll and Coll-HA. Cells with PLGA/Ag-TCP for 72 h showed similar relative BrdU incorporation than cells stimulated with Coll and Coll-HA. A prominent increase in the pro-inflammatory genes IL-6 and TNF-α was observed when cells were cultured with PLGA/Ag-TCP compared to the other groups. This increase was parallel with a slight increase in AP expression. Overall, no differences between the two culture methods were observed. Conclusions PLGA/Ag-TCP decreased viability and proliferation rate of human dental pulp cells and increased the pro-inflammatory capacity and alkaline phosphatase expression. Whether these cellular responses observed in vitro translate into pulp regeneration in vivo will be assessed in further studies.
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Affiliation(s)
- Barbara Cvikl
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dentistry, University of Bern, Bern, Switzerland.,Department of Conservative Dentistry & Periodontology, Medical University of Vienna, Vienna, Austria
| | - Samuel C Hess
- Institute for Chemical and Bioengineering, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | - Richard J Miron
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontology, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Hermann Agis
- Department of Conservative Dentistry & Periodontology, Medical University of Vienna, Vienna, Austria
| | - Dieter Bosshardt
- Robert K. Schenk Laboratory of Oral Histology, Department of Periodontology, Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | - Thomas Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, CH-8032, Switzerland
| | - Patrick R Schmidlin
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dentistry, University of Bern, Bern, Switzerland. .,Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, CH-8032, Switzerland.
| | - Adrian Lussi
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dentistry, University of Bern, Bern, Switzerland
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17
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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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