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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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Axe A, Patel N, Qaqish J, Ling MR, Araga M, Parkinson C, Goyal CR. Efficacy of an experimental toothpaste containing sodium bicarbonate, sodium hyaluronate and sodium fluoride on gingivitis. BMC Oral Health 2024; 24:209. [PMID: 38336635 PMCID: PMC10858478 DOI: 10.1186/s12903-024-03981-9] [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: 02/10/2023] [Accepted: 02/04/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Gingivitis is driven by plaque accumulation and, if left untreated, can progress to irreversible periodontitis. For many, the mechanical action of toothbrushing does not achieve adequate plaque control. The aim of this study was to investigate whether twice-daily use of a toothpaste containing 0.2% high molecular weight (HMW) sodium hyaluronate with 67% sodium bicarbonate and 0.221% sodium fluoride (experimental toothpaste) could improve gingival health compared with a regular fluoride toothpaste (negative control). The study also assessed whether the experimental toothpaste could provide additive gingival health benefit over a toothpaste containing only 67% sodium bicarbonate and 0.221% sodium fluoride (positive control). METHODS This was a single-center, examiner-blinded, randomized, clinical study in healthy adults with mild-to-moderate gingivitis. At baseline, after abstaining from toothbrushing for 12 h, prospective participants underwent oral soft tissue (OST) and oral hard tissue examination followed by assessments for gingival inflammation (Modified Gingival Index [MGI]), gingival bleeding (Bleeding Index [BI]), and supra-gingival plaque (Turesky Plaque Index [TPI]). Eligible participants were stratified by gender and baseline number of bleeding sites (low: <45; high: ≥45 bleeding sites). Following randomization, participants underwent prophylactic dental treatment. Participants received a full OST examination, MGI, BI and TPI assessments after 3 days, 1, 2 and 6 weeks of product use. RESULTS In total, 110 participants were screened for study entry and all were randomized to receive one of three toothpastes (experimental: sodium hyaluronate, sodium bicarbonate, sodium fluoride; positive control: sodium bicarbonate, sodium fluoride; negative control: regular fluoride toothpaste). For all measures, significant improvements were observed in participants receiving either sodium bicarbonate-containing toothpaste (experimental or positive control) compared with the regular fluoride toothpaste (negative control) at week 6. No significant difference was observed in any assessment or visit comparing the experimental toothpaste with the positive control. CONCLUSIONS Both the experimental and the positive control toothpastes demonstrated clinically relevant improvements in gingival health compared with a regular fluoride toothpaste (negative control). However, no additional gingival health improvement was observed for the experimental toothpaste compared with the positive control, therefore, no additional gingival health benefit can be attributed to the inclusion of sodium hyaluronate in this formulation. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04737538 (04/02/2021).
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Affiliation(s)
- Alyson Axe
- Haleon, St George's Avenue Weybridge, Surrey, ODE, KT13, UK.
| | - Nisha Patel
- Haleon, St George's Avenue Weybridge, Surrey, ODE, KT13, UK
| | | | - Martin R Ling
- Haleon, St George's Avenue Weybridge, Surrey, ODE, KT13, UK
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Perelli M, Abundo R, Semenza M, Centracchio M, Chiara SD, Monaco A, Arduino PG. Preliminary Evaluation of a NitrAdine-Based Brushing Solution for Patients Suffering from Gingivitis: A Prospective Clinical Case-Control Study. Eur J Dent 2022; 16:612-618. [PMID: 34875712 PMCID: PMC9507566 DOI: 10.1055/s-0041-1741120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This article aimed to evaluate the clinical efficacy of a nonantibiotic biofilm-removal formulation based on NitrAdine (PerioTabs), combined with a regular home oral hygiene regimen, in Caucasian patients with gingivitis. MATERIALS AND METHODS A sample of 60 patients were included in this clinical prospective study. All selected subjects underwent regular prophylaxis and professional oral hygiene at baseline; 30 days later, they were recalled for the measurements of the reference parameters about bleeding on probing (full-mouth bleeding upon probing score [FMBS]) and plaque index (full-mouth plaque score [FMPS]); no other clinical procedure was performed. Consequently, half of the patients (n = 30) were instructed to use PerioTabs for 10 days. The remaining patients (n = 30) were used as the negative control, only instructed to continue with their usual oral hygiene regimen. Fifteen days after, the clinical parameters of FMBS and FMPS were re-evaluated in both groups. RESULTS Changes in the scores of clinical indices FMBS and FMPS were calculated and compared. A significant difference between pre- and post-values, for both FMBS and FMPS, was noticed in the test group; in particular, the bleeding index value demonstrated the more significant changes: 22 participants showed a clinically meaningful improvement, and 5 had a small improvement. Only three patients had no evidence of change. In addition, 50% of patients had a reduction in plaque levels. No side effects were reported. CONCLUSIONS The adjunctive use of 10-day PerioTabs treatment in the daily oral hygiene routine seemed to be efficient in reducing gingival bleeding and plaque accumulation, with absence of adverse effects. These results should be confirmed in studies with a larger number of participants following a controlled-blinded design.
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Affiliation(s)
- Michele Perelli
- Departemnt of Periodontology, Private Practice, Torino, Italy
| | - Roberto Abundo
- Departemnt of Periodontology, Private Practice, Torino, Italy
| | - Mario Semenza
- Departemnt of Prosthodontist, Private Practice, Sant'Angelo Lodigiano, Italy
| | | | | | - Andrea Monaco
- Departemnt of Dental Hygiene, Private Practice, San Remo, Italy
| | - Paolo Giacomo Arduino
- Department of Surgical Sciences, CIR-Dental School, University of Torino, Torino, Italy
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Kida D, Zakrzewska A, Zborowski J, Szulc M, Karolewicz B. Polymer-Based Carriers in Dental Local Healing-Review and Future Challenges. MATERIALS 2021; 14:ma14143948. [PMID: 34300865 PMCID: PMC8308048 DOI: 10.3390/ma14143948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 02/01/2023]
Abstract
Polymers in drug formulation technology and the engineering of biomaterials for the treatment of oral diseases constitute a group of excipients that often possess additional properties in addition to their primary function, i.e., biological activity, sensitivity to stimuli, mucoadhesive properties, improved penetration of the active pharmaceutical ingredient (API) across biological barriers, and effects on wound healing or gingival and bone tissue regeneration. Through the use of multifunctional polymers, it has become possible to design carriers and materials tailored to the specific conditions and site of application, to deliver the active substance directly to the affected tissue, including intra-periodontal pocket delivery, and to release the active substance in a timed manner, allowing for the improvement of the form of application and further development of therapeutic strategies. The scope of this review is polymeric drug carriers and materials developed from selected multifunctional groups of natural, semi-synthetic, and synthetic polymers for topical therapeutic applications. Moreover, the characteristics of the topical application and the needs for the properties of carriers for topical administration of an active substance in the treatment of oral diseases are presented to more understand the difficulties associated with the design of optimal active substance carriers and materials for the treatment of lesions located in the oral cavity.
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Affiliation(s)
- Dorota Kida
- Department of Drug Form Technology, Wroclaw Medical University, Borowska 211 A, 50-556 Wroclaw, Poland;
- Correspondence: ; Tel.: +48-71-784-0315
| | - Aneta Zakrzewska
- Department of Periodontology, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland; (A.Z.); (J.Z.); (M.S.)
| | - Jacek Zborowski
- Department of Periodontology, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland; (A.Z.); (J.Z.); (M.S.)
| | - Małgorzata Szulc
- Department of Periodontology, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland; (A.Z.); (J.Z.); (M.S.)
| | - Bożena Karolewicz
- Department of Drug Form Technology, Wroclaw Medical University, Borowska 211 A, 50-556 Wroclaw, Poland;
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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: 14] [Impact Index Per Article: 4.7] [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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Adekenov S, Zhabayeva A, Itzhanova K, Amirzhanova A, Shaimerdenova Z. Development of the Composition and Technology of a New Dental Gel with Anti-Inflammatory and Antimicrobial Action. EURASIAN CHEMICO-TECHNOLOGICAL JOURNAL 2020. [DOI: 10.18321/ectj958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The development of a dental gel that meets modern requirements for the effectiveness and safety of a medicinal product is a serious scientific study related to the selection of active and auxiliary substances, providing the necessary biopharmaceutical and rheological properties of the gel composition, standardizing the quality of the dosage form. The article presents the results of a study on the development of the composition and technology of the soft dosage form of the new dental gel «Matripin- Dent» using pharmacologically active ingredients of the sum of flavonoids from Populus balsamifera L. buds (pinostrobin, pinocembrin, chrysin, techtochrysin) and the sum of terpenoids from Matricaria chamomilla L. (bisabolol oxides A and B, chamazulene). Three bases are selected: fat, gel, and multicomponent. According to the results of pharmacological studies, the optimal composition is a gel base containing polyethylene oxide 1500 and 400. The rheological index of the gel base confirms its thixotropic properties, good spreadability, the ability of the obtained gel to extrude from the tube, and stability. The indicators of control and critical points of the technological process are determined and a technological scheme for the production of dental gel is developed.
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Evaluation of the Effectiveness of Esterified Hyaluronic Acid Fibers on Bone Regeneration in Rat Calvarial Defects. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3874131. [PMID: 30050929 PMCID: PMC6046155 DOI: 10.1155/2018/3874131] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/03/2018] [Indexed: 01/26/2023]
Abstract
Hyaluronic acid (HA) constitutes one of the major components of the extracellular matrix domain in almost all mammals. The aim of this study was to evaluate the regenerative capacity of HA matrix in rat calvarial bone defects and compare with those of different combinations of resorbable collagen membrane (M) and bovine-derived xenograft (G). Twenty-four 3-month-old male Sprague-Dawley rats weighing 200-250 g were included. Control group was created by leaving one defect empty from 2 critical size defects with 5 mm diameter formed in the calvarial bones of 8 rats. In the same rats, the other defect was treated with HA matrix alone. One of the 2 defects formed in other 8 rats was treated with HA+G and the other with HA+M. One of the 2 defects formed in the remaining 8 rats was treated with G+M and the other with HA+G+M. The animals were sacrificed at 4 weeks. Histologic, histomorphometric, and immunohistochemical analyses were performed. Both HA matrix alone and its combinations with G and M supported new bone formation (NBF). However, NBF was significantly greater in G+M and HA+G+M groups compared to control and HA alone (P<0.001). Bone morphogenetic protein-2 was expressed with varying degrees in all groups, without any difference among them. Within the limitations of the present study, HA matrix, used alone or in combination with G and M, did not contribute significantly to bone regeneration in rat calvarial bone defects.
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Zhang J, Ab Malik N, McGrath C, Lam O. The effect of antiseptic oral sprays on dental plaque and gingival inflammation: A systematic review and meta-analysis. Int J Dent Hyg 2018; 17:16-26. [PMID: 29405627 DOI: 10.1111/idh.12331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To review the effectiveness of antiseptic oral sprays on oral health. METHODS AND MATERIALS Three electronic databases (PubMed, Cochrane Library and Web of Science) were systematically searched to identify relevant studies. Only randomized controlled trials (RCTs) comparing the effect of oral sprays to placebo/control spray or mouthrinse on dental plaque and gingival inflammation were included. RESULTS Among a total of 996 papers, 20 effective studies fulfilled the selection criteria, and 8 studies were suitable for inclusion in meta-analyses. A meta-analysis of three studies using a 0.2% chlorhexidine (CHX) spray intervention, without prophylaxis at baseline, showed reductions in Plaque Index (PI) (Silness and Löe) and Gingival Index (GI) (Silness and Löe) scores of 0.74 (95% CI: -1.03 to -0.45) and 0.22 (95% CI: -0.38 to -0.06), respectively. Five studies provided a prophylaxis for subjects before study initiation. Three of these five studies used 0.2% CHX spray. A meta-analysis demonstrated an increase of 0.18 (95% CI: -0.01 to 0.37) in PI (Silness and Löe) scores. Two RCTs compared 0.12% and 0.2% CHX spray, and a meta-analysis showed increases of 1.71 (95% CI: 1.27 to 2.14) and 1.58 (95% CI: 1.23 to 1.93), respectively, in PI (Quigley and Hein) scores. Of the RCTs not amenable to meta-analysis, eight studies reported significant improvements in PI and GI scores. CONCLUSIONS Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents. Further high-quality studies are warranted to determine the effectiveness of alternative chemotherapeutic agents delivered via oral sprays on oral health.
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Affiliation(s)
- J Zhang
- Prosthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - N Ab Malik
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - C McGrath
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Olt Lam
- Prosthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Romanò C, De Vecchi E, Bortolin M, Morelli I, Drago L. Hyaluronic Acid and Its Composites as a Local Antimicrobial/Antiadhesive Barrier. J Bone Jt Infect 2017; 2:63-72. [PMID: 28529865 PMCID: PMC5423572 DOI: 10.7150/jbji.17705] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Living in biofilms is probably the most common condition for bacteria and fungi and biofilm-related infections account for the majority of bacterial infectious diseases worldwide. Among others biofilm-related infections, those associated with implanted biomaterials have an enormous and still largely underestimated impact in orthopaedics and trauma, cardio-surgery and several other surgical disciplines. Given the limited efficacy of existing antibiotics in the prevention and treatment of bacterial biofilms, new strategies are needed to protect implants and host tissues, overcoming the striking ability of the microorganisms to adhere on different surfaces and to immediately protect themselves by forming the biofilm matrix. Adhesion is a necessary first step in microbial colonization and pathogenesis and provides a potential target for new preventive and treatment approach. Among various polymers, tested as antibacterial coatings, hyaluronic acid and some of its composites do offer a well-established long-term safety profile and a proven ability to reduce bacterial adhesion and biofilm formation. Aim of the present review is to summarize the available evidence concerning the antiadhesion/antibiofilm activity of hyaluronic acid and some of its derivatives to reduce/prevent bacterial adhesion and biofilm formation in various experimental and clinical settings.
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Affiliation(s)
- C.L. Romanò
- Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milano, Italy
| | - E. De Vecchi
- Laboratory of Clinical Chemistry and Microbiology, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milan, Italy
| | - M. Bortolin
- Laboratory of Clinical Chemistry and Microbiology, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milan, Italy
| | - I. Morelli
- Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milano, Italy
| | - L. Drago
- Laboratory of Technical Sciences for Laboratory Medicine, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Laboratory of Clinical Chemistry and Microbiology, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milan, Italy
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Gupta S, Kediege SD, Gupta A, Jain K. Evaluation of Gengigel® Application in the Management of Furcation with Coronally Advanced Flap through Surgical Re-Entry-A Split Mouth Clinical Study. J Clin Diagn Res 2017; 11:ZC27-ZC32. [PMID: 28274039 PMCID: PMC5324490 DOI: 10.7860/jcdr/2017/21938.9169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/14/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION One of the challenging and unique periodontal problem of Grade II furcation defect has been managed through different treatment modalities in the past. A successful approach is based on complete closure of the defect. Different regenerative approaches have been tried. AIM This study was carried out with an aim to evaluate the role of Gengigel® (0.8% hyaluronic acid) as a potential material for regeneration of lost attachment apparatus. MATERIALS AND METHODS A total of 20 sites with Grade II furcation defects from 10 patients were selected using random sampling technique. These were divided into Group A (placement of hyaluronic acid) and Group B (without placement of hyaluronic acid) according to treatment modality. Furcation defect assessment was done in vertical and horizontal depth preoperatively and postoperatively at six months through surgical re-entry. Recorded data was subjected to the statistical analysis unpaired and paired t-tests for intergroup and intragroup comparisons respectively. RESULTS Mean plaque index, gingival index and bleeding index score showed statistically highly significant and significant results respectively, for both the groups at baseline and six months. Mean difference in probing pocket depth and Relative Attachment Level (RAL) were statistically highly significant, whereas, mean difference of gingival position margin was non significant for both the groups, at baseline and six months. Mean difference in horizontal component at baseline and six months was statistically highly significant for both the groups. Mean difference in vertical component at baseline and six months was statistically significant for both the groups. On comparison, the mean difference in vertical and horizontal component of Group A and Group B at six months was statistically not significant. CONCLUSION Both Gengigel® with coronally positioned flap and coronally positioned flap alone are effective in the treatment of Grade II furcation defects. The combination of Gengigel® with coronally positioned flap leads to better results in hard tissue measurement as compared to coronally positioned flap alone.
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Affiliation(s)
- Sugandha Gupta
- Private Practitioner, Goel Eye and Dental Clinic, Shimla, Himachal Pradesh, India
| | - Suresh D Kediege
- Head of Department, Department of Periodontology, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Akanksha Gupta
- Chief Periodontist, Ferris Mission Hospital, Firozpur, Punjab, India
| | - Kanu Jain
- Reader, Department of Oral Pathology and Microbiology, Maharaja Ganga Singh Dental College and Research Center, Shri Ganganagar, Rajasthan, India
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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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13
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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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14
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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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