Clinical and microbiological effects of topical subgingival application of hyaluronic acid gel adjunctive to scaling and root planing in the treatment of chronic periodontitis

Effectiveness of 0.2% Hyaluronic Acid on Clinical, Biomolecular and Microbiological Parameters in Type 2 Diabetes Mellitus Patients with Periodontitis

OBJECTIVE

 This double-blind randomized clinical trial assessed the effectiveness of 0.2% hyaluronic acid (HA) gel as an adjunct to scaling and root planning (SRP) in patients with periodontitis and type 2 diabetes mellitus (DM), focusing on changes in clinical periodontal parameters, the expression of inflammatory mediators, and oral pathogens.

MATERIALS AND METHODS

 The randomized clinical trial involved 36 participants, 18 DM patients, and 18 healthy patients. The participants in each group were randomly assigned to receive placebo or HA gel after SRP. Gingival crevicular fluid and subgingival plaque samples were taken before treatment and at 4-week follow-up. Clinical parameters, interleukin-1β (IL-1β) and IL-10 levels, and proportions of Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) were evaluated at baseline and follow-up.

STATISTICAL ANALYSIS

 Paired t-test (parametric data) or Wilcoxon signed-rank test (nonparametric data) was used for intragroup comparison between baseline and follow-up, and comparisons between groups one-way analysis of variance test (parametric data) or Kruskal-Wallis test (nonparametric data).

RESULTS

 At 4 weeks, most of the groups showed statistically significant decreases (p ≤ 0.05) in various clinical and biomolecular parameters. However, there were exceptions: the pocket probing depth (PPD) and clinical attachment loss (CAL) parameter did not significantly decrease for the placebo (p > 0.05) non-DM group, and the IL-10 parameter in the DM HA gel group (p = 0.108). Regarding bacterial proportions, the non-DM and DM placebo group exhibited significant test results for Pg after 4 weeks (p ≤ 0.05). In the case of Fn bacteria proportions, they decreased in all groups, but these results were not statistically significant (p ≥ 0.05). An intergroup analysis revealed no significant differences (p ≤ 0.05) for bleeding on probing (BOP), PPD, and both proinflammatory and anti-inflammatory cytokines. Only clinical attachment loss (CAL) exhibited a statistically significant intergroup difference 0.042.

CONCLUSION

 The use of 0.2% HA gel into periodontal pockets alongside SRP, for both diabetic and healthy individuals, showed no statistically significant variances in clinical, biomolecular, and microbiological measures.

Hyaluronic acid-based gels for oral application: Comparison of in vitro effects on gingival cells and bacteria

Purpose

This study aimed to evaluate the cytotoxic effects of different topical hyaluronic acid-based gels on human gingival fibroblasts and oral bacteria.

Methods

Four different hyaluronate gels - Bexident® Aftas (BA), GUM® AftaClear (AfC), Gengigel®(G), Aloclair® Plus (AlC) and a chlorhexidine gel - Bexident®Gums(BG) were selected. Human gingival fibroblasts (HGF) were seeded in 48-well plates with different gel/culture medium concentrations (v/v%) and cell viability was evaluated at 1 and 3 days of culture. Cell morphology was assessed, and alterations graded according to ISO 10993-5:2009(E). Streptococcus oralis CECT 907T colony was, seed on 48-well plate or spread onto the blood agar plates and exposed to the different gel's concentration. The optical density (OD) was assessed, and the diameter of the inhibition zone was measured (mm).

Results

BA and G elicited reduced HGF cytotoxicity, followed by AfC. AlC and BG were cytotoxic at concentrations up to 3% for all exposure times. PCM images of HGF showed moderate-to-severe alterations for AlC and BG and slight to mild changes, for BA, AfC and G. The highest antibacterial activity against S.oralis was observed on AlC and AfC, and no antibacterial activity was observed for BA and G. Inhibitory effect in sessile colonies was only observed in AlC and BG.

Conclusions

AlC demonstrated superior antibacterial activities against S.oralis but a higher cytotoxic potential in HGF. BA and G presented the lowest cytotoxicity with little to no antibacterial effect. AfC demonstrated bacteriostatic effects and low cytotoxicity on HGF.

Effects of topically administered 0.6% hyaluronic acid on the healing of labial frenectomy in conventional and 940-nm indium gallium arsenide phosphide (InGaAsP) diode laser techniques in pediatric patients: a randomized, placebo-controlled clinical study

This study aimed to investigate the effects of 0.6% hyaluronic acid (HA) gel on the healing process and postoperative pain levels after diode laser-assisted labial frenectomy in pediatric patients. Ninety-six pediatric patients (females, 50 and males, 46) aged 8-14 years were randomly divided into four groups as follows: (1) conventional frenectomy with 0.6% topically administered HA (CFH, n = 24); (2) conventional frenectomy with placebo gel (CFP, n = 24); (3) frenectomy performed by diode laser with 0.6% topically administered HA (DLH, n = 24); and (4) frenectomy performed by diode laser with placebo gel (DLP, n = 24). HA application was continued for 1 week thrice daily after the frenectomy. Visual analog scale forms were collected from patients 1 week after the operation. In addition, the plaque index, gingival index, periodontal probing depth, and keratinized tissue width and thickness were recorded. This process was repeated 1 and 3 months after the first visit. The DLH group revealed significant differences in the probing depth, bleeding on probing, keratinized gingiva width, and attached gingiva width according to dual comparisons of the initial, first, and third-month values (p = 0.010, p = 0.007, p<0.001, and p = 0.001, respectively). Significant differences were observed between the CFP and CFH groups according to the initial and initial third-month values with regard to the bleeding on probing (p=0.019 and p = 0.019, respectively). The attached gingival thickness revealed significant differences between the CFP and CFH groups for the initial and initial-third-month comparisons (p = 0.005 and p = 0.007, respectively). The mean values of the initial and initial-third-month differences were significantly higher in the CFH group than those in the CFP group. HA- and laser-assisted labial frenectomies revealed better outcomes in terms of the probing depth, attached gingiva width, keratinized gingiva width, healing process, and postoperative comfort.

Efficacy of hyaluronic acid gel and photobiomodulation therapy on wound healing after surgical gingivectomy: a randomized controlled clinical trial

BACKGROUND

Surgical gingivectomy can be considered the gold standard treatment for gingival enlargement. The healing of wound site after gingivectomy occurs slowly by secondary intention. To accelerate the wound healing process, several studies have been conducted evaluating the effect of various treatment modalities. Photobiomodulation therapy (PBMT) was proposed to provide minimally invasive and painless treatment as well as to decrease discomfort of the patient following the surgical process. Another factor that is expected to improve the healing after surgery is topical application of chemotherapeutic agents such as Hyaluronic acid (HA). This study aims to assess the effect of topically applied HA gel after PBMT on the healing of wound site after surgical gingivectomy.

METHODS

This randomized controlled clinical trial included twenty-six surgical gingivectomy wound sites, equally divided into two groups, Group-I (test group): the surgical sites after gingivectomy were irradiated with a diode laser (980 nm, 0.2 W) then covered by 2% HA gel loaded in a special custom-made soft transparent tissue guard appliance for each patient. Group II (control group): the surgical sites were irradiated with a diode laser (980 nm, 0.2 W) only. Wound healing was assessed subjectively by Landry healing index on the 3rd, 7th, 14th and 21st days after surgery, and pain perception was assessed by the patients using visual analog scale (VAS) throughout the 21 days of the follow up period. Comparisons between the two study groups were performed using Mann-Whitney U test, while comparisons between different time points were performed using Friedman test. Significance was inferred at p value < 0.05.

RESULTS

By the end of the follow-up period, surgical sites of the test group showed excellent healing compared to the control group. There were no significant differences in VAS scores between both groups (p > 0.05).

CONCLUSIONS

Application of 2% HA gel as an adjunctive to PBMT was found to have significant clinical effects and higher power of repair among test group when compared to that achieved by PBMT alone in control group.

TRIAL REGISTRATION

This study was retrospectively registered on ClinicalTrials.gov and first posted on 28th of March 2023 with an identifier number: NCT05787912.

Dental Restorations

Fulfilling a patient's request for a healthy, functional and esthetic smile represents a daily challenge for dental practitioners [...].

The Effect of Adjunctive Use of Hyaluronic Acid on Prevalence of Porphyromonas gingivalis in Subgingival Biofilm in Patients with Chronic Periodontitis: A Systematic Review

Porphyromonas gingivalis (P. gingivalis) is a Gram-negative anaerobic bacterium that plays an important role in the development and progression of periodontitis. Hyaluronic acid (HA) is a naturally occurring glycosaminoglycan that has previously demonstrated antibacterial potential in vitro against multiple bacterial species, including P. gingivalis. The purpose of this systematic review is to evaluate the effectiveness of HA as an adjunctive topical antibacterial agent to non-surgical mechanical therapy of periodontitis in reducing the prevalence of P. gingivalis in subgingival biofilms. Five clinical studies were identified that satisfied the eligibility criteria. Only three trials were suitable for the meta-analysis as they provided data at three and six months. Data on the prevalence of P. gingivalis in each study were collected. The odds ratio (OR) for measuring the effect size with a 95% confidence interval (CI) was applied to the available data. The results did not favor the use of HA during non-surgical mechanical therapy to reduce the prevalence of P. gingivalis in subgingival biofilm (odd ratio = 0.95 and 1.11 at three and six months, consecutively). Within their limitations, the current data do not indicate an advantage for using HA during mechanical periodontal therapy to reduce the prevalence of P. gingivalis.

The Effect of Hyaluronic Acid Gel on Periodontal Parameters, Pro-Inflammatory Cytokines and Biochemical Markers in Periodontitis Patients

Hyaluronic acid in its various forms shows bacteriostatic, fungistatic, anti-inflammatory, anti-edematous, osteoinductive, and pro-angiogenetic properties. This study aimed to evaluate the effect of subgingival delivery of 0.8% hyaluronic acid (HA) gel on clinical periodontal parameters, pro-inflammatory cytokines (IL-1 beta and TNF-alpha) and biochemical markers of inflammation (C-reactive protein (CRP) and alkaline phosphatase (ALP) enzymes) in patients with periodontitis. Seventy-five patients with chronic periodontitis were divided randomly into three groups (25 in each group): group I received scaling and surface root debridement (SRD) + HA gel; group II received SRD + chlorhexidine gel; and group III received surface root debridement alone. Clinical periodontal parameter measurements and blood samples were collected to estimate pro-inflammatory and biochemical parameters at the baseline before therapy and after two months of therapy. The results show that HA gel has a significant effect on the reduction in clinical periodontal parameters (PI, GI, BOP, PPD, and CAL), IL-1 beta, TNF-alpha, CRP, and ALP after 2 months of therapy as compared to the baseline (p < 0.05) with nonsignificant differences from the CHX group (p > 0.05), except GI (p < 0.05), and significant differences from the SRD group (p < 0.05). Moreover, significant differences were found between the three groups regarding the mean improvements of GI, BOP, PPD, IL-1β, CRP, and ALP. It can be concluded that HA gel has a positive effect on clinical periodontal parameters and improvements in inflammatory mediators similar to chlorhexidine. Therefore, HA gel can be used as an adjuvant to SRD in the treatment of periodontitis.

Oxygen-Releasing Hyaluronic Acid-Based Dispersion with Controlled Oxygen Delivery for Enhanced Periodontal Tissue Engineering

Periodontitis is a chronic biofilm-associated inflammatory disease of the tooth-supporting tissues that causes tooth loss. It is strongly associated with anaerobic bacterial colonization and represents a substantial global health burden. Due to a local hypoxic environment, tissue regeneration is impaired. Oxygen therapy has shown promising results as a potential treatment of periodontitis, but so far, local oxygen delivery remains a key technical challenge. An oxygen (O₂)-releasing hyaluronic acid (HA)-based dispersion with a controlled oxygen delivery was developed. Cell viability of primary human fibroblasts, osteoblasts, and HUVECs was demonstrated, and biocompatibility was tested using a chorioallantoic membrane assay (CAM assay). Suppression of anaerobic growth of Porphyromonas gingivalis was shown using the broth microdilution assay. In vitro assays showed that the O₂-releasing HA was not cytotoxic towards human primary fibroblasts, osteoblasts, and HUVECs. In vivo, angiogenesis was enhanced in a CAM assay, although not to a statistically significant degree. Growth of P. gingivalis was inhibited by CaO₂ concentrations higher than 256 mg/L. Taken together, the results of this study demonstrate the biocompatibility and selective antimicrobial activity against P. gingivalis for the developed O₂-releasing HA-based dispersion and the potential of O₂-releasing biomaterials for periodontal tissue regeneration.

Clinical Performance Evaluation of a Hyaluronic Acid Dental Gel for the Treatment of Traumatic Ulcers in Patients with Fixed Orthodontic Appliances: A Randomized Controlled Trial

BACKGROUND

A newly available gel containing hyaluronic acid (HA) and polyvinylpyrrolidone was tested for efficacy on traumatic oral ulcers (TOU) caused by fixed orthodontic appliances.

METHODS

A double-blind RCT was conducted to test the new gel versus a placebo. According to the sample size calculation, a total of 60 patients were considered sufficient and randomly allocated to one of the two groups out of a pool of 100 total patients who initially agreed to participate in the study. A VAS scale test and lesion measurements at T0, T1, and T2 were performed on the patients.

RESULTS

A total of 70 patients developed TOU, with 8 drop-outs; the intergroup comparison showed a statistically significant greater dimension of the lesion in the control group at T2 when compared to the test group. The pain experienced by the patients belonging to the test group was significantly lower than the pain in the patients in the control group Conclusions: Under the limitations of the study, the new formula might provide faster healing with less pain experienced by the patient when compared to a placebo.

Local delivery of hyaluronic acid as an adjunct to scaling and root planing in the treatment of chronic periodontitis in smokers and non-smokers: A clinical and microbiological study

Objective

The objective of the study is to assess the effects of adjunctive use of hyaluronic acid (HA), clinically and microbiologically in smokers and nonsmokers, in the management of chronic periodontitis.

Material and Methods

48 sites from 24 chronic periodontitis patients, including smokers and nonsmokers with probing depth >5 mm, were selected for the study. A split-mouth design was followed. Scaling and root planing (SRP) was performed for all the patients. The test sites received 0.8% HA gel whereas the control site received placebo gel. The clinical parameters plaque, gingival and bleeding indices, Pocket Probing Depth (PPD), and clinical attachment level (CAL) were evaluated at baseline, 1 and 3 months. Microbiological parameters were evaluated at baseline and 1 month.

Results

The results showed reduction in PPD and gain in CAL in both smokers and nonsmokers at the end of 3rd month. The improvements in the test sites were statistically significant when compared with that of control sites. The microbiological analysis showed a significant reduction in Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at the test sites when compared to the controls in both the groups.

Conclusion

The findings in both groups suggest that the use of locally delivered 0.8% HA gel may be valuable as an adjunct to SRP in the treatment of chronic periodontitis.

A thermosensitive gel with an active hyaluronic acid ingredient that contains an octenidine preservation system as an adjunct to scaling and root planning: a randomized prospective clinical study

OBJECTIVES

To evaluate the adjunctive effect of a thermosensitive gel formulation that contains 0.8% oligo hyaluronic acid (HA) combined with a preservation system of octenidine HCl 0.625% and phenoxyethanol to scaling and root planing (SRP) as compared with SRP alone in the treatment of residual pockets of patients with stage 3 periodontitis.

MATERIALS AND METHODS

Thirty-four patients (21 males and 13 females) aged 29-78 years (51.3 ± 13.1) with stage 3 periodontitis were recruited to participate in the present split-mouth study. None of the patients has been previously treated for periodontitis. Plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were evaluated at baseline and at 3 and 6 months post treatment. Full-mouth SRP was performed in all residual pockets ≥ 5 mm. Treatment was performed by means of ultrasonic and hand instruments and lasted 45-60 min. The gel was applied subgingivally in the test sites immediately after SRP (baseline) and 1 month later. The paired t-test for two means was applied to test the statistical significance of the change from baseline within each arm and determine the difference between groups. The level of significance was set at 0.05 for all tests.

RESULTS

Mean PD reductions between baseline and 3 and 6 months were 1.98 mm and 2.79 mm for the test and 1.22 mm and 1.50 mm for the control group, respectively. Comparisons between the test and control groups revealed that SRP + gel yielded statistically significantly higher PD reductions compared to SRP alone (p < 0.0001). Compared to baseline, CAL and BOP values improved statistically significantly in both groups, although the test group presented statistically significantly higher CAL gains and BOP reductions than the control group (P < 0.0001).

CONCLUSION

In residual pockets of stage 3 periodontitis patients, the local application of a thermosensitive gel with an active HA ingredient and a preservation system of octenidine HCl 0.625% in conjunction with SRP may additionally improve the clinical outcomes obtained with SRP alone.

CLINICAL RELEVANCE

A novel HA and octenidine containing thermosensitive gel effectively improved the clinical parameters in stage 3 periodontitis patients over a 6-month period.

Biomolecules in Dental Applications: Randomized, Controlled Clinical Trial Evaluating the Influence of Hyaluronic Acid Adjunctive Therapy on Clinical Parameters of Moderate Periodontitis

The biological activity of hyaluronic acid (HA) has been well-researched during the past decades; however, there are few randomized, controlled trials of its clinical effects in periodontal therapy. The purpose of this study was to evaluate the effect of hyaluronic acid on the principal parameters of periodontal healing. A specific, commercially available formulation designed and registered for professional dental application, composed of 16 mg/mL of cross-linked and 2 mg/mL of non-cross-linked HA, was used as an adjunctive to non-surgical periodontal therapy, and clinical parameters were evaluated after 3 months. The addition of HA to periodontal therapy demonstrated more favorable clinical results regarding reduction in inflammation, measured by bleeding on probing (-6% compared to the control group) and gain in periodontal attachment (1 mm more than control group), while it had no effect on probing depth reduction. No side effects were reported. Our study demonstrated that HA is a safe and easy-to-use biological agent; due to its wide array of properties, it may significantly improve the results of periodontal therapy. However, more long-term studies are needed to investigate whether these favorable effects remain over time.

Assessment of the Plaque-Induced Gingivitis Patient With and Without Hyaluronic acid and Xylitol Toothpaste

Context:

The traditional manner of treatment of periodontal tissue inflammation includes giving information about the problem to the patient, oral motivation, and mechanical scaling and root planning (SRP).

Aims:

We aimed at estimating the effect of using toothpaste with hyaluronic acid (Hyaluronan, HA) and xylitol (HAX) as a therapeutic agent in the treatment of plaque-induced gingivitis.

Materials and Methods:

Sixty male patients who were in the age group of 20 to 35 years participated in this study. All of them endured 4 appointments, who suffered plaque-induced gingivitis, they distributed into 2 groups depending on the toothpaste variety: group 1 (G1): made up of 30 patients who consume toothpaste that contains HAX, while group 2 (G2): made up of 30 patients who consume toothpaste without HAX (placebo type). Clinical periodontal parameters (CPPs) for all of them were recorded, once at the beginning of the treatment besides four times throughout the treatment at weekly interims during all visits.

Results:

The means of plaque indices (PLI) and gingival indices (GI) decreased along with the sessions for both groups, where the initial means of PLI and GI (baseline) were 2.55 ± 0.14, 2.33 ± 0.15 for the G1, and 2.57 ± 0.13, 2.34 ± 0.16 for G2, respectively; whereas the least means shown at the fourth visit were 0.39 ± 0.05, 0.30 ± 0.06 for G1, and 0.71 ± 0.07, 0.61 ± 0.05 for G2, respectively. There was a reduction in the mean percent of bleeding on probing (BOP) score 1 for all visits in both groups. Finally, an intragroup comparison among dissimilar visits and intergroup comparisons for each visit showed highly significant differences at a P-value of ≤ 0.001 for PLI, GI, and BOP.

Conclusions:

Using toothpaste with or without HAX can decrease gingival inflammation; it can result in a higher improvement in the periodontal status of patients than toothpaste without HAX.

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

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.

Healing of intrabony defects following regenerative surgery by means of single-flap approach in conjunction with either hyaluronic acid or an enamel matrix derivative: a 24-month randomized controlled clinical trial

Objectives

The aim of this randomized controlled clinical trial was to compare the clinical outcomes obtained in intrabony defects following regenerative periodontal surgery using the single-flap approach (SFA) in conjunction with either hyaluronic acid (HA) or enamel matrix derivative (EMD).

Materials and methods

Thirty-two intrabony defects in 32 healthy subjects were randomly assigned: HA (test group) or EMD (control group). Clinical attachment level (CAL), probing depth (PD), gingival recession (REC), and bleeding on probing (BOP) were recorded at baseline,12, 18, and 24 months after surgery.

Results

At 24 months, both treatments resulted in statistically significant clinical improvements evidenced by PD-reduction and CAL-gain (p<0.001). The mean CAL-gain was 2.19±1.11 mm in the test and 2.94±1.12 mm in the control sites (p=0.067). PD-reduction was statistically significantly higher for the control group (4.5±0.97 mm) than the test group (3.31±0.70 mm), (p=0.001). CAL-gain ≤ 3 mm was observed in 87.5% and in 62.5% of the test and control sites, respectively. Test sites showed slightly lower REC values than the control sites. No statistically significant differences were found for BOP between treatments.

Conclusions

The present findings indicate that both treatments led to statistically significant clinical improvements compared to baseline, although the application of EMD resulted in statistically significantly higher PD-reduction compared to the use of HA.

Clinical relevance

The use of HA in conjunction with a SFA resulted in significant PD-reduction and CAL-gain, pointing to the potential clinical relevance of this material in regenerative periodontal surgery.

Evaluation of the Bactericidal Activity of a Hyaluronic Acid-Vehicled Clarithromycin Antibiotic Mixture by Confocal Laser Scanning Microscopy

Confocal laser scanning microscopy (CLSM) was used to evaluate the antibacterial effect and depth of action of a novel clarithromycin-containing triple antibiotic mixture, which was proposed for root canal disinfection in dental pulp regeneration. A previous study reported that this mixture had no tooth discoloration effects in vitro. After infection with Enterococcus faecalis for 3 weeks, the dentinal tubules in the cylindrical root specimens were exposed to different antibiotic mixtures: ciprofloxacin, metronidazole and minocycline (3-MIX); ciprofloxacin, metronidazole and clarithromycin (3-MIXC) and ciprofloxacin and metronidazole (2-MIX). Each antibiotic formulation was mixed with macrogol (MG) or hyaluronic acid (HA) vehicles. CLSM and viability staining were used to quantitatively analyze the mean depth of the antibacterial effect and the proportions of dead and live bacteria inside the dentinal tubules. The 3-MIX and 3-MIXC demonstrated a similar depth of action. The mean proportion of dead bacteria was similar in the 3-MIX and 3-MIXC groups, and both were statistically higher than that of 2-MIX (p = 0.014). Each antibiotic mixture showed a higher bactericidal efficacy if conveyed with HA, compared to MG (3-MIX, p = 0.019; 3-MIXC, p = 0.013 and 2-MIX, p = 0.0125). The depth of action and the antibacterial efficacy of 3-MIXC seemed comparable with 3-MIX.

Effect of topically applied hyaluronic acid on pain and palatal epithelial wound healing: An examiner-masked, randomized, controlled clinical trial

BACKGROUND

This study aims to evaluate the effects of two different concentrations of topical hyaluronic acid (HA) on postoperative patient discomfort and wound healing of palatal donor sites after free gingival graft (FGG) surgery.

METHODS

Thirty-six patients requiring FGG were randomly assigned into three groups in an examiner-masked, randomized, controlled clinical trial. After harvesting palatal grafts, 0.2% and 0.8% HA gels were used in test groups 1 and 2, respectively. Gels were applied on donor sites and protected with periodontal dressing in the test groups, whereas the wound was covered only with periodontal dressing in the control group. On days 3, 7, 14, and 21, pain and burning sensation were recorded using a visual analog scale (VAS) as well as other parameters such as complete epithelization (CE) and color match on days 3, 7, 14, 21, and 42.

RESULTS

Test groups experienced less pain than the control group on days 3 and 7 (P <0.001 and P <0.001, respectively). Mean VAS score for burning sensation was higher in the control group on day 3 compared with test groups 1 and 2 (P = 0.03 and P = 0.02, respectively). CE in all patients was achieved on day 21 in both test groups, whereas it was achieved on day 42 in the control group. The test groups showed higher color match scores than the control group on days 21 (P <0.001 and P <0.001, respectively) and 42 (P = 0.004 and P = 0.002, respectively).

CONCLUSION

Topical application of HA exhibits positive impact on postoperative pain and burning sensation, and accelerates palatal wound healing in terms of epithelization and color match.

Hyaluronic acid as adjunctive to non-surgical and surgical periodontal therapy: a systematic review and meta-analysis

OBJECTIVES

To evaluate the potential added benefit of the topical application of hyaluronic acid (HA) on the clinical outcomes following non-surgical or surgical periodontal therapy.

MATERIALS AND METHODS

A systematic search was performed in Medline, Embase, Cochrane, Web of Science, Scopus and Grey literature databases. The literature search was preformed according to PRISMA guidelines. The Cochrane risk of bias tool was used in order to assess the methodology of the included trials. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) between the treatment and controls were estimated using the random-effect model for amount of bleeding on probing (BOP), probing depth (PD) reduction and clinical attachment level (CAL) gain. In order to minimize the bias and to perform meta-analysis, only randomized clinical studies (RCTs) were selected.

RESULTS

Thirteen RCTs were included: 11 on non-surgical periodontal treatment and two on surgical periodontal treatment. Overall analysis of PD reduction, CAL gain and BOP reduction in non-surgical therapy with adjunctive HA presented WMD of - 0.36 mm (95% CI - 0.54 to - 0.19 mm; p < 0.0001), 0.73 mm (95% CI 0.28 to 1.17 mm; p < 0.0001) and - 15% (95% CI - 22 to - 8%; p < 0.001) respectively, favouring the application of HA. The overall analysis on PD and CAL gain in surgical therapy with adjunctive HA presented WMD of - 0.89 mm (95% CI - 1.42 to - 0.36 mm; p < 0.0001) for PD reduction and 0.85 mm (95% CI 0.08 to 1.62 mm; p < 0.0001) for CAL gain after 6-24 months favouring the treatment with HA. However, comparison presented considerable heterogeneity between the non-surgical studies and a high risk of bias in general.

CONCLUSIONS

Within their limits, the present data indicate that the topical application of HA may lead to additional clinical benefits when used as an adjunctive to non-surgical and surgical periodontal therapy. However, due to the high risk of bias and heterogeneity, there is a need for further well-designed RCTs to evaluate this material in various clinical scenarios.

CLINICAL RELEVANCE

The adjunctive use of HA may improve the clinical outcomes when used in conjunction with non-surgical and surgical periodontal therapy.

BDNF/HMW-HA complex as an adjunct to nonsurgical periodontal treatment of ligature-induced periodontitis in dogs

BACKGROUND

Recently, brain-derived neurotrophic factor (BDNF)/high molecular weight hyaluronic acid (HMW-HA) complex with flap surgery has been shown to promote periodontal tissue regeneration. The objective of this study was to evaluate the effects of local subgingival application of BDNF/HMW-HA complex adjunctive to scaling and root planning (SRP) on ligature-induced periodontitis in dogs.

METHODS

The dogs were divided into four treatment groups: no treatment (control), SRP alone, SRP followed by local application of HMW-HA (SRP+HMW-HA), and SRP followed by local application of BDNF (500 μg/ml)/ HMW-HA complex (SRP+BDNF/HMW-HA). HMW-HA or BDNF/HMW-HA complex was topically applied to periodontal pockets using a syringe without surgery. Two weeks after treatment, clinical parameters (gingival index, clinical attachment level, periodontal pocket depth and bleeding on probing) were recorded and specimens were collected from anesthetized animals for histological analysis.

RESULTS

The SRP+BDNF/HMW-HA group showed significant improvement in all clinical parameters compared to other treatment groups. Histologic analysis showed greater suppression of apical migration of epithelial tissue and milder inflammatory cell infiltration in the SRP+BDNF/HMW-HA group than in the other treatment groups. Furthermore, new cementum and alveolar bone were regenerated, and collagen fibers were inserted into them in the SRP+BDNF/HMW-HA group.

CONCLUSION

BDNF/HMW-HA complex as an adjunct to nonsurgical periodontal treatment has the potential to reduce excess inflammation. Further investigation will be needed to clarify periodontal tissue regenerative effects of BDNF/HMW-HA complex in a nonsurgical setting.

Hyaluronic Acid and Periodontitis

Hyaluronic acid (HA; synonyms- Hyaluronan, Hyaluronate) is a glycosaminoglycan found in the connective tissue of vertebrates. It is the most abundant glycosaminoglycan of higher molecular weight in the extracellular matrix of soft periodontal tissues. The use of HA in the treatment of inflammatory process is established in medical areas such as orthopedics, dermatology and ophthalmology. In the field of dentistry, it has shown anti-inflammatory and anti-bacterial effects in gingivitis and periodontitis therapy. Due to its tissue healing properties, it could be used as an adjunct to mechanical therapy in the treatment of periodontitis.

Comparative evaluation of coenzyme Q10-based gel and 0.8% hyaluronic acid gel in treatment of chronic periodontitis

BACKGROUND

The anti-inflammatory and immune enhancing effects of coenzyme Q₁₀ (CoQ₁₀) and hyaluronic acid are well established in medical literature. The present study was undertaken to evaluate their role in chronic periodontitis.

MATERIALS AND METHODS

One hundred twenty sites in 24 patients with clinically confirmed periodontitis were included in the study. A split-mouth design was used for intrasulcular application of CoQ₁₀ as adjunct to scaling and root planing (SRP), 0.8% hyaluronic acid as adjunct to SRP and SRP alone. Clinical parameters such as plaque index (PI), gingival color change index (GCCI), Eastman interdental bleeding index (EIBI), pocket depth (PD), and clinical attachment level (CAL) were recorded. All the clinical parameters PI, EIBI, GCCI, PD, and CAL were recorded at baseline before SRP. Only PI, EIBI, and GCCI were recorded at 1^st and 2^nd week. Twenty-one days post 2^nd week, i.e., 6^th week all the clinical parameters were recorded again.

RESULTS

Intragroup analysis of all the clinical parameters showed clinical significant results between baseline and 6^th week. However, on intergroup analysis, the results were not significant.

CONCLUSION

The local application of CoQ₁₀ and hyaluronic acid gel in conjunction with SRP may have a beneficial effect on periodontal health in patients with chronic periodontitis.

Hyaluronic acid: Perspectives in dentistry. A systematic review

To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the soft periodontal tissue, gingiva, and periodontal ligament as well as to the hard tissue such as alveolar bone and cementum. Topical hyaluronic acid (HA) has recently been recognized as an adjuvant treatment for chronic inflammatory disease in addition to its use to improve healing after dental procedures. The aim of our work was to systematically review the published literature about potential effects of HA as an adjuvant treatment for chronic inflammatory disease, in addition to its use to improve healing after common dental procedures. Relevant published studies were found in PubMed, Google Scholar, and Ovid using a combined keyword search or medical subject headings. At the end of our study selection process, 25 relevant publications were included, three of them regarding gingivitis, 13 of them relating to chronic periodontitis, seven of them relating to dental surgery, including implant and sinus lift procedures, and the remaining three articles describing oral ulcers. Not only does topical administration of HA play a pivotal key role in the postoperative care of patients undergoing dental procedures, but positive results were also generally observed in all patients with chronic inflammatory gingival and periodontal disease and in patients with oral ulcers.

Evaluation of effectiveness of hyaluronic acid in combination with bioresorbable membrane (poly lactic acid-poly glycolic acid) for the treatment of infrabony defects in humans: A clinical and radiographic study

Background:

The combination of biomaterials, bone graft substitutes along with guided tissue regeneration (GTR) has been shown to be an effective modality of periodontal regenerative therapy for infrabony defects. Therefore, the present randomized controlled clinical study was undertaken to evaluate the effectiveness of hyaluronic acid (HA) in combination with bioresorbable membrane for the treatment of human infrabony defects.

Materials and Methods:

Twenty four infrabony defects in 20 systemically healthy patients were randomly assigned to test (HA in combination with bioresorbable membrane) and control (bioresorbable membrane alone) treatment groups. Probing pocket depth (PPD), relative attachment level, and relative gingival margin level were measured with a computerized Florida disc probe at baseline and at 6 months follow-up. Radiographic measurements were also evaluated at baseline and at 6 months of postsurgery.

Results:

At 6 months, the mean reduction in PPD in test group and control group was 4.52 mm and 2.97 mm, respectively. Significantly higher clinical attachment level with a gain of 2.20 mm was found in the test group as compared to control group. In addition, statistically significant greater reduction of radiographic defect depth was observed in the test group.

Conclusion:

Regenerative approach using hyaloss in combination with GTR for the treatment of human infrabony defects resulted in a significant added benefit in terms of CAL gains, PPD reductions and radiographic defect fill, as well as LBG, compared to the GTR alone.

To compare the effect of the local delivery of hyaluronan as an adjunct to scaling and root planing versus scaling and root planing alone in the treatment of chronic periodontitis

Background:

Hyaluronan is a critical component of the extracellular matrix and contributes significantly to tissue hydrodynamics and cell migration and proliferation. Studies have demonstrated its anti-inflammatory, antibacterial, and regenerative effects. The present study aimed to assess the clinical effects of the subgingival application of 0.8% hyaluronic acid gel as an adjunct to scaling and root planing (SRP) in the treatment of generalized chronic periodontitis.

Materials and Methods:

Patients with chronic periodontitis were recruited to participate in a study with a split-mouth design and provided informed consent. One hundred sites were included in the study and divided into fifty test sites and fifty control sites. These were assessed for plaque index (PI), gingival index (GI), pocket probing depths, and relative attachment level (RAL) at-pretreatment (baseline), 4, and 12 weeks posttreatment. The patients received full-mouth SRP. A 0.8% hyaluronan gel was administered subgingivally in the test sites at baseline and after 1 week. Significant differences between test and control were evaluated using the t-test, analysis of variance (test) followed by Bonferroni post hoc test.

Results:

A significant reduction in PI and GI was observed in both groups at 12 weeks (P < 0.05). Significant reduction in the pocket probing depths and gain RAL was observed in both the groups as compared to baseline (P < 0.05). The hyaluronan group compared to control at 12 weeks showed statistically significant reduction in the probing pocket depth and gain in RAL (P < 0.05).

Conclusion:

The subgingival application of 0.8% hyaluronan gel in conjunction with SRP may have a beneficial effect on periodontal health in patients with chronic periodontitis.

Hyaluronic Acid as an adjunct to scaling and root planing in chronic periodontitis. A randomized clinical trail

AIM

AIM of the present study was to evaluate the adjunctive effect of local application of hyaluronon gel following scaling and root planing (SRP) in chronic periodontitis patients.

MATERIALS AND METHODS

In this randomized split mouth study 33 subjects with chronic periodontitis were evaluated after full mouth SRP. In the test sites hyaluronon gel was applied immediately after SRP and one week post therapy, the control sites were treated with SRP alone. Bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline, 4 wk and 12 wk.

RESULTS

Significant reduction in BOP scores was observed in both the groups at 12weeks (p<0.001). The hyaluronon group showed a greater reduction in BOP (p<0.001). In the hyaluronon group the mean PPD at baseline was 6.33±0.09 which reduced to 2.49±0.51 at 12 weeks which was statistically significant (p<0.001). In the control group the mean PPD at baseline was 6.09±1.26 which reduced to 4.36±1.29 at 12 weeks which was statistically significant (p<0.001). The CAL measurements showed a significant difference between the groups (p<0.001) at 12 wk post therapy.

CONCLUSION

Hyaluronic Acid (HA) has a beneficial effect on periodontal health in patients with chronic Periodontitis. HA appears to be a suitable candidate as an adjunct to SRP in chronic periodontitis patients.

Short-term microbiological effects of scaling and root planing and essential-oils mouthwash in Chinese adults

OBJECTIVE

To assess the short-term effect of scaling and root planing (SRP) and essential-oils mouthwash on the levels of specific bacteria in Chinese adults.

METHODS

Fifty Chinese adults with chronic periodontitis were randomly assigned to full-mouth SRP or a 7-d essential-oils mouthwash regimen. In addition, 22 periodontally healthy adults used essential-oils mouthwash for 7 d. Clinical examination and plaque/saliva sampling were performed at baseline and on Day 7. Quantitative real-time polymerase chain reaction (PCR) was used to measure Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), and total bacterial loads in saliva, supra- and sub-gingival plaque samples.

RESULTS

The detection frequencies of four tested species remained unchanged after either treatment. However, the bacterial loads of Fn, Pg, and Pi were significantly reduced by SRP; the mean reduction of bacterial counts in saliva ranged from 52.2% to 62.5% (p<0.01), in supragingival plaque from 68.2% to 81.0% (p<0.05), and in subgingival plaque from 67.9% to 93.0% (p<0.01). Total bacterial loads were reduced after SRP in supra- and sub-gingival plaque (p<0.05). Essential-oils mouthwash reduced Fn levels in supragingival plaque by a mean of 53.2%, and reduced total bacterial loads in supra- and sub-gingival plaque (p<0.01). In subgingival plaque from periodontal patients, Pg and Pi reductions were high after SRP compared to essential-oils mouthwash (93.0% vs. 37.7% and 87.0% vs. 21.0%, p<0.05). No significant bacterial reduction was observed in periodontally healthy subjects using essential-oils mouthwash.

CONCLUSIONS

SRP and essential-oils mouthwash both have an impact on saliva and gingival plaque flora in Chinese periodontitis patients in 7 d, with greater microbiological improvement by SRP.

Comparative analysis of hyaluronan gel and xanthan-based chlorhexidine gel, as adjunct to scaling and root planing with scaling and root planing alone in the treatment of chronic periodontitis: A preliminary study

AIM

The aim of this study was to evaluate the effects of hyaluronan (HA) and chlorhexidine (CHX) gels as adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.

MATERIALS AND METHODS

Sixty patients within the age group of 30-65 years recruited to participate in the study were randomly equally divided into three groups. Complete SRP and subgingival debridement were performed within 6 h in all the patients. For control (Group I) patients, SRP was the only treatment modality given; for Group II and III patients, at least 8 teeth with 4-8 mm probing pocket depth (PPD) were selected for subgingival application of HA gel and CHX gel, respectively. Clinical periodontal parameters such as gingival index, PPD, and clinical attachment level (CAL) were recorded at baseline and 3 months, whereas plaque index was recorded at baseline, 1 month, and 3 months. For measuring systemic/hematological parameters, blood samples for laboratory tests for total leucocyte count (TLC), differential leucocyte count (DLC), and C-reactive protein (CRP) were obtained using standard 2-mL syringe from each subject in all the three groups at baseline, 24 h, and on the 1 month and 3 months post-baseline.

RESULTS

In all the three groups, a significant reduction in PPD and gain in CAL were observed between baseline and 3 months follow-up (P< 0.05); however, at 3 months, change in PPD and CAL was more in Group II than Group III, but the difference was non-significant, and Group I (control) showed less changes in PPD and CAL than both experimental groups. Only one patient revealed positive value for CRP at baseline only, and hence could not be statistically analyzed. In all the three groups, the peak values for TLC count were observed at 24 h. At 1-month and 3-month intervals, a significant improvement in TLC and DLC counts was observed among the experimental (HA gel/SRP and Xan-CHX gel) groups as compared to control group (SRP alone).

Hyaluronic Acid: a boon in periodontal therapy

Hyaluronic acid is a naturally occurring linear polysaccharide of the extracellular matrix of connective tissue, synovial fluid, and other tissues. Its use in the treatment of the inflammatory process is established in medical areas such as orthopedics, dermatology, and ophthalmology. The Pubmed/Medline database was searched for keywords “Hyaluronic acid and periodontal disease” and “Hyaluronic acid and gingivitis” which resulted in 89 and 22 articles respectively. Only highly relevant articles from electronic and manual search in English literature were selected for the present review article. In the field of dentistry, hyaluronic acid has shown anti-inflammatory and anti-bacterial effects in the treatment of periodontal diseases. Due to its tissue healing properties, it could be used as an adjunct to mechanical therapy in the treatment of periodontitis. Further studies are required to determine the clinical efficacy of hyaluronic acid in healing of periodontal lesion. The aim of the present review, article is to discuss the role of hyaluronic acid in periodontal therapy.

Microbial sampling process can change results of microbiological analysis in periodontitis diagnosis. A minireview

This minireview aims to verify the supposition that the microbial sampling process can change results of microbiological analysis in periodontitis diagnosis. The literature search via Pubmed yielded 52 appropriate articles for analysis. Of which 38% (20/52) described that the sampling sites were isolated from saliva, whereas 62% (32/52) did not. Also, 29% (15/52) declared that the microbial sampling was performed before probing pocket depth (PPD), whereas 71% (37/52) did not. Comparison of the results of microbiological analysis in these studies showed that the bacteria most frequently detected in periodontal pockets was variable. Therefore, a sampling process that includes both the microbial sample being taken before PPD and saliva isolation of the sampling sites is needed to ensure the accuracy of microbiological analysis in periodontitis diagnosis.

Protective effect of topical Cordia verbenacea in a rat periodontitis model: immune-inflammatory, antibacterial and morphometric assays

BACKGROUND

This study evaluated the effects of C. verbenacea essential oil topically administered in a rat periodontitis model.

METHODS

Periodontitis was induced on rats in one of the mandibular first molars assigned to receive a ligature. Animals were randomly divided into two groups: a) non-treatment group (NT) (n = 18): animals received 1mL of vehicle; b) C. verbenacea group (C.v.) (n = 18): animals received 5mg/Kg of essential oils isolated from C. verbenacea. The therapies were administered topically 3 times daily for 11 days. Then, the specimens were processed for morphometric analysis of bone loss. The ligatures were used for microbiological assessment of the presence of Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Porphyromonas gingivalis using PCR. The gingival tissue was collected to Elisa assay of interleukin (IL)-1α and IL-10 levels.

RESULTS

Bone loss was inhibited by C. verbenacea when compared to the NT group (p < 0.05). A decrease in the levels of IL-1α and increase in the IL-10 amounts was observed in the C.v. group as compared to NT group (p < 0.05). A lower frequency of P. gingivalis was found in C.v. group (p < 0.05).

CONCLUSION

C. verbenacea essential oil topically administered diminished alveolar bone resorption, promoting a positive local imbalance in the pro/anti-inflammatory system and reducing the frequency of detection of P. gingivalis.

Effect of hyaluronan on periodontitis: A clinical and histological study

BACKGROUND

Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL®) as an adjunct to scaling and root planing (SRP) in chronic periodontitis patients.

MATERIALS AND METHODS

One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm). Experimental sites additionally received HA gel subgingivally at baseline, 1(st), 2(nd), and 3(rd) week. Clinical parameters were re-assessed at 4(th), 6(th), and 12(th) week. At 4(th) week recall, a gingival biopsy was obtained from test and control site for histologic examination.

RESULTS

Intra-group analysis of all the clinical parameters at all sites from baseline to 4(th), 6(th), and 12(th) week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6(th) and 12(th) week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4(th), 6(th), and 12(th) week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment.

CONCLUSION

Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant.

The bactericidal effects of an acidified sodium chlorite-containing oral moisturizing gel: a pilot study

The aim of this study was to examine the bactericidal effects and bactericidal time of an acidified sodium chlorite compound gel (ASC-Gel) on bacteria isolated from the peri-implant sulci of 10 patients who received implants 3-27 years previously, and the depth of each peri-implant sulcus was 5 mm or less. Porphyromonas gingivalis (ATCC33277) was used as the control bacterium. Five ASC-Gel preparations were created by adding 3.3%, 5.0%, 7.0%, 9.0%, and 11.0% citric acid (CA) (condition a, b, c, d, and e, respectively) into an oral moisturizing gel containing sodium chlorite. The concentrations of chlorine dioxide (ClO2) generated in ASC-Gel under conditions (a) to (e) were 12.1, 14.1, 17.2, 21.2, and 39.3 ppm, respectively. We examined the bactericidal effects of the 5 ASC-Gel preparations at volumes of 0.5, 1.0, and 2.0 mL, and measured the bactericidal time when 2.0 mL of ASC-Gel was used under condition (e). The bactericidal effects of ASC-Gel became significantly greater with increased concentrations of CA and ClO2 and with increased usage (0.5-2.0 mL) of the gel. All bacteria were killed by using 2.0 mL of ASC-Gel under condition (e). ASC-Gel also needed between 45 and 90 minutes to kill all microbes under condition (e). Within the limits of the present investigation, these results suggest that ASC-Gel is useful as a chemical disinfectant against bacteria in the peri-implant sulcus. Further studies are also required to protect teeth, the surface of hydroxyapatite-coated implants, and the surrounding soft tissues from effects of chemical dissolution such as acid erosion due to the low pH of ASC-Gel.

Histological evaluation of Curcuma longa-ghee formulation and hyaluronic acid on gingival healing in dog

ETHNOPHARMACOLOGICAL RELEVANCE

The experimental finding of Asian traditional medicine revealed the pharmacological effect of the local application of ghee which was taken from cow butterfat and the rhizomes of Curcuma longa. These materials significantly improved the healing process of the wound. In addition, ancient physicians of Middle East discovered that the powdered rhizomes of Curcuma longa (common turmeric) also had impressive medicinal qualities. Over the centuries, this spice has been used as a pain relieving, anti-inflammatory agent to relieve pain and inflammation in the skin and muscles.

AIM OF THE STUDY

We decided to mix ghee which was taken from sheep butterfat with the powdered rhizomes of Curcuma longa to formulate a novel cost-benefit material and then, evaluate its potential therapeutic effect on acceleration of surgical wound healing; moreover, this present study was performed to compare the effects of Curcuma longa-ghee formulation and hyaluronic acid on gingival wound healing following surgery.

MATERIALS AND METHODS

Five healthy 3-year-old male beagle dogs were used in this study. They had intact teeth and the clinical and radiographic examination revealed no periodontal disease. Ghee was obtained from the refined sheep butterfat heated to 70 degrees C mixed with the powdered rhizomes of Curcuma longa and was applied with two different ratios including materials A and B. Randomly, these three materials including hyaluronic acid, materials A and B were applied topically in test regions and then covered with periodontal pack. Histological changes were monitored in days 4 and 7 after operation to evaluate the inflammatory and repair stage of healing process.

RESULTS

We observed significant difference in the inflammatory and repair parameters of the healing process between cases treated with this new formulation and cases of hyaluronic acid application.

CONCLUSION

The results suggested a positive potential therapeutic effect on surgical wound healing particularly improvement of periodontal treatment consequences after surgery.