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Schmidt J, Pavlík V, Suchánek J, Nešporová K, Soukup T, Kapitán M, Pilbauerová N. Low, medium, and high molecular weight hyaluronic acid effects on human dental pulp stem cells in vitro. Int J Biol Macromol 2023; 253:127220. [PMID: 37827401 DOI: 10.1016/j.ijbiomac.2023.127220] [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: 07/25/2023] [Revised: 09/20/2023] [Accepted: 10/01/2023] [Indexed: 10/14/2023]
Abstract
Hyaluronic acid (HA), an extracellular biopolymer found throughout the human body, holds promise as a biocompatible and biodegradable scaffold material. High molecular weight (HMW) HA degrades, generating low molecular weight (LMW) fragments with distinct properties. These fragments can influence the behaviour of cells, including human dental pulp stem cells (hDPSCs) incorporated into HA-containing hydrogels or scaffolds. Therefore, a comprehensive examination of the impact of a range of HA molecular weights on hDPSCs is essential before designing HA-based scaffolds for these cells. hDPSC lines were cultured with LMW HA (800 Da, 1600 Da, 15 kDa), medium molecular weight HA (237 kDa), or HMW HA (1500 kDa) over six passages. The various molecular weights had negligible effects on hDPSCs viability, morphology, adhesion, or relative telomere length. Furthermore, the expression of key surface stemness markers (CD29, CD44, CD73, CD90) remained unaltered. HA did not induce osteogenic, chondrogenic, or adipogenic differentiation. Moreover, the potential for chondrogenic and osteogenic differentiation was not adversely affected by LMW or HMW HA. Various molecular weights of HA seem safe, biocompatible and therefore suitable components for hDPSCs-containing scaffolds. These findings affirm that the hDPCSs will not be negatively affected by HA fragments resulting from scaffold degradation.
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Affiliation(s)
- Jan Schmidt
- Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic
| | - Vojtěch Pavlík
- Cell Physiology Research Group, Contipro a.s., 561 02 Dolni Dobrouc, Czech Republic.
| | - Jakub Suchánek
- Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic
| | - Kristina Nešporová
- Cell Physiology Research Group, Contipro a.s., 561 02 Dolni Dobrouc, Czech Republic
| | - Tomáš Soukup
- Department of Histology and Embryology, Charles University, Faculty of Medicine in Hradec Kralove, 500 03 Hradec Kralove, Czech Republic
| | - Martin Kapitán
- Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic
| | - Nela Pilbauerová
- Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic
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Domic D, Bertl K, Lang T, Pandis N, Ulm C, Stavropoulos A. Hyaluronic acid in tooth extraction: a systematic review and meta-analysis of preclinical and clinical trials. Clin Oral Investig 2023; 27:7209-7229. [PMID: 37963982 PMCID: PMC10713798 DOI: 10.1007/s00784-023-05227-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/16/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVES To assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication management compared to any other treatment or no treatment. MATERIALS AND METHODS Three databases were searched until April 2022. The most relevant eligibility criteria were (1) local application of HyA as adjunct to tooth extraction or as treatment of alveolar osteitis, and (2) reporting of clinical, radiographic, histological, or patient-reported data. New bone formation and/or quality were considered main outcome parameters in preclinical studies, while pain, swelling, and trismus were defined as main outcome parameters in clinical studies. RESULTS Five preclinical and 22 clinical studies (1062 patients at final evaluation) were included. In preclinical trials, HyA was applied into the extraction socket. Although a positive effect of HyA was seen in all individual studies on bone formation, this effect was not confirmed by meta-analysis. In clinical studies, HyA was applied into the extraction socket or used as spray or mouthwash. HyA application after non-surgical extraction of normally erupted teeth may have a positive effect on soft tissue healing. Based on meta-analyses, HyA application after surgical removal of lower third molars (LM3) resulted in significant reduction in pain perception 7 days postoperatively compared to either no additional wound manipulation or the application of a placebo/carrier. Early post-operative pain, trismus, and extent of swelling were unaffected. CONCLUSIONS HyA application may have a positive effect in pain reduction after LM3 removal, but not after extraction of normally erupted teeth. CLINICAL RELEVANCE HyA application may have a positive effect in pain reduction after surgical LM3 removal, but it does not seem to have any impact on other complications or after extraction of normally erupted teeth. Furthermore, it seems not to reduce post-extraction alveolar ridge modeling, even though preclinical studies show enhanced bone formation.
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Affiliation(s)
- Danijel Domic
- Division of Oral Surgery, University Clinic of Dentistry, Medical University Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Kristina Bertl
- Department of Periodontology, Dental Clinic, Faculty of Medicine, Sigmund Freud University, Freudplatz 3, 1020, Vienna, Austria
- Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs Väg 34, 205 06, Malmö, Sweden
| | - Tobias Lang
- Division of Oral Surgery, University Clinic of Dentistry, Medical University Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Christian Ulm
- Division of Oral Surgery, University Clinic of Dentistry, Medical University Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Andreas Stavropoulos
- Periodontology, Faculty of Odontology, University of Malmö, Carl Gustafs Väg 34, 205 06, Malmö, Sweden.
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
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Stryja J, Teplá K, Routek M, Pavlík V, Perutková D. Octenidine with hyaluronan dressing versus a silver dressing in hard-to-heal wounds: a post-marketing study. J Wound Care 2023; 32:480-491. [PMID: 37572339 DOI: 10.12968/jowc.2023.32.8.480] [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] [Indexed: 08/14/2023]
Abstract
OBJECTIVE This study was conducted to provide comparative data on the clinical efficacy and safety of a novel hard-to-heal wound dressing (Sorelex; Contipro a.s., Czech Republic) that combines octenidine and hyaluronan, compared with a silver-based dressing. METHOD This multicentre, open-label, randomised, post-market, clinical follow-up study provides a comparison of a octenidine and hyaluronan combination with a standard-of-care (SoC) silver-containing dressing. The investigators evaluated the management of infection in the hard-to-heal wounds based on recorded changes in the appearance of the wound bed tissue and the presence of clinical signs of infection after three weeks of treatment. Other relevant assessed parameters of wound healing were: wound size; exudation level; wound pain level; and surrounding skin appearance. RESULTS The study cohort included 48 patients in the Sorelex arm and 39 patients in the SoC arm. Both products evinced numerous parameters of wound infection management: reductions in the wound bed slough; marked decreases in wound size; the formation of re-epithelialisation and granulation tissue; and improved pain management. Sorelex significantly improved the condition of surrounding skin after three weeks of treatment, unlike SoC. Sorelex reduced wound area significantly more than SoC (p=0.04). No statistically significant differences were detected in other assessed parameters between the two study arms. All the participating investigators expressed their satisfaction with both products. No adverse reactions to Sorelex were recorded over the mean treatment period of 53 days. CONCLUSION The octenidine and hyaluronan combination provides a new alternative choice of dressing for the treatment of infected hard-to-heal wounds when compared with a silver-based product.
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Affiliation(s)
- Jan Stryja
- Centre of Vascular and Miniinvasive Surgery, Hospital Agel, Trinec Podlesi, The Czech Republic; Salvatella Ltd., Centre of Non-healing Wounds Treatment, Podiatric Outpatients' Department, Trinec, The Czech Republic
| | | | - Miroslav Routek
- Ambulance for Treatment of Chronic Wounds, Regional Hospital Nachod, Broumov, The Czech Republic
| | - Vojtech Pavlík
- Department of Dermatology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Darja Perutková
- Department of dermatology, Military hospital, Olomouc, The Czech Republic
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ALHarthi SS, Ali D, Alamry NZ, Alshehri MK, Divakar DD, BinShabaib MS. Photobiomodulation for Managing "Dry Socket": A Randomised Controlled Trial. Int Dent J 2023; 73:267-273. [PMID: 35803777 PMCID: PMC10023530 DOI: 10.1016/j.identj.2022.06.002] [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: 05/18/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE There are no studies that have evaluated the effect of Alveogyl with and without adjunct photobiomodulation therapy (PBMT) in reducing self-rated post-operative pain (SPP) in patients with alveolar osteitis (AO; dry socket). The aim of the present randomised controlled trial was to assess the effectiveness of Alveogyl with and without PBMT for the management of SPP in patients with AO. METHODS Adult nonsmokers with diagnosed AO were included. Patients were randomly divided into 4 groups. In Group 1, patients underwent mechanical curettage (MC) with copious normal saline irrigation. In Group 2, patients underwent MC + Alveogyl dressings in extraction sites which were changed every 48 hours until cessation of pain. In Group 3, patients underwent MC + Alveogyl followed by PBMT using a 660-nm indium-gallium-aluminum-phosphide diode laser. In Group 4, patients were treated solely with PBMT. The visual analogue scale was used up to 3 postoperative days to assess SPP up to 3 days at 6- (T0) and 12-hour (T1) intervals. Statistical analyses were performed using the analysis of variance and Bonferroni post hoc adjustment tests. Correlation between SPP scores and age, sex, and eruption status of teeth was assessed using logistic regression models. P values <.01 were nominated as being statistically significant. RESULTS In all, 14, 13, 14, and 14 individuals with AO were included in groups 1, 2, 3 and 4, respectively. All patients had undergone extraction of mandibular third molars. At baseline and on day 1, there was no difference in SPP in all groups. On days 2 and 3, mean visual analogue scale (VAS) scores at T1 (P < .01) and T2 (P < .01) intervals were significantly high in Group 2 compared with Group 3. On days 2 and 3, mean VAS scores at T1 (P < .01) and T2 (P < .01) intervals were significantly high in Group 4 compared with Group 3. There was no difference in SPP in groups 3 and 4 on day 3 at T0 and T1 intervals. CONCLUSIONS PBMT following MC and Alveogyl dressing is more efficient in reducing SPP compared with MC with or without Alveogyl dressing in patients with AO.
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Affiliation(s)
- Shatha S ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Dena Ali
- Department of General Dental Practice, Kuwait University, Safat, Kuwait
| | - Nujud Zayed Alamry
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Majed K Alshehri
- Department of Preventive Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Darshan D Divakar
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University, Ministry of Health, Lusaka, Zambia
| | - Munerah S BinShabaib
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
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Suchánek J. Editorial of Special Issue “Hyaluronic Acid in Human Medicine”. Biomolecules 2022; 12:biom12101495. [PMID: 36291704 PMCID: PMC9599049 DOI: 10.3390/biom12101495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
Hyaluronic acid (HA) is an acidic, non-sulfated glycosaminoglycan that is intensively studied as a biodegradable and biocompatible material for scaffolding, regenerative medicine, and clinical applications [...]
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Affiliation(s)
- Jakub Suchánek
- Department of Dentistry, Faculty of Medicine in Hradec Kralove, Charles University, Simkova 870, 500 03 Hradec Kralove, Czech Republic;
- Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic
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Endosseous Dental Implant Materials and Clinical Outcomes of Different Alloys: A Systematic Review. MATERIALS 2022; 15:ma15051979. [PMID: 35269211 PMCID: PMC8911578 DOI: 10.3390/ma15051979] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 12/17/2022]
Abstract
In recent years, implantology has made significant progress, as it has now become a safe and predictable practice. The development of new geometries, primary and secondary, of new surfaces and alloys, has made this possible. The purpose of this review is to analyze the different alloys present on the market, such as that in zirconia, and evaluate their clinical differences with those most commonly used, such as those in grade IV titanium. The review, conducted on major scientific databases such as Scopus, PubMed, Web of Science and MDPI yielded a startling number of 305 results. After the application of the filters and the evaluation of the results in the review, only 10 Randomized Clinical Trials (RCTs) were included. Multiple outcomes were considered, such as Marginal Bone Level (MBL), Bleeding on Probing (BoP), Survival Rate, Success Rate and parameters related to aesthetic and prosthetic factors. There are currently no statistically significant differences between the use of zirconia implants and titanium implants, neither for fixed prosthetic restorations nor for overdenture restorations. Only the cases reported complain about the rigidity and, therefore, the possibility of fracture of the zirconium. Certainly the continuous improvement in these materials will ensure that they could be used safely while maintaining their high aesthetic performance.
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Célien E, Julie A, Maarten G, Jan C. A randomized controlled trial evaluating hyaluronic acid gel as wound healing agent in alveolar ridge preservation. J Clin Periodontol 2021; 49:280-291. [PMID: 34961942 DOI: 10.1111/jcpe.13589] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/11/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022]
Abstract
AIM To compare the results of administration of hyaluronic acid (HA) gel to no gel administration following alveolar ridge preservation (ARP) in terms of changes in wound dimensions over time. MATERIALS AND METHODS Systemically healthy patients scheduled for ARP at one or two sites in the incisor, cuspid, or premolar area with at least one neighbouring tooth and >50% buccal bone present following extraction were included. ARP consisted of socket grafting with collagen-enriched, deproteinized bovine bone mineral and socket sealing by means of a collagen matrix. Following surgical therapy, sites were randomly allocated to the control group (no gel application) or the test group (0.8% HA gel applied onto the collagen matrix three times per day for 7 days). Bucco-lingual and mesio-distal wound dimensions were registered at T0 (immediately post operation), T1 (1 week), and T2 (3 weeks). Patient-reported outcomes, clinical outcomes, and hard and soft tissue changes were recorded up to 4 months (T3). RESULTS In the control group, 20 patients (7 males, 13 females; mean age 53.30) with 23 sites, and in the test group 18 patients (9 males, 9 females; mean age 52.56) with 23 sites, were included. There were no significant differences between the groups in the changes in wound dimensions from T0 to T2 (bucco-lingual aspect: p = .340; mesio-distal aspect: p = .883). Three sites (13%) in the control group and six (26%) in the test group demonstrated complete wound resolution at T2 (p = .259). HA failed to show any effect on the number of analgesics taken (p = .175), patient-reported outcomes (p ≥ .263), alveolitis (p = .136), socket healing (p ≥ .424), soft tissue changes (p ≥ .064), or mucosal scarring (p = .548). However, significantly more horizontal bone loss at the coronal aspect was found in the test group (p ≤ .025). CONCLUSION HA failed to promote wound resolution on a collagen matrix. This study was registered in ClinicalTrials.gov (NCT04467736).
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Affiliation(s)
- Eeckhout Célien
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Ackerman Julie
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Glibert Maarten
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Cosyn Jan
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Garola F, Gilligan G, Panico R, Leonardi N, Piemonte E. Clinical management of alveolar osteitis. A systematic review. Med Oral Patol Oral Cir Bucal 2021; 26:e691-e702. [PMID: 34704976 PMCID: PMC8601644 DOI: 10.4317/medoral.24256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/27/2021] [Indexed: 11/06/2022] Open
Abstract
Background Alveolar Osteitis (AO) is one of the most common complications of tooth extraction. Several therapeutic interventions have been described for the treatment of AO, however, there are no treatment standardized protocols. The aim of this study was to conduct a systematic review on the efficacy in pain control of the different treatments for AO. The feasibility of the application of these interventions is also discussed. Material and Methods A structured electronic and hand search strategy was applied to PubMed, Scopus, Cochrane Library, OpenGrey, and Google Scholar between January 2010 and July 2020 to identify studies according to PRISMA guidelines. The inclusion criteria were original English and Spanish clinical trials that analyzed pain-control parameters according to visual analog scale (VAS, 0-10 scale), or pain relief patients’ percentages. Those treatments that reach VAS ≤ 4 on day 2 or before; or ≥ 85% of patients with absence of pain symptoms at day 7 or before were considered accepTable for their recommendation. Results The final review included 17 clinical trials. Among them, there were analyzed a total of 39 different AO treatments. 53,8% of the treatments fulfill the proposed parameters for pain control. Conclusions Treatment alternatives are multiple, heterogeneous, and difficult to compare. The management of AO is summarized in basic (intra-alveolar irrigation) and specific procedures (Alveogyl®, Neocones®, SaliCept Patch®, Low-Level Laser, Platelet-Rich Fibrin) that reach pain control success. They could be selected according to their availability and advantages or disadvantages. Key words:Dry socket, alveolar osteitis, treatment, management, pain control, pain relief.
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Affiliation(s)
- F Garola
- Haya de la Torre SN PA: 5000. Ciudad Universitaria Córdoba, Argentina
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Marinho A, Nunes C, Reis S. Hyaluronic Acid: A Key Ingredient in the Therapy of Inflammation. Biomolecules 2021; 11:1518. [PMID: 34680150 PMCID: PMC8533685 DOI: 10.3390/biom11101518] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 02/08/2023] Open
Abstract
Hyaluronic acid (HA) is a natural polymer, produced endogenously by the human body, which has unique physicochemical and biological properties, exhibiting desirable biocompatibility and biodegradability. Therefore, it has been widely studied for possible applications in the area of inflammatory diseases. Although exogenous HA has been described as unable to restore or replace the properties and activities of endogenous HA, it can still provide satisfactory pain relief. This review aims to discuss the advances that have been achieved in the treatment of inflammatory diseases using hyaluronic acid as a key ingredient, essentially focusing on studies carried out between the years 2017 and 2021.
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Affiliation(s)
| | - Cláudia Nunes
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal; (A.M.); (S.R.)
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Ghosh A, Aggarwal VR, Moore R. Aetiology, Prevention and Management of Alveolar Osteitis-A Scoping Review. J Oral Rehabil 2021; 49:103-113. [PMID: 34625985 DOI: 10.1111/joor.13268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/09/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alveolar osteitis (AO) is a poorly understood, common, painful complication following exodontia. It is sometimes managed by inappropriate prescription of antibiotics which contributes to the global threat of antimicrobial resistance. Use of intra-alveolar chlorhexidine also presents a serious risk of anaphylaxis to the patient. OBJECTIVE This scoping review aims to investigate the aetiology, prevention and management of AO and highlight the extent of inappropriate prescribing and intra-alveolar chlorhexidine use. DESIGN A scoping review was undertaken using the PRISMA guidelines. Medline, Ovid and Pubmed were searched between 2010 and 2020, from which 63 studies were selected for review that related to the aetiology, prevention or management of AO. Data were analysed for frequency of studies reporting information on risk factors for aetiology, prevention strategies and management including inappropriate management using antibiotic prescribing and intra-alveolar chlorhexidine. RESULTS Impaired immune response, surgical technique and age were identified as significant factors in the development of AO, while there is conflicting evidence regarding the effects of smoking and gender. With regard to prevention, the use of prophylactic antibiotics is not supported within the literature. Saline irrigation and eugenol pastes used preventively have been shown to be cheap and effective alternatives to chlorhexidine with no adverse effects. Hyaluronic acid and low-level laser therapies showed a significant reduction in pain and soft-tissue inflammation in the management of AO compared to Alveogyl. CONCLUSIONS Further understanding of the pathophysiology of AO is needed, in addition to large high-quality RCTs or long-term observational studies into the aetiology, prevention, and management of AO to produce up-to-date evidence-based clinical guidelines. Clinicians should also be mindful of their contribution to growing antimicrobial resistance and avoid inappropriate prescribing of antibiotics. Saline should replace chlorhexidine as the intra-alveolar irrigant of choice.
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Affiliation(s)
- Anna Ghosh
- Department of Oral and Maxillofacial Surgery, Hull Royal Infirmary, Hull, United Kingdom of Great Britain and Northern Ireland
| | - Vishal R Aggarwal
- Department of Academic Oral Surgery & Oral Medicine, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - Richard Moore
- Lecturer in Oral Surgery, Department of Academic Oral Surgery & Oral Medicine, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
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Natural Polymers for the Maintenance of Oral Health: Review of Recent Advances and Perspectives. Int J Mol Sci 2021; 22:ijms221910337. [PMID: 34638678 PMCID: PMC8508910 DOI: 10.3390/ijms221910337] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 12/14/2022] Open
Abstract
The success of modern dental treatment is strongly dependent on the materials used both temporarily and permanently. Among all dental materials, polymers are a very important class with a wide spectrum of applications. This review aims to provide a state-of-the-art overview of the recent advances in the field of natural polymers used to maintain or restore oral health. It focuses on the properties of the most common proteins and polysaccharides of natural origin in terms of meeting the specific biological requirements in the increasingly demanding field of modern dentistry. The use of naturally derived polymers in different dental specialties for preventive and therapeutic purposes has been discussed. The major fields of application cover caries and the management of periodontal diseases, the fabrication of membranes and scaffolds for the regeneration of dental structures, the manufacturing of oral appliances and dentures as well as providing systems for oral drug delivery. This paper also includes a comparative characteristic of natural and synthetic dental polymers. Finally, the current review highlights new perspectives, possible future advancements, as well as challenges that may be encountered by researchers in the field of dental applications of polymers of natural origin.
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Ajdnik U, Luxbacher T, Vesel A, Štern A, Žegura B, Trček J, Fras Zemljič L. Polysaccharide-Based Bilayer Coatings for Biofilm-Inhibiting Surfaces of Medical Devices. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4720. [PMID: 34443242 PMCID: PMC8398363 DOI: 10.3390/ma14164720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 01/16/2023]
Abstract
Chitosan (Chi) and 77KS, a lysine-derived surfactant, form polyelectrolyte complexes that reverse their charge from positive to negative at higher 77KS concentrations, forming aggregates that have been embedded with amoxicillin (AMOX). Dispersion of this complex was used to coat polydimethylsiloxane (PDMS) films, with an additional layer of anionic and hydrophilic hyaluronic acid (HA) as an outer adsorbate layer to enhance protein repulsion in addition to antimicrobial activity by forming a highly hydrated layer in combination with steric hindrance. The formed polysaccharide-based bilayer on PDMS was analyzed by water contact angle measurements, X-ray photoelectron spectroscopy (XPS), and surface zeta (ζ)-potential. All measurements show the existence and adhesion of the two layers on the PDMS surface. Part of this study was devoted to understanding the underlying protein adsorption phenomena and identifying the mechanisms associated with biofouling. Thus, the adsorption of a mixed-protein solution (bovine serum albumin, fibrinogen, γ-globulin) on PDMS surfaces was studied to test the antifouling properties. The adsorption experiments were performed using a quartz crystal microbalance with dissipation monitoring (QCM-D) and showed improved antifouling properties by these polysaccharide-based bilayer coatings compared to a reference or for only one layer, i.e., the complex. This proves the benefit of a second hyaluronic acid layer. Microbiological and biocompatibility tests were also performed on real samples, i.e., silicone discs, showing the perspective of the prepared bilayer coating for medical devices such as prostheses, catheters (balloon angioplasty, intravascular), delivery systems (sheaths, implants), and stents.
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Affiliation(s)
- Urban Ajdnik
- Institute of Engineering Materials and Design, Faculty of Mechanical Engineering, University of Maribor, Smetanova 17, 2000 Maribor, Slovenia
| | | | - Alenka Vesel
- Department of Surface Engineering and Optoelectronics, Jožef Stefan Institute, Teslova 30, 1000 Ljubljana, Slovenia;
| | - Alja Štern
- Department of Genetic Toxicology and Cancer Biology, National Institute of Biology, Večna Pot 111, 1000 Ljubljana, Slovenia; (A.Š.); (B.Ž.)
| | - Bojana Žegura
- Department of Genetic Toxicology and Cancer Biology, National Institute of Biology, Večna Pot 111, 1000 Ljubljana, Slovenia; (A.Š.); (B.Ž.)
| | - Janja Trček
- Department of Biology, Faculty of Natural Sciences and Mathematics, University of Maribor, Koroška cesta 160, 2000 Maribor, Slovenia;
| | - Lidija Fras Zemljič
- Institute of Engineering Materials and Design, Faculty of Mechanical Engineering, University of Maribor, Smetanova 17, 2000 Maribor, Slovenia
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Initial Observation of Factors Interfering with the Treatment of Alveolar Osteitis Using Hyaluronic Acid with Octenidine-A Series of Case Reports. Biomolecules 2021; 11:biom11081157. [PMID: 34439823 PMCID: PMC8391686 DOI: 10.3390/biom11081157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 12/15/2022] Open
Abstract
Alveolar osteitis (AO) is a common complication following the extraction of the teeth, particularly the lower third molars. It starts within a few days after the extraction and manifests mainly as pain in the extraction site. Several strategies of treatment are available in order to relieve pain and heal the extraction wound. Recently, a novel medical device combining hyaluronic acid (HA) and octenidine (OCT) was introduced for the treatment of AO. This series of case reports aims to summarize the initial clinical experiences with this new device and to highlight factors possibly interfering with this treatment. The medical documentation of five patients with similar initial situations treated for AO with HA + OCT device was analyzed in detail. Smoking and previous treatment with Alveogyl (Septodont, Saint-Maur-des-Fossés, France) were identified as factors interfering with the AO treatment with the HA + OCT device. In three patients without these risk factors, the treatment led to recovery within two or three days. The patient pretreated with Alveogyl and the smoker required six and seven applications of the HA + OCT device, respectively. According to these initial observations, it seems smoking and previous treatment with Alveogyl prolong the treatment of AO using the HA + OCT device that, in turn, shows a rapid effect if these risk factors are not present.
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Cervino G, Meto A, Fiorillo L, Odorici A, Meto A, D’Amico C, Oteri G, Cicciù M. Surface Treatment of the Dental Implant with Hyaluronic Acid: An Overview of Recent Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094670. [PMID: 33925742 PMCID: PMC8125310 DOI: 10.3390/ijerph18094670] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 12/17/2022]
Abstract
Recently, interest has grown by focusing on the evaluation of a molecule already produced in the human body such as hyaluronic acid (HA), as an application to the surface of the titanium implant. Its osteo-conductive characteristics and positive interaction with the progenitor cells responsible for bone formation, consequently, make it responsible for secondary stability. The aim of this work was to analyze the various surface treatments in titanium implants, demonstrating that the topography and surface chemistry of biomaterials can correlate with the host response; also focusing on the addition of HA to the implant surface and assessing the biological implications during early stages of recovery. Used as a coating, HA acts on the migration, adhesion, proliferation and differentiation of cell precursors on titanium implants by improving the connection between implant and bone. Furthermore, the improvement of the bioactivity of the implant surfaces through HA could therefore facilitate the positioning of the dental prosthesis precisely in the early loading phase, thus satisfying the patients’ requests. It is important to note that all the findings should be supported by further experimental studies in animals as well as humans to evaluate and confirm the use of HA in any field of dentistry.
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Affiliation(s)
- Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
| | - Agron Meto
- Department of Implantology, Faculty of Dentistry, University of Aldent, 1000 Tirana, Albania;
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
- Correspondence:
| | - Alessandra Odorici
- Laboratory of Microbiology and Virology, School of Doctorate in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Via G. Campi 287, 41125 Modena, Italy;
| | - Aida Meto
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania;
| | - Cesare D’Amico
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
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