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Hyaluronic Acid

Activity of Two Hayluronic Perparations on Primary Human Oral Fibroblasts

Activity of Two Hyaluronan Preparations on Primary Human Fibroblasts

Background and Objective: The potential benefit of using hyaluronan (HA) in
reconstructive periodontal surgery is still a matter of debate. The aim of the present
study was to evaluate the effects of two HA formulations on human oral fibroblasts
involved in soft tissue wound healing/regeneration.
Material and Methods: Metabolic, proliferative and migratory abilities of primary
human palatal and gingival fibroblasts were examined upon HA treatment. To uncover
the mechanisms whereby HA influences cellular behavior, wound healing-related
gene expression and activation of signaling kinases were analyzed by qRT-PCR
and immunoblotting, respectively.
Results: The investigated HA formulations maintained the viability of oral fibroblasts
and increased their proliferative and migratory abilities. They enhanced expression
of genes encoding type III collagen and transforming growth factor-β3,
characteristic
of scarless wound healing. The HAs upregulated the expression of genes encoding
pro-proliferative,
pro-migratory,
and pro-inflammatory
factors, with only a moderate
effect on the latter in gingival fibroblasts. In palatal but not gingival fibroblasts, an
indirect effect of HA on the expression of matrix metalloproteinases 2 and 3 was
detected, potentially exerted through induction of pro-inflammatory
cytokines.
Finally, our data pointed on Akt, Erk1/2 and p38 as the signaling molecules whereby
the HAs exert their effects on oral fibroblasts.
Conclusion: Both investigated HA formulations are biocompatible and enhance the
proliferative, migratory and wound healing properties of cell types involved in soft
tissue wound healing following regenerative periodontal surgery. Our data further
suggest that in gingival tissues, the HAs are not likely to impair the healing process by
prolonging inflammation or causing excessive MMP expression at the repair site.

Hyaluronic Acid as an Adjunctive

Hyaluronic Acid as Adjunctive to Non-Surgical 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 ofHA 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.

Hyaluronic Acid Slows Down Collagen Membrane

Hyaluronic Acid Slows Down Collagen Membrane Degradation In Uncontrolled Diabetic Rats

Abstract
Aim: To examine the in vitro biokinetics of hyaluronic acid (HA) from a collagen membrane
(CM) and to evaluate the in vivo effect of immersion of the CM in HA solution
on its degradation in streptozotocin (STZ)‐induced diabetes conditions in a rat calvaria
subcutaneous model.
Background: CM degradation is accelerated in uncontrolled diabetic rats. Immersion
of CM in HA has been suggested to decrease their resorption rate without interfering
with their tissue integration and structural degradation. However, it is unknown
to what extent CM degradation may be influenced by its immersion in HA solution
under a condition mimicking a medically compromised situation with an increased
inflammatory level such as diabetes.
Materials and Methods: CMs were soaked in cross‐linked HA. Protein adsorption and
the HA release were quantified by ELISA. Diabetes was induced in sixteen rats, while
16 healthy rats served as control. CM was prepared and labeled prior to implantation
with Biotin. Seventeen CM were immersed in HA and 17 CM in PBS. In each animal,
one test or one control disk was implanted. In order to compare the collagen content,
two similar non‐implanted CM were used as baseline. Fourteen days after surgery,
thirty‐two animals were sacrificed. The entire calvaria including the skin above, was
chemically fixed, decalcified, and embedded in paraffin. Five‐μm‐thick sections were
analyzed histologically and histomorphometrically using H&E and avidin‐peroxidase
staining.
Results: The in vitro results demonstrated that the CM adsorbed roughly 80% of
the total HA content. After 10 days, 36.3% of the initial HA remained on the CM.
The in vivo results demonstrated that diabetes significantly reduced the thickness of
the CM, while HA had a significant effect on keeping the membrane thickness. HA
increased the residual collagen content in the diabetic group (P < 0.0001) but no such effect was observed in the healthy group. Conclusion: Immersion of CM in HA prior to the implantation delays membrane degradation in uncontrolled diabetic compared with normoglycemic rats.

Extraction of Lost Tooth, While Saving Adjacent Implant

Extraction of Lost Tooth While Saving Adjacent Implant

The article introduces how to prepare surrounding area of an implant after extraction of a lost tooth.   The article includes before pictures and X-Rays, results after 10 days of healing and a video of the surgery. An 80 year old male patient was referred to me by his prosthodontist.  They wanted the lost tooth extracted, […]

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