Cross‐linked hyaluronic acid gel with or without a collagen matrix in the treatment of class III furcation defects: A histologic and histomorphometric study in dogs

Abstract

Aim: To histologically evaluate the effects of cross-linked hyaluronic acid (xHyA) with or without a collagen matrix (CM) on periodontal wound healing/regeneration in class III furcation defects in dogs. Materials and Methods: Class III furcation defects were surgically created in the mandibular premolars in six beagle dogs. The defects were randomly treated as follows: open flap debridement (OFD) + CM (CM), OFD + xHyA (xHyA), OFD +-xHyA + CM (xHyA/CM) and OFD alone (OFD). At 10 weeks, the animals were euthanized for histological evaluation. Results: The newly formed bone areas in the xHyA (4.04 ± 1.51 mm 2 ) and xHyA/CM (4.32 ± 1.14 mm 2 ) groups were larger than those in the OFD (3.25 ± 0.81 mm 2 ) and CM (3.31 ± 2.26 mm 2 ) groups. The xHyA (6.25 ± 1.45 mm) and xHyA/CM (6.40 ± 1.35 mm) groups yielded statistically significantly (p < .05) greater formation of new connective tissue attachment (i.e., new cementum, with inserting connective tissue fibres) compared with the OFD (1.47 ± 0.85 mm) group. No significant differences were observed in any of the histomorphometric parameters between the xHyA and xHyA/CM groups. Complete furcation closure was not observed in any of the four treatment modalities. Conclusions: Within their limits, the present results suggest that the use of xHyA with or without CM positively influences periodontal wound healing in surgically created, acute-type class III furcation defects.

Adjunctive Application of Hyaluronic Acid in Combination with a Sodium Hypochlorite Gel for Non-Surgical Treatment of Residual Pockets Reduces the Need for Periodontal Surgery—Retrospective Analysis of a Clinical Case Series

“…The histomorphometric assessments revealed that xHyA-treated intraosseous and furcation sites formed significantly greater areas of new cementum and periodontal ligament fibers on previously exposed root surfaces. Similar observations were made from the same treatment sequence applied in gingival recessions [ 39 , 40 , 41 ].…”

Clinical effects of the adjunctive use of polynucleotide and hyaluronic acid‐based gel in the subgingival re‐instrumentation of residual periodontal pockets: A randomized, split‐mouth clinical trial

“…28,29 The periodontal wound healing/regeneration effects were further supported by in vitro studies showing that HA: (a) acts as lubricant and space filler 30 ; (b) preserves human periodontal ligament cell viability and increased early osteogenic differentiation 31 ; (c) controls the balance between selfrenewal and differentiation during bone regeneration 32 ; and (d) induces root cementum, periodontal ligament, and bone formation in experimentally created two-wall intrabony defects in dogs. 33 Based on the above-mentioned properties, HA effects on nonsurgical periodontal treatment were also investigated. In particular, it was applied in (a) initial periodontal treatment as a monotherapy or associated with subgingival instrumentation, showing moderate improvement of clinical parameters; 34,35 and (b) as an adjunctive therapy in conjunction to subgingival re-instrumentation of residual pockets, resulting in nonstatistically significant differences compared with nonsurgical retreatment alone.…”

Coronally advanced flap with and without hyaluronic acid (HYALOSS) for the treatment of gingival recession – a randomized clinical trial

“…Shirakata et al conducted an experimental study on dogs in which they found successful periodontal regeneration of gingival recession defects after treatment with CAF + HA. Statistically significant differences were observed in CAL (p < 0.05), width of gingival recession (p < 0.01), in formation of cementum and connective tissue attachment (p < 0.05) at 10 weeks in HA + CAF group [43]. From these observations we can assume some amount of true regeneration to take place under CAF with connective tissue attachment [41].…”