The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 19 , ISSUE 5 ( 2018 ) > List of Articles

ORIGINAL RESEARCH

Effect of 0.8% Hyaluronic Acid in Conventional Treatment of Moderate to Severe Chronic Periodontitis

Nour M Al-Shammari, Sanaa M Shafshak, Mohamed S Ali

Keywords : Adjunctive therapy, Chronic periodontitis, Hyaluronic acid, Inflammation, Scaling and root planing, Subgingival application

Citation Information : Al-Shammari NM, Shafshak SM, Ali MS. Effect of 0.8% Hyaluronic Acid in Conventional Treatment of Moderate to Severe Chronic Periodontitis. J Contemp Dent Pract 2018; 19 (5):527-534.

DOI: 10.5005/jp-journals-10024-2294

License: CC BY-NC 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Objective: The aim of this study is to evaluate the effect of the subgingival application of 0.8% hyaluronic acid (HA) gel (GENGIGEL®) as an adjunct to scaling and root planing (SRP) on clinical parameters and expression of human beta defensin-2 (hBD-2) in patients with moderate to severe chronic periodontitis. Materials and methods: In this randomized, split mouth design study, 24 participants with moderate to severe chronic periodontitis were evaluated after full mouth SRP. In the test sites 1 mL of 0.8% hyaluronan gel was applied subgingivally after SRP at baseline and 1 week post therapy. Plaque index (PI), gingival index (GI), papillary bleeding index (PBI), periodontal probing depth (PPD), and clinical attachment loss (CAL) were recorded and gingival crevicular fluid (GCF) samples were collected at baseline, after 6 and 12 weeks. Expression of human beta defensin-2 (hBD-2) was analyzed by enzyme-linked immunosorbent assay. Results: At baseline, there were no statistical differences between test and control sites in all clinical parameters and hBD-2 expression. An improvement of PI, GI, PBI, PPD, and CAL was observed at 6 and 12 weeks (p < 0.05) in both groups. Clinically, it was noticed that all indices except CAL had more statistically significant reduction in test sites than control sites at 6 and 12 weeks. The hBD-2 levels were significantly higher in the test sites than in the control sites at 6 and 12 weeks. Conclusion: The local application of 0.8% hyaluronan gel with SRP have a positive effect on periodontal health of moderate to severe chronic periodontitis patients after 6 and 12 weeks. Clinical significance: Subgingival application of 0.8% HA gel following SRP has shown anti-inflammatory effect and has a beneficial effect on clinical parameters in moderate to severe chronic periodontitis patients.


PDF Share
  1. Haffajee AD, Socransky SS. Microbiological and etiologic agents of destructive periodontal diseases. Periodontol 2000 1994 Jun;5:78-111.
  2. Williams RC, Barnett AH, Claffey N, Davis M, Gadsby R, Kellett M, Lip GY, Thackray S. The potential impact of periodontal disease on general health: a consensus view. Curr Med Res Opin 2008 Jun;24(6):1635-1643.
  3. Slots J, Ting M. Systemic antibiotics in the treatment of periodontal disease. Periodontol 2000 2002 Jan;28(1):106-176.
  4. Sukumar S, Drizhal I. Hyaluronic acid and periodontitis. Acta Medica (Hradec Kralove) 2007;50(4):225-228.
  5. Shaddox LM, Walker CB. Treating chronic periodontitis: current status, challenges, and future directions. Clin Cosmet Investig Dent 2010 Aug;2:79-91.
  6. Apatzidou DA, Kinane DF. Nonsurgical mechanical treatment strategies for periodontal disease. Dent Clin 2010 Jan;54(1):1-12.
  7. Armitage GC. Periodontal diagnoses and classification of periodontal diseases. Periodontol 2000 2004 Feb;34(1):9-21.
  8. Highfield J. Diagnosis and classification of periodontal disease. Aust Dent J 2009 Sep;54(Suppl 1):S11-S26.
  9. Deepa R, Parkash S. Accuracy of probing attachment levels using a new computerized cemento enamel junction probe. J Indian Soc Periodontol 2012 Jan;16(1):74-79.
  10. Slots J. The search for effective, safe and affordable periodontal therapy. Periodontol 2000 2002 Jan;28(1):9-11.
  11. van Winkelhoff AJ, Herrera D, Oteo A, Sanz M. Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in The Netherlands and Spain. J Clin Periodontol 2005 Aug;32(8):893-898.
  12. Ranney RR. Diagnosis of periodontal diseases. Adv Dent Res 1991 Dec;5(1):21-36.
  13. Rajan P, Baramappa R, Rao NM, Pavaluri AK, Rahaman SM. Hyaluronic acid as an adjunct to scaling and root planing in chronic periodontitis. A randomized clinical trial. J Clin Diagn Res 2014 Dec;8(12):ZC11-ZC14.
  14. Gontiya G, Galgali SR. Effect of hyaluronan on periodontitis: a clinical and histological study. J Indian Soc Periodontol 2012 Apr;16(2):184-192.
  15. Remien J. Thoughtful use of local delivery antimicrobial agents in periodontitis. Tulsa (OK): Dentistry iQ; 2015.
  16. Newman MG, Kornman KS, Doherty FM. A 6-month multicenter evaluation of adjunctive tetracycline fiber therapy used in conjunction with scaling and root planing in maintenance patients: clinical results. J Periodontol 1994 Jul;65(7):685-691.
  17. Embery G, Waddington RJ, Hall RC, Last KS. Connective tissue elements as diagnostic aids in periodontology. Periodontol 2000 2000 Oct;24:193-214.
  18. Jentsch H, Pomowski R, Kundt G, Gocke R. Treatment of gingivitis with hyalurona. J Clin Periodontol 2003 Feb;30(2):159-164.
  19. Chen WY, Abatangelo G. Functions of hyaluronan in wound repair. Wound Repair Regen 1999 Mar-Apr;7(2):79-89.
  20. Nakamura M, Hikida M, Nakano T, Ito S, Hamano T, Kinoshita S. Characterization of water retentive properties of hyaluronan. Cornea 1993 Sep;12(5):433-436.
  21. West DC, Kumar S. Hyaluronan and angiogenesis. In: Evered D, Whelan J, editors. The biology of hyaluronan: Ciba foundation Symposium, 143. Chichester: John Wiley & Sons; 1989. pp. 187-207.
  22. Sasaki T, Watanabe C. Stimulation of osteoinduction in bone wound healing by high-molecular hyaluronic acid. Bone 1995 Jan;16(1):9-15.
  23. Pirnazar P, Wolinsky L, Nachnani S, Haake S, Pilloni A, Bernard GW. Bacteriostatic effects of hyaluronic acid. J Periodontol 1999 Apr;70(4):370-374.
  24. Gorr SU. Antimicrobial peptides of the oral cavity. Periodontol 2000 2009 Oct;51(1):152-180.
  25. Gorr SU, Abdolhosseini M. Antimicrobial peptides and periodontal disease. J Clin Periodontol 2011 Mar;38(Suppl 11):126-141.
  26. Dale BA, Krisanaprakornkit S. Defensin antimicrobial peptides in the oral cavity. J Oral Pathol Med 2001 Jul;30(6):321-327.
  27. Guncu GN, Yilmaz D, Kononen E, Gursoy UK. Salivary antimicrobial peptides in early detection of periodontitis. Front Cell Infect Microbiol 2015 Dec;5:99.
  28. Polepalle T, Srinivas M, Swamy N, Aluru S, Chakrapani S, Chowdary BA. Local delivery of hyaluronan 0.8% as an adjunct to scaling and root planing in the treatment of chronic periodontitis: a clinical and microbiological study. J Indian Soc Periodontol 2015 Jan-Feb;19(1):37-42.
  29. Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, et al. Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2015;146(7):508-524.
  30. Eick S, Renatus A, Heinicke M, Pfister W, Stratul SI, Jentsch H. Hyaluronic Acid as an adjunct after scaling and root planing: a prospective randomized clinical trial. J Periodontol 2013 Jul;84(7):941-949.
  31. Xu Y, Hofling K, Fimmers R, Frentzen M, Jervoe-Storm PM. Clinical and microbiological effects of topical subgingival application of hyaluronic acid gel adjunctive to scaling and root planing in the treatment of chronic periodontitis. J Periodontol 2004 Aug;75(8):1114-1118.
  32. Vianna ME, Conrads G, Gomes BP, Horz HP. T-RFLP-based mcrA gene analysis of methanogenic archaea in association with oral infections and evidence of a novel Methanobrevibacter phylotype. Oral Microbiol Immunol 2009 Oct;24(5):417-422.
  33. Diamond DL, Kimball JR, Krisanaprakornkit S, Ganz T, Dale BA. Detection of ƒÀ-defensins secreted by human oral epithelial cells. J Immunol Methods 2001 Oct;256(1-2):65-76.
  34. Darveau RP, Tanner A, Page RC. The microbial challenge in periodontitis. Periodontol 2000 1997 Jun;14(1):12-32.
  35. Lu Q, Jin L, Darveau RP, Samaranayake LP. Expression of human ƒÀ-defensins-1 and-2 peptides in unresolved chronic periodontitis. J Periodontal Res 2004 Aug;39(4):221-227.
  36. Jaradat SW, Hoder-Przyrembel C, Cubillos S, Krieg N, Lehmann K, Piehler S, Sigusch BW, Norgauer J. Betadefensin- 2 genomic copy number variation and chronic periodontitis. J Dent Res 2013 Nov;92(11):1035-1040.
  37. Wang P, Duan D, Zhou X, Li X, Yang J, Deng M, Xu Y. Relationship between expression of human gingival betadefensins and levels of periodontopathogens in subgingival plaque. J Periodontal Res 2015 Feb;50(1):113-122.
  38. Pereira AL, Franco GC, Cortelli SC, Aquino DR, Costa FO, Raslan SA, Cortelli JR. Influence of periodontal status and periodontopathogens on levels of oral human â-defensin-2 in saliva. J Periodontol 2013 Oct;84(10):1445-1453.
  39. Liu J, Chen J, Du X, Hu L, Chen L. The expression of hBDs in the gingival tissue and keratinocytes from healthy subjects and periodontitis patients. Arch Oral Biol 2014 Feb;59(2): 193-198.
  40. Yong X, Chen Y, Tao R, Zeng Q, Liu Z, Jiang L, Ye L, Lin X. Periodontopathogens and human â-defensin-2 expression in gingival crevicular fluid from patients with periodontal disease in Guangxi, China. J Periodontal Res 2015 Jun;50(3): 403-410.
  41. Wolgin M, Liodakis S, Pries AR, Zakrzewicz A, Kielbassa AM. HBD-1 and hBD-2 expression in HaCaT keratinocytes stimulated with nicotine. Arch Oral Biol 2012 Jun;57(6):814-819.
  42. Casale M, Moffa A, Vella P, Sabatino L, Capuano F, Salvinelli B, Lopez MA, Carinci F, Salvinelli F. Hyaluronic acid: perspectives in dentistry. A systematic review. Int J Immunopathol Pharmacol 2016 Dec;29(4):572-582.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.