Abstract
Background
Recent studies reported that hyaluronic acid (HA) has anti-inflammatory, anti-edematous, and anti-bacterial activities in dentistry, particularly in gingival disorders caused by subgingival plaque microorganisms.
Aims
This study aimed to evaluate the early term effects of HA as an adjunct to scaling and root planing (SRP) on clinical parameters, periodontal inflamed surface area (PISA), and adenosine deaminase (ADA), catalase (CAT), and glutathione (GSH) levels in gingival crevicular fluid (GCF) in periodontitis.
Methods
A total of 24 periodontitis patients per group were included in this randomized-controlled study. The study population was divided into four groups: in Group 1: SRP+ saline; in Group 2: SRP + HA gel; in Group 3: SRP+ HA mouth rinse; and in Group 4: SRP + HA mouth rinse + HA gingival gel were applied. At baseline and week 4, clinical parameters and PISA were calculated. Also, biochemicals’ (ADA, CAT, and GSH) levels were determined by spectrophotometric analysis.
Results
There was a statistically significant improvement in clinical parameters and PISA in all four groups in control sessions (p < 0.05). There was a significant decrease in ADA in GCF and significant increases in CAT and GSH levels after SRP (p < 0.05) in all four groups. The groups that were administered only gel (2nd and 4th) were different from other groups in terms of ADA, CAT, and GSH levels at 1st week (p < 0.05).
Conclusion
HA application as an adjunct to SRP did not affect the clinical results, although, in the control sessions following the application, the results were favorable for the biochemical data in gel-applied groups.
Trial registration
ClinicalTrials.gov.tr (NCT03754010)
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References
Tonetti MS, Greenwell H, Kornman KS (2018) Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol 89:159–172
Nesse W, Abbas F, Van Der Ploeg I et al (2008) Periodontal inflamed surface area: quantifying inflammatory burden. J Clin Periodontol 35(8):668–673
Cugini MA, Haffajee AD, Smith C et al (2000) The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol 27(1):30–36
Jiang D, Liang J, Noble PW (2011) Hyaluronan as an immune regulator in human diseases. Physiol Rev 91(1):221–264
Shimabukuro Y, Ichikawa T, Takayama S et al (2005) Fibroblast growth factor-2 regulates the synthesis of hyaluronan by human periodontal ligament cells. J Cell Physiol 203(3):557–563
Hakansson L, Hallgren R, Venge P (1980) Regulation of granulocyte function by hyaluronic acid: in vitro and in vivo effects on phagocytosis, locomotion, and metabolism. J Clin Invest 66(2):298–305
Surdacka A, Stopa J (2005) The effect of xylitol tooth paste on the oral cavity environment. J Prev Med 13(1–2):98–107
Dahiya P, Kamal R, Gupta R et al (2013) Reactive oxygen species in periodontitis. J Indian Soc Periodontol 17(4):411–416
Matés JM, Sánchez-Jiménez F (1999) Antioxidant enzymes and their implications in pathophysiologic processes. Front Biosci 4:339–345
Day BJ (2009) Catalase and glutathione peroxidase mimics. Biochem Pharmacol 77(3):285–296
Xia Y, Khatchikian G, Zweier JL (1996) Adenosine deaminase inhibition prevents free radical-mediated injury in the postischemic heart. J Biol Chem 271(17):10096–10102
Liao YJ, Wu CY, Lee SW et al (2012) Adenosine deaminase activity in tuberculous peritonitis among patients with underlying liver cirrhosis. World J Gastroenterol 18(37):5260–5265
Dikensoy O, Namiduru M, Hocaoglu S et al (2002) Increased pleural fluid adenosine deaminase in brucellosis is difficult to differentiate from tuberculosis. Respiration 69(6):556–559
Giusti G (1974) Adenosine deaminase. In: Bergmeyer HI (ed) Methods of enzymatic analyses. Academic Press, New York, pp 1092–1098
Aebi H, Bergmayer H (1974) Catalase. In: Bergmayer HU (ed) Methods of enzymatic analysis. Academic Press, pp 673–684
Sun Y, Oberley LW, Li Y (1988) A simple method for clinical assay of superoxide dismutase. Clin Chem 34(3):497–500
Eick S, Renatus A, Heinicke M et al (2013) Hyaluronic acid as an adjunct after scaling and root planing: a prospective randomized clinical trial. J Periodontol 84(7):941–949
Johannsen A, Tellefsen M, Wikesjö U, Johannsen G (2009) Local delivery of hyaluronan as an adjunct to scaling and root planing in the treatment of chronic periodontitis. J Periodontol 80(9):1493–1497
Rajan P, Baramappa R, Rao NM et al (2014) Hyaluronic acid as an adjunct to scaling and root planing in chronic periodontitis. A randomized clinical trail. J Clin Diagn Res 8(12):ZC11–ZC14
Pilloni A, Annibali S, Dominici F et al (2011) Evaluation of the efficacy of an hyaluronic acid-based biogel on periodontal clinical parameters. A randomized-controlled clinical pilot study. Ann Stomatol (Roma) 2:3–9
Mesa FL, Aneiros J, Cabrera A et al (2002) Antiproliferative effect of topic hyaluronic acid gel. Study in gingival biopsies of patients with periodontal disease. Histol Histopathol 17:747–753
Bevilacqua L, Eriani J, Serroni I et al (2012) Effectiveness of adjunctive subgingival administration of amino acids and sodium hyaluronate gel on clinical and immunological parameters in the treatment of chronic periodontitis. Ann Stomatol (Roma) 3(2):75–81
Engström P-E, Shi X-Q, Tronje G et al (2001) The effect of hyaluronan on bone and soft tissue and immune response in wound healing. J Periodontol 72(9):1192–1200
Leira Y, Martín-Lancharro P, Blanco J (2018) Periodontal inflamed surface area and periodontal case definition classification. Acta Odontol Scand 76(3):195–198
Slot DE, Timmerman MF, Versteeg PA et al (2012) Adjunctive clinical effect of a water-cooled Nd:YAG laser in a periodontal maintenance care programme: a randomized controlled trial. J Clin Periodontol 39(12):1159–1165
Rosenberg DR, Andrade CX, Chaparro AP et al (2015) Short-term effects of 2% atorvastatin dentifrice as an adjunct to periodontal therapy: a randomized double- masked clinical trial. J Periodontol 86(5):623–630
Bertl K, Bruckmann C, Isberg P-E et al (2015) Hyaluronan in non-surgical and surgical periodontal therapy: a systematic review. J Clin Periodontol 42:236–246
Jentsch H, Pomowski R, Kundt G, Göcke R (2003) Treatment of gingivitis with hyaluronan. J Clin Periodontol 30:159–164
Pagnacco A, Vangelisti R, Erra CPA (1997) Double-blind clinical trial vs. placebo of a new sodium-hyaluro-nate-based gingival gel. Attual Ter Internazionale 15:1–7
Pistorius A, Martin M, Willershausen B, Rockmann P (2005) The clinical application of hyaluronic acid in gingivitis therapy. Quintessence Int 36:531–538
Weigel PH, Fuller GM, LeBoeuf RD (1986) A model for the role of hyaluronic acid and fibrin in the early events during the inflammatory response and wound healing. J Theor Biol 119(2):219–234
Trivedi S, Lal N (2017) Antioxidant enzymes in periodontitis. J Oral Biol Craniofacial Res 7(1):54–57
Dede F, Dogan S, Balli U, Avcı B (2017) Relationship between gingival inflammation and total glutathione. J Turgut Ozal Med Cent 24(2):162–166
Palwankar P, Rana M, Arora K, Deepthy C (2015) Evaluation of non-surgical therapy on glutathione levels in chronic periodontitis. Eur J Dent 9(3):415–422
Dahiya P, Kamal R, Gupta R, Saini H (2016) Evaluation of the serum antioxidant status in patients with chronic periodontitis. Indian J Multidiscip Dent 6(1):3–6
Hasko G, Kuhel DG, Nemeth ZH et al (2000) Inosine inhibits inflammatory cytokine production by a posttranscriptional mechanism and protects against endotoxin- induced shock. J Immunol 164:1013–1019
Sahin Aydinyurt H, Taskin C, Eskin K (2019) Comparison of adenosine deaminase and catalase activity of periodontally different diagnosed teeth in smokers. Van Sag Bil Derg 12(2):1–7
Sarhat ER, Hamad AI, Mohammaed IJ, Sarhat TR (2018) The effect of diabetic patients with chronic periodontitis on serum paraoxonase, adenosine deaminase. Mustansiria Dent J 15:130–134
Antonioli L, Colucci R, La Motta C et al (2012) Adenosine deaminase in the modulation of immune system and its potential as a novel target for treatment of inflammatory disorders. Curr Drug Targets 13(6):842–862
Chauhan AS, Bains VK, Gupta V et al (2013) Comparative analysis of hyaluronan gel and xanthan-based chlorhexidine gel, as adjunct to scaling and root planing with scaling and root planning alone in the treatment of chronic periodontitis:a preliminary study. Contemp Clin Dent 4:54–61
Chaves ES, Wood RC, Jones AA et al (1993) Relationship of “bleeding on probing” and “gingival index bleeding” as clinical parameters of gingival inflammation. J Clin Periodontol 20(2):139–143
Gharbi A, Hamila A, Bouguezzi A et al (2019) Biochemical parameters and oxidative stress markers in Tunisian patients with periodontal disease. BMC Oral Health 19:225
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Van Yuzuncu Yil University, Ethics Committee (Date/No. 19.07.2017/09).
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Aydinyurt, H.S., Akbal, D., Altindal, D. et al. Evaluation of biochemical and clinical effects of hyaluronic acid on non-surgical periodontal treatment: a randomized controlled trial. Ir J Med Sci 189, 1485–1494 (2020). https://doi.org/10.1007/s11845-020-02230-6
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DOI: https://doi.org/10.1007/s11845-020-02230-6