Hyaluronic Acid or HA is a natural polysaccharide or glycosaminoglycan, it is also one of the most common tissue matrix polysaccharides which is found in many parts of the body – Skin, connective tissue, synovial joints and other tissues. Hyaluronic Acid is known for its tissue healing and regeneration properties mainly along with other roles like Anti Inflammatory, anti-bacterial agents specifically for the Periodontal tissue.
Hyaluronic Acid is synthesized by hyaluronan synthase enzymes in the Periodontal Tissues, gingiva, periodontal ligament and in Alveolar Bone. Then it goes through degradation to a lower molecular weigh molecules in chronically inflamed tissues like inflammation of gingival tissue, other surgical procedures like Impaction surgery, implant surgery, etc.
Due to its properties, it is also being used in conditions such as Socket healing post extraction, reduction in pain after Surgical procedures and Clot Stabilization as well. Due to its many beneficial properties, it has been used in many medical departments as well like Rheumatology, Dermatology, Orthopedics, Opthalmology (Cosmetic), Urology, General Surgery (Wound Healing), Cancer studies (Carrier of DNA molecules), etc. Let us look at the various benefits and uses in Dentistry.
Hyaluronic acid is active in tissue regeneration and influences the migration of fibroblast and fibrogenesis which helps in healing the tissue faster playing a key role in healing such as Soft Periodontal tissues, gingiva, alveolar bone and cementum. It plays a regulatory role in inflammatory response
How does Hyaluronic Acid Work on Inflammation:
The Hyaluronic acid which has degraded into lower molecular weight structure signals tissue damage and mobilizes the immune cells to the site of inflammation, on the other hand the higher molecular weight HA prevents excess exacerbation of inflammation by suppressing the immune response.
During initial stages of Periodontitis Low molecular weight HA has been found to be present mostly due to the action of bacterial enzymes or hyaluronidases. HA is known to be the most hygroscopic molecule known in nature. HA retains water and maintain stiffness when it in incorporated into aqueous solution where hydrogen bonding occurs between adjacent carboxyl and N-acetyl groups.
There has not been any interactions with drugs or contraindications to any drugs with HA.
Use of Hyaluronic Acid in Dental Conditions:
Hyaluronic Acid in Dental Surgeries
Various Dental Surgical procedures like Implant Surgery, Sinus Lift, Wisdom tooth disimpaction surgeries, etc.
The Use of HA Gel or Chlorexidine Gels in IMPLANT Surgery has been found to improve the peri implant
Bevilacqua et al. proved that the subgingival application of 0.5 mL of amino acids and HA gel following ultrasonic mechanical instrumentation is beneficial for improving periodontal parameters in patients with moderate to severe chronic periodontitis in comparison to patients treated with only ultrasonic debridement.
When used in Periodontal Surgery – It helps in attracting blood, Stabilizes coagulum and supports tissue regeneration, it shows reduction in inflammation and is known to accelerate Angiogenesis.
Topical application of HA in the form of Spray following Impacted 3rd Molar Surgery has given beneficial effect by reducing swelling and trismus considerably.
Romeo et al. has used amino acids and 1.33% HA gel applied 3 times per day for 1 week showed faster secondary healing in cases where incisions were done.
References –
Hyaluronic Acid significantly enhances healing and reduces inflammation in dental procedures. A valuable tool!