Versatile strategies for bioproduction of hyaluronic acid driven by synthetic biology.

Abstract Objectives To assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication management compared to any other treatment or no treatment. Materials and methods Three databases were searched until April 2022. The most relevant eligibility criteria were (1) local application of HyA as adjunct to tooth extraction or as treatment of alveolar osteitis, and (2) reporting of clinical, radiographic, histological, or patient-reported data. New bone formation and/or quality were considered main outcome parameters in preclinical studies, while pain, swelling, and trismus were defined as main outcome parameters in clinical studies. Results Five preclinical and 22 clinical studies (1062 patients at final evaluation) were included. In preclinical trials, HyA was applied into the extraction socket. Although a positive effect of HyA was seen in all individual studies on bone formation, this effect was not confirmed by meta-analysis. In clinical studies, HyA was applied into the extraction socket or used as spray or mouthwash. HyA application after non-surgical extraction of normally erupted teeth may have a positive effect on soft tissue healing. Based on meta-analyses, HyA application after surgical removal of lower third molars (LM3) resulted in significant reduction in pain perception 7 days postoperatively compared to either no additional wound manipulation or the application of a placebo/carrier. Early post-operative pain, trismus, and extent of swelling were unaffected. Conclusions HyA application may have a positive effect in pain reduction after LM3 removal, but not after extraction of normally erupted teeth. Clinical relevance HyA application may have a positive effect in pain reduction after surgical LM3 removal, but it does not seem to have any impact on other complications or after extraction of normally erupted teeth. Furthermore, it seems not to reduce post-extraction alveolar ridge modeling, even though preclinical studies show enhanced bone formation. 

Hyaluronic acid in tooth extraction: a systematic review and meta-analysis of preclinical and clinical trials.

Photobiomodulation for Managing “Dry Socket”: A Randomised Controlled Trial

To evaluate the practical value of delayed enhancement 320 row volume multidetector computed tomography (DE-320 row volume MDCT) for reperfused acute and old myocardial infarction (MI) in a porcine model, 14 pigs underwent balloon-induced occlusion of the middle segment of the left circumflex coronary artery (LCX) for 90 min. The balloons were removed and reperfusion was performed. DE-320 row volume MDCT was performed 15 min after the injection of iodinated contrast. Delayed-enhancement magnetic resonance imaging (DE-MRI) was completed 15 min after injection of gadolinium-DTPA. The pigs were then divided into acute vs old MI groups. Six pigs in the acute MI group were sacrificed immediately and their hearts were harvested for triphenyltetrazolium chloride (TTC) pathology. The pigs in the old MI group were reared for another 6 months before undergoing repeat DE-320 row volume MDCT and DE-MRI prior to being sacrificed. On DE-320 row volume MDCT, the size of the acute and old myocardial infarction was 23.95±9.8% and 16.93%±7.04%, respectively, which had a high consistency and correlation with DE-MRI and TTC pathology. The CT values of the delayed enhanced area were different between acute MI and old MI and were 132.5±30.5 HU and 91.2±18.3 HU, respectively (P <0.001). The CT values of the delayed enhanced areas were different from that of viable myocardium (acute, P <0.001, old, P <0.001). The diagnosis of the infarcted segments by DE-320 row volume MDCT had good consistency with the results of TTC pathology (acute, kappa = 0.76; old, kappa = 0.64). DE-320 row volume MDCT can be an effective method for assessing MI.

Delayed-enhancement 320 row volume multidetector computed tomography for the assessment of reperfused acute and old myocardial infarction in a porcine model

Introduction Several articles have investigated the intra-alveolar applications of bioadhesive gels containing various medicines and active chemicals, such as chlorhexidine (CHX) and hyaluronic acid (HA) to minimize the numerous postoperative sequelae, such as a dry socket. The purpose of this study was to investigate the postoperative outcomes of intra-alveolar application of 0.2% chlorhexidine or hyaluronic acid following atraumatic extraction. Methods A randomized clinical trial was conducted on a sample of 36 patients who need extraction of lower first premolar for orthodontic treatment. The patients were assigned randomly into two groups: CHX group and HA group. The signs and symptoms of the dry socket were evaluated on the third day in two groups. Results There was no statistically significant difference between the study and control groups when comparing the CHX group (P=0.2.6). In contrast, a significant difference was seen between the study and control sides in the HA group. Conclusions Within the limitation of this clinical trial, using hyaluronic gel with a gelatin sponge may be a preventive strategy for a dry socket following tooth extraction. After non-surgical tooth extraction, the topical administration of CHX with a gelatin sponge as a carrier did not seem to act as a protective substance against a dry socket.

/pdf/comparative-clinical-study-between-chlorhexidine-gel-0-2-and-3ireqdrq.pdf

Comparative Clinical Study Between Chlorhexidine Gel (0.2%) and Hyaluronic Gel (1%) in the Prevention of a Dry Socket After Tooth Extraction for Orthodontic Treatment

The aim of this study was to analyze the postoperative effects of intra-alveolar applications of 0.2% chlorhexidine (CHL) or 1% hyaluronic (HA) acid bioadhesive gels following the extraction of mandibular impacted third molars (MITMs). In this double-blind randomized controlled clinical trial, 90 patients with one asymptomatic MITM were randomized into three group (n = 30 per group): group 1 (0.2% CHL), group 2 (1% HA), and group 3 (control). Visual analogue scales (VAS) were used to assess postoperative pain 24, 48, and 72 h and 7 days after surgery. Postsurgical complications were recorded: trismus, alveolitis osteitis, infection, or hematoma. In order from least to greatest, postoperative pain at all evaluation times was 0.2% CHL  0.050). Both 0.2% CHL and 1% HA bioadhesive gels applied intra-alveolarly minimize the postoperative complications after MITM extraction. Further research is necessary to confirm the present results. This study might help to reduce the postsurgical complications in patients after MITM extraction.

Postoperative effects of intra-alveolar application of 0.2% chlorhexidine or 1% hyaluronic acid bioadhesive gels after mandibular third molar extraction: a double-blind randomized controlled clinical trial.

Background Few studies have reported the outcomes of immediate placement at infected post-extraction sites. The aim of this study was to compare clinical and radiological outcomes of immediately placed implants with immediate prosthetic provisionalization in sockets with or without acute periapical pathology. Material and methods A total of 100 patients with immediately placed implants with immediate provisionalization and 1- year of follow up were included (50 patients with acute periapical pathology and a control group of 50 patients without acute periapical pathology). Clinical parameters (bleeding on probing, buccal keratinized mucosa width, clinical recession, and probing depth) and radiological parameters (distance from implant shoulder to first point of bone-to-implant contact [IS-BIC]) were assessed. Results Clinical parameters showed no significant differences between the study and control groups after 1-year follow up (p>0.05). IS-BIC presented the following values: 0.35 ± 0.51 mm (study group) and 0.15 ± 0.87 mm (control), without significant differences between the groups (p=0.160). None of the 50 radiographs of immediate implants placed in sockets with periapical pathology revealed retrograde peri-implantitis. Conclusions Immediate placement of implants with immediate prosthetic provisionalization at sites with acute periapical pathology can be a successful treatment modality for at least 1-year.

/pdf/immediate-post-extraction-implants-placed-in-acute-35rw65ff8s.pdf

Immediate post-extraction implants placed in acute periapical infected sites with immediate prosthetic provisionalization: a 1-year prospective cohort study.

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Postoperative effects of intra-alveolar application of 0.2% chlorhexidine or 1% hyaluronic acid bioadhesive gels after mandibular third molar extraction: a double-blind randomized controlled clinical trial.

Immediate post-extraction implants placed in acute periapical infected sites with immediate prosthetic provisionalization: a 1-year prospective cohort study.