Evaluation of Osteogenic Potential of Fucoidan Containing Chitosan Hydrogel in the Treatment of Periodontal Intra-Bony Defects—A Randomized Clinical Trial

Abstract

Periodontal diseases significantly impact about half of the global population, and their treatment often encompasses relieving symptoms as well as regenerating the destroyed tissues. Revolutionary research in the management of periodontal disease includes biomaterials, a boon to re-generative dentistry owing to their excellent biological properties: non-toxicity, anti-inflammatory, biocompatibility, biodegradability, and adhesion. This study aimed to fabricate an injectable fucoidan containing chitosan hydrogel and prove its effectiveness in periodontal bone regeneration. The injectable hydrogel was prepared using the sol-gel method and was subjected to various physical, chemical, and biological characterizations to understand its efficacy in formation of new bone. The effectiveness of the developed hydrogel was assessed in periodontal bony defects to study the soft and hard tissue changes. A total of 40 periodontitis patients with bony defects were recruited and randomized into two groups to receive fucoidan-chitosan hydrogel and concentrated growth factor, respectively. Customized acrylic stents were used to guide the hydrogel placement into the defect site. Post-surgical changes in clinical parameters were assessed at 3, 6, and 9 months to appreciate the soft and hard tissue changes using repeated measures analysis of variance and Bonferroni’s post hoc test. Significance was kept at 5%. The porosity, water uptake of the prepared hydrogel showed good efficacy, with particle size of the fucoidan containing chitosan hydrogel of 6.000 nm. The MG-63 osteoblasts cell line revealed biocompatibility, biodegradability and showed slow and sustained drug release, increased cell proliferation, and enhanced alkaline phosphatase secretion. Mineralization assay was greatest in the fucoidan containing chitosan hydrogel. Clinically, it exhibited significantly lower probing depth values and a higher mean improvement in clinical attachment level as compared to the concentrated growth factor (CGF) group at the end of 3 and 6 months (p < 0.05). The mean of the defect fills in the fucoidan containing chitosan group was 1.20 at the end of 9 months (p < 0.001) as compared with defect fills observed in the CGF group. The presence of fucoidan in the hydrogel significantly contributed to bone regeneration in humans, thus strengthening its potential in tissue engineering. Fucoidan-chitosan will be a promising biomaterial for bone tissue regeneration.

Therapeutic potential of fucoidan in dentistry: A review

“…At three-and six-month evaluations, this study found that the therapy significantly reduced probing depth values and increased clinical attachment levels than the group treated with concentrated growth factor (CGF). After nine months, defect filling in the hydrogel group was also more elevated than in CGF cluster (47).…”

Emerging roles of hydrogel in promoting periodontal tissue regeneration and repairing bone defect

“…EPO-FK506-CS/β-GP/GA hydrogel could promote periodontal tissue regeneration. Eshwar et al (2023) investigated an alginate-chitosan hydrogel, and clinical randomized trials indicated that the hydrogel enhanced the clinical attachment levels and fostered human bone regeneration, thus augmenting its potential in the field of tissue engineering.…”

Evolving Strategies and Materials for Scaffold Development in Regenerative Dentistry

“…Researchers are exploring the use of advanced materials, such as composites, hydrogels [22][23][24][25], and bioactive materials [26], to further enhance the performance of scaffolds. These materials may incorporate growth factors, signaling molecules, or other bioactive agents to promote cell adhesion, proliferation, and differentiation [27][28][29].…”