Hyaluronic Acid Improves Bone Formation in Extraction Sockets With Chronic Pathology: A Pilot Study in Dogs

Kim, Jung‐Ju; Song, He Sun; Amara, Heithem Ben; Kang, Kyung‐Sun; Koo, Ki‐Tae

doi:10.1902/jop.2016.150707

Cited by 44 publications

(47 citation statements)

References 26 publications

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“…In addition, it was reported that HA stimulated the expression of BMP‐2 and osteopontin (OPN) to regulate the healing process of tooth sockets . These effects may result in bone overgrowth with the socket healing potential immediately after extraction, and HA was intensively transferred with ACS than the gel type used in our previous study …”

Section: Discussionmentioning

confidence: 87%

“…The experimental model used in the present study (extraction socket model with induced chronic pathology) was presented in our previous studies and is suggested to be effective to reproduce clinical situations that can retard the bone healing process and induce severe bone destruction after tooth extraction . Even though our previous research showed an enhanced bone formation by HA application, the extent was not compared with comparable growth factors such as rhBMP‐2 and this was also true for other studies evaluating the effects of HA .…”

Section: Discussionmentioning

confidence: 99%

“…Six beagle dogs (weight 10 to 12 kg, aged 12 to 15 months) were used in this research. The sample size was calculated using the data of our previous pilot study . An effect size of 1.8567 was obtained from the mean proportions of mineralized bone in the control and test groups (47.80 ± 6.60 and 63.29 ± 9, respectively).…”

Section: Methodsmentioning

confidence: 99%

“…After 3 months (socket healing period) from forming infected sockets, the six beagle dogs were euthanized, and mandibles were separated and sawed for microcomputed tomography and histologic and immunohistochemical examination. For more detailed explanation about surgical procedures and post‐surgery protocol, see our previous studies …”

Section: Methodsmentioning

confidence: 99%

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Biomodification of compromised extraction sockets using hyaluronic acid and rhBMP‐2: An experimental study in dogs

Kim

Amara

Park

et al. 2018

Journal of Periodontology

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Background This experimental study aims to evaluate the effect of hyaluronic acid on healing of infected extraction sockets compared with recombinant human bone morphogenetic protein‐2 (rhBMP‐2). Methods Both third and fourth mandibular premolars of six beagle dogs were hemisected, and the distal roots were extracted at baseline. Subsequently, combined endodontic‐periodontic lesions were induced at the remaining mesial roots. After 4 months, the mesial roots on both sides of the mandible were removed. Four sockets per dog were randomly allocated to four groups: Group 1, Control; Group 2, only absorbable collagen sponge (ACS: carrier); Group 3, 1% hyaluronic acid (HA) gel + ACS; and Group 4, rhBMP‐2 + ACS. After 3 months of healing, the dogs were euthanized for microcomputed tomography and histologic analysis. Results After the lesion induction period (4 months), communication between the periodontal lesion and endodontic periapical lesion was observed at all remaining mesial roots. Alveolar bone overgrowth was observed in groups 3 and 4, but bone volume density was not significantly different among all groups. At the crestal portion, mineralization, and osteocalcin expression were higher in groups 3 and 4 than in groups 1 and 2. Conclusion Treatment with HA can promote bone formation and improve the wound healing rate comparable to rhBMP‐2 in infected extraction sockets.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Biomodification of compromised extraction sockets using hyaluronic acid and rhBMP‐2: An experimental study in dogs

Kim

Amara

Park

et al. 2018

Journal of Periodontology

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“…This junction was identified using the method developed by Araújo and Lindhe [12], who reported that newly formed bone could be differentiated from old bone by the detection of primary and secondary osteons and parallel-fibered bone. The following parameters were evaluated for the mesial and distal extraction socket walls for each section using established routines and measured as a percentage: fibrin clots, inflamed granulation tissue, fibrous connective tissue [1314], bone trabeculae, and bone marrow [2315]. Summary statistics (mean±standard deviation) based on recordings from the mesial and distal extraction socket walls of the 4th premolar roots were used to compare diseased and fresh extraction socket sites.…”

Section: Methodsmentioning

confidence: 99%

Periodontal and endodontic pathology delays extraction socket healing in a canine model

Capetillo

Yoo

Amara

et al. 2017

J Periodontal Implant Sci

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PurposeThe aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology.MethodsThe mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls. The mandibular 4th premolar teeth were then extracted with minimal trauma, followed by careful wound debridement. The animals were sacrificed at days 1, 7, 30, 60, and 90 post-extraction for analysis, and the healing patterns at the healthy and diseased extraction sites were compared using radiography, scanning electron microscopy, histology, and histometry.ResultsDuring the first 7 days of healing, a significant presence of inflammatory granulation tissue was noted at the diseased sites (day 1), along with a slightly accelerated rate of fibrin clot resolution on day 7. On day 30, the diseased extraction sites showed a greater percentage of persistent fibrous connective tissue, and an absence of bone marrow formation. In contrast, healthy sites showed initial signs of bone marrow formation on day 30, and subsequently a significantly greater proportion of mature bone marrow formation on both days 60 and 90. Radiographs exhibited sclerotic changes adjoining apical endodontic lesions, with scanning electron microscopy showing collapsed Volkmann canals protruding from these regions in the diseased sites. Furthermore, periodontal ligament fibers exhibited a parallel orientation to the alveolar walls of the diseased sites, in contrast to a perpendicular arrangement in the healthy sites.ConclusionsWithin the limitations of this study, it appears that a history of periodontal and endodontic pathology may critically affect bone formation and maturation, leading to delayed and compromised extraction socket healing.

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Association of hyaluronic acid with a deproteinized bovine graft improves bone repair and increases bone formation in critical‐size bone defects

Matheus

Ervolino

Gusman

et al. 2020

Journal of Periodontology

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Background: This study is designed to evaluate the potential of different formulations of hyaluronic acid (HA) to improve new bone formation in critical-size calvaria defect (CSD) when combined with a deproteinized bovine graft (DBG) material. Methods: Thirty male rats were used. A 5-mm-diameter CSD was created and three experimental groups (n = 10) were randomly assigned based on the treatments performed. Group DBG: CSD filled with a DBG; group DBG/LV: CSD filled by the combination of DBG and HA in a low-viscosity crosslinking agent; group DBG/HV: CSD filled by the combination of DBG and HA in a high-viscosity crosslinking agent. Animals were euthanized 30 days postoperatively. Histological, histometric (percentage of newly formed bone [PNFB], percentage of remaining graft particles, histochemical, and immunohistochemical (bone morphogenetic protein 2/4 [BMP2/4], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analyses were performed. Results: The highest PNFB was observed in DBG/HV when compared with the other groups (P ≤0.05). DBG/LV and DBG/HV presented almost no inflammatory cells. In contrast, inflammation was observed in group DBG. Extensive resorption of graft particles was observed in group DBG, which was not present in DBG/LV and DBG/HV as confirmed by the larger size of the particles (P ≤0.05). BMP2/4 and OCN immunolabeling were higher in DBG/HV when compared with group DBG (P ≤0.05). Increased number of TRAP-positive cells was observed in DBG/LV and DBG/HV (P ≤0.05). Lower percentage of mature collagen fibers was observed in DBG/HV (P ≤0.05). Conclusion:The combination of HA in a high-viscosity crosslinking agent with DBG improves the bone repair process and increases the amount of newly formed bone towards CSDs in rat calvaria.

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Hyaluronic Acid Improves Bone Formation in Extraction Sockets With Chronic Pathology: A Pilot Study in Dogs

Abstract: An infected socket shows delayed healing of the socket wound, and HA, because of its osteoinductive, bacteriostatic, and anti-inflammatory properties, may improve bone formation and accelerate wound healing in infected sockets.

Cited by 44 publications

References 26 publications

Biomodification of compromised extraction sockets using hyaluronic acid and rhBMP‐2: An experimental study in dogs

Biomodification of compromised extraction sockets using hyaluronic acid and rhBMP‐2: An experimental study in dogs

Periodontal and endodontic pathology delays extraction socket healing in a canine model

Association of hyaluronic acid with a deproteinized bovine graft improves bone repair and increases bone formation in critical‐size bone defects

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