The Influence of Hyaluronic Acid Adjunctive Therapy of Periodontitis on Salivary Markers of Oxidative Stress: Randomized, Controlled Clinical Trial.

Iwona Olszewska-Czyz,Marin Tota,Jelena Prpic,Kristina Kralik

doi:10.3390/antiox11010135

Abstract

Periodontitis is a common oral disease affecting the tooth-supporting tissues. Bacteria have been long viewed as the main causative factor in its development; however, many investigations have proved that aberrant immune and inflammatory response and the resulting misbalance between the damage caused by reactive oxygen species and the antioxidant capacity of tissues may be an underlying factor in disease progression that reduces healing potential. The objective of the current trial is to assess the outcomes of the addition of hyaluronic acid (HA) to standard non-surgical periodontal therapy (NST) on some major oxidative stress markers in saliva. HA-based gel designed for dental application was used and the measurements were taken after 3 months. HA adjunctive therapy had a significantly greater increase in markers with antioxidant properties as well as total antioxidant capacity compared to standard NST alone. Furthermore, clinically measured levels of gingival inflammation (bleeding on probing-BOP) and periodontal destruction (clinical attachment loss-CAL) were significantly correlated with these markers, and the correlation was negative. This investigation demonstrates that HA may indeed express antioxidant properties and improve the antioxidant capacity of periodontal tissues, thus improving the prognosis for the teeth and the results of periodontal therapy. Further investigations will be necessary to determine the duration of these effects over time.

Highlights

Mohamed Mekhemar and Department of Periodontology, Prophylaxis and Oral Pathology, Dental Institute, Medical Faculty, Jagiellonian University, 31155 Krakow, Poland
Unlike the observational studies, which are quite numerous, interventional studies are significantly fewer and cover many different interventions that were not always limited or even related to periodontal therapy [31]. In this interventional study performed on 100 patients, we show that both non-surgical periodontal therapy and non-surgical periodontal therapy coupled with the addition of hyaluronic acid gel significantly increase the levels of markers with antioxidant properties and total antioxidant capacity (TAC) in the saliva of the patients after three months of the follow-up period
We demonstrated that the levels of oxidative stress markers were significantly more reduced and levels of total antioxidant capacity were more increased upon the addition of hyaluronic acid as a part of the non-surgical treatment; this biological macromolecule may be viewed as a potentially important tool/material to improve the chances of periodontal tissue recovery and increase the success of non-surgical periodontal therapy

Summary

Introduction

Bacterial dysbiosis is considered the main causative factor that, in genetically susceptible individuals, triggers a strong inflammatory and immune response. This is further aggravated by diseases such as diabetes or obesity, habits such as smoking, and—common in the modern-day world—. The above-mentioned inflammatory and immune host responses play a crucial role in disease progression, especially in cases that do not respond well to therapy. In this context, many authors have suggested the role of reactive oxygen species and subsequent published maps and institutional affiliations. It is stipulated that these play a significant role in the pathogenesis of periodontitis and other chronic inflammatory diseases such as diabetes, atherosclerosis, rheumatoid arthritis, cancer, and inflammatory lung disease [4,5,6,7]

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