Application Of Hyaluronic Acid Gel Research Articles

A prospective study on application of human umbilical cord mesenchymal stem cells combined with autologous Meek microskin transplantation in patients with extensive burns

Objective: To investigate the effects of human umbilical cord mesenchymal stem cells (hUCMSCs) combined with autologous Meek microskin transplantation on patients with extensive burns. Methods: The prospective self-controlled study was conducted. From May 2019 to June 2022, 16 patients with extensive burns admitted to the 990th Hospital of PLA Joint Logistics Support Force met the inclusion criteria, while 3 patients were excluded according to the exclusion criteria, and 13 patients were finally selected, including 10 males and 3 females, aged 24-61 (42±13) years. A total of 20 trial areas (40 wounds, with area of 10 cm×10 cm in each wound) were selected. Two adjacent wounds in each trial area were divided into hUCMSC+gel group applied with hyaluronic acid gel containing hUCMSCs and gel only group applied with hyaluronic acid gel only according to the random number table, with 20 wounds in each group. Afterwards the wounds in two groups were transplanted with autologous Meek microskin grafts with an extension ratio of 1∶6. In 2, 3, and 4 weeks post operation, the wound healing was observed, the wound healing rate was calculated, and the wound healing time was recorded. The specimen of wound secretion was collected for microorganism culture if there was purulent secretion on the wound post operation. In 3, 6, and 12 months post operation, the scar hyperplasia in wound was assessed using the Vancouver scar scale (VSS). In 3 months post operation, the wound tissue was collected for hematoxylin-eosin (HE) staining to observe the morphological changes and for immunohistochemical staining to observe the positive expressions of Ki67 and vimentin and to count the number of positive cells. Data were statistically analyzed with paired samples t test and Bonferronni correction. Results: In 2, 3, and 4 weeks post operation, the wound healing rates in hUCMSC+gel group were (80±11)%, (84±12)%, and (92±9)%, respectively, which were significantly higher than (67±18)%, (74±21)%, and (84±16)% in gel only group (with t values of 4.01, 3.52, and 3.66, respectively, P<0.05). The wound healing time in hUCMSC+gel group was (31±11) d, which was significantly shorter than (36±13) d in gel only group (t=-3.68, P<0.05). The microbiological culture of the postoperative wound secretion specimens from the adjacent wounds in 2 groups was identical, with negative results in 4 trial areas and positive results in 16 trial areas. In 3, 6, and 12 months post operation, the VSS scores of wounds in gel only group were 7.8±1.9, 6.7±2.1, and 5.4±1.6, which were significantly higher than 6.8±1.8, 5.6±1.6, and 4.0±1.4 in hUCMSC+gel group, respectively (with t values of -4.79, -4.37, and -5.47, respectively, P<0.05). In 3 months post operation, HE staining showed an increase in epidermal layer thickness and epidermal crest in wound in hUCMSC+gel group compared with those in gel only group, and immunohistochemical staining showed a significant increase in the number of Ki67 positive cells in wound in hUCMSC+gel group compared with those in gel only group (t=4.39, P<0.05), with no statistically significant difference in the number of vimentin positive cells in wound between the 2 groups (P>0.05). Conclusions: The application of hyaluronic acid gel containing hUCMSCs to the wound is simple to perform and is therefore a preferable route. Topical application of hUCMSCs can promote healing of the autologous Meek microskin grafted area in patients with extensive burns, shorten wound healing time, and alleviate scar hyperplasia. The above effects may be related to the increased epidermal thickness and epidermal crest, and active cell proliferation.

Effect of local application of hyaluronic acid gel on marginal bone loss and stability of dental implants

ABSTRACT Aim: To evaluate and compare the crestal bone loss and implant stability with and without hyaluronic acid gel delivery at osteotomy site. Materials and Methods: This is a Prospective randomized controlled clinical trial. Eleven patients with 30 edentulous sites were randomly divided into two groups. Test (15 sites with hyaluronic acid gel injection) and Control (15 sites without hyaluronic acid gel injection). Peri-implant crestal bone loss around the implant and stability were measured at baseline and three months. Statistical analysis was done using Mann-Whitney U test and Wilcoxson Signed-Rank test. Results: Primary stability scores for the test and control groups were 70.45 ± 1.49 and 69.53 ± 1.69, respectively and was not statistically significant. Secondary stability scores for the test and control group were 72.37 ± 1.42and 70.63 ± 1.61 respectively and was statistically significant, mean crestal bone loss for the test and control groups was 0.83 ± 0.31 and 1.27 ± 0.32, respectively. which was statistically significant (p-value &lt; 0.05). Conclusion: Within the study’s limitations, the results showed that the local injection of osteotomy sites with hyaluronic acid showed a significant increase in stability and reduction in crestal bone loss.

Clinical Comparison of Topical Application of Platelet Rich Fibrin Versus Application of Hyaluronic Acid Gel In Pain Management And Wound Healing After Free Gingival Graft Harvesting: A Randomized Controlled Clinical Trial.

Clinical Comparison of Topical Application of Platelet Rich Fibrin Versus Application of Hyaluronic Acid Gel In Pain Management And Wound Healing After Free Gingival Graft Harvesting: A Randomized Controlled Clinical Trial.

Clinical and radiographic evaluation of 0.8% hyaluronic acid as an adjunct to open flap debridement in the treatment of periodontal intrabony defects: randomized controlled clinical trial.

Present study aimed to evaluate and compare the clinical and radiographic efficacy of 0.8% hyaluronic acid (HA) gel as an adjunct to open flap debridement (OFD) versus open flap debridement (OFD) alone in the treatment of periodontal intrabony defects. This randomized, controlled, split-mouth, clinical trial included 20 chronic periodontitis (stage II or III (grades A to B)) patients, having at least two contralateral intrabony defects. Forty bilateral intrabony defects (20 in each group) were randomly divided into test (0.8% HA gel + OFD) and control (OFD + placebo) groups. Clinical parameters evaluated at baseline, 6-months, and 12-months were plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and gingival recession (GR). Using cone beam computed tomography (CBCT), radiographic parameters were evaluated at baseline and 12 months. This included bone defect fill (DF), alveolar crest changes (ACC), and defect resolution (DR). CAL served as the primary outcome variable. After 12 months, the test group showed significantly greater CAL gain (5.1 ± 1.2 versus 4.05 ± 1.19 mm) and bone defect fill (DF) (5.67 ± 2.01 versus 4.49 ± 1.78 mm) compared to the control group. Mean PD reduction in the test group (5.3 ± 1.2 versus 4.35 ± 0.81 mm) was statistically significant compared to the control group at 12-month period. The control group showed statistically significant increase in GR (1.2 ± 0.76 versus 0.7 ± 0.73 mm) compared to the test group after 12 months. Application of hyaluronic acid gel in conjunction with open flap debridement resulted in enhanced clinical and radiographic outcomes compared to open flap debridement alone. Adjunctive application of HA gel in open flap debridement may improve clinical and radiographic outcomes. CTRI/2018/03/012334.

The effect of Hyaluronic Acid as an Adjunct after Scaling and Root Planning in the Treatment of Chronic Periodontitis

The aim of this study is to evaluate the effect of the subgingival application of 0.8% hyaluronic acid (HA)gel as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Twenty patientswith chronic periodontitis were recruited to participate in a study and divided to Group 1 (G1) treated with8% hyaluronic acid gel as an adjunctive to scaling and root planning (HARP) and Group 2 (G 2) treated withscaling and root planning only. Plaque index (PL.I) Gingival index (G.I) and bleeding on probing (B.O.P)were evaluated pretreatment (baseline) (1st visits), one week (2nd visits), and 4 weeks (3rd visit) posttreatment. Subgingival plaque sample were taken for microbiologic analysis at baseline and 4 weeks posttreatment. Intragroup comparison result between visits for Group 1showed that there was highly significantdifferent for BOP, CFU, and no significant different for PLI and GI between 2nd and 3rd visit. For G 2, therewas highly significant different for GI and significant for PLI and BOP, and non-significant different CFU,between 2nd and 3rd visit. Intergroup comparison for clinical parameter and bacteriological result betweenvisits Showed that there was highly significant different in1st visit for PLI, BOP and CFU in 3 rd visit. Itcan be conclude that the local application of hyaluronic acid gel (0.8%) in conjunction with scaling androot planning have a beneficial effect on clinical periodontal parameter and may prevent recolonization ofperiodontal pathogens in patients with chronic periodontitis

The influence of different concentration of proFLEX® INTRA on clinical progression and dynamics of laboratory test values in different age patients with knee osteoarthrosis

Introduction: application of hyaluronic acid gel for intraarticular administration is actual topic of modern orthopaedic concerning to its therapeutical efficacy. Objective: to assess the influence of different concentrations of proFLEX® INTRA on the synovial fluid and biochemical blood markers in patients with the 2nd knee osteoarthritis stage in the different age groups. Materials and methods: 30 patients with Kellgren–Lawrence stage II knee osteoarthritis were examined. The first group consisted of 15 patients aged 40–50 years, in the second group the average age of patients was 50–70 years. Each group was divided into 3 subgroups (a, b, c) of 5 patients. In each group the first subgroup of patients received intra-articular 1 injection of proFLEX® INTRA 10 mg/ml 2.0 ml, І-b, ІІ-b — 12 mg/ml 2.5 ml, І-с, ІІ-с — 20 mg/ml 3.0 ml. Results: an inflammatory-dystrophic process in the knee joint of patients was found in both groups, which was more expressed in elderly patients. The dynamics of blood markers in patients of the 1st and 2nd groups after the treatment showed a decreasing the level of inflammatory and dystrophic processes in the knee joints. In the 1st group 1 month after intra-articular injection, the content of glycoproteins and chondroitin sulfates (CS) decreased, did not reach the normative values. In subgroup II-c the level of glycoproteins and CS decreased, the concentration of interleukin-6 (IL-6) remained elevated comparing to subgroups II-a and II-b. Conclusions: it was found that patients with stage II knee osteoarthritis had increased CS and lower levels of hyaluronic acid in their synovial fluid. Markers of inflammation (glycoproteins and IL-6) and destruction markers (CS) in the blood serum changed unidirectionally and indicated a decreasing in the activity of inflammatory process after the injection of hyaluronic acid gel, which was clinically confirmed 1 month after intra-articular injection. In this case, the results after the reexamination of blood biomarkers of patients aged 40–50 years indicated a higher efficiency of hyaluronic acid gel injection with a concentration of 10 and 12 mg/ml, aged 50–70 years — a concentration of 20 mg/ml was confirmed by a decrease in the level of glycoproteins, CS and IL-6 in the blood of patients.

Pregnancy and neonatal outcomes 42 months after application of hyaluronic acid gel following dilation and curettage for miscarriage in women who have experienced at least one previous curettage: follow-up of a randomized controlled trial

To study whether intrauterine application of auto-crosslinked polymers of hyaluronic acid (ACP) gel after dilation and curettage (D&C) improves reproductive outcomes. Follow-up of a prospective randomized trial. University and university-affiliated teaching hospitals. Women with a miscarriage at <14 weeks' gestation with at least one previous D&C were randomized to D&C plus ACP gel (intervention) or D&C alone (control). A hysteroscopy was performed after 8-12 weeks, and if intrauterine adhesion (IUAs) were encountered, adhesiolysis was executed. Participants received a questionnaire 30 months after treatment. Ongoing pregnancy and outcome of subsequent pregnancies. Ongoing pregnancies were recorded in 74.6% (50/67) of the intervention group versus 67.2% (43/64) of the control group, and in, respectively, 94.3% (50/53) versus 71.7% (43/60) in the women wishing to conceive. The median times to conception leading to a live birth were, respectively, 21.9 versus 36.1 months. Reduced menstrual blood loss was reported in 7.5% (5/67) versus 20.3% (13/64) and dysmenorrhea in 14.9% (10/67) versus 34.4% (22/64), respectively. Application of ACP gel following D&C performed after miscarriage seems to have a favorable effect on subsequent reproductive outcomes in women with at least one previous D&C. Given the fact that the study was not powered for reproductive outcomes, the data should be interpreted with caution. The effect may be underestimated due to routine removal of IUAs. NTR 3120.

Derma Fillers: Ray of Light in Black Triangles - A Pilot Study.

Background and Aim:Open gingival embrasure often poses complex functional and esthetic problems. Interdental papilla reconstruction is among the most challenging periodontal treatments. Hyaluronic acid (HA) gel injection, a noninvasive technique with immediate papilla reconstruction, has been recently proposed. This minimally invasive therapeutic procedure has shown predictable esthetic outcome, thus, gaining rapid acceptance as an esthetic treatment modality in dentistry. The aim of the study is to evaluate the clinical application of derma fillers (HA gel) for the reconstruction of the interdental papilla in the esthetic zone.Materials and Methods:Six patients were included with interdental papilla deficiency. After the induction of local anesthesia, 0.2 ml of 0.2% HA injection was given at baseline, 3 weeks and 3 months. Measurements of the black triangle were done clinically using acrylic stent as a reference. The application of HA gel for the reconstruction of interdental papilla was found successful at a 6-month period.Results:The study showed a significant gain in papillary volume, and esthetics improvement was notable. A statistically significant result was obtained in context to papilla fill.Conclusion:Interdental papilla reconstruction with injectable HA gel is a promising minimally invasive treatment option for interdental deficiency in small areas.

Effect of Diode Laser combined with Hyaluronic Acid Gel in Treatment of Recurrent Aphthous Stomatitis in Children: Randomized Clinical Trial

Background: Recurrent Aphthous Stomatitis (RAS) is a painful rounded ulcer characteristic by erythematous margin and pseudo yellowish- gray membrane in its center. All forms of RAS have bad effects on quality of life that interfere with daily activities. Hyaluronic acid has essential part in tissue hydrodynamics, cell migration, proliferation and differentiation. It shows an anti-inflammatory role so; it prevents tissue destruction and helps in tissue healing. Low level laser therapy is recognized with various terminologies such as “biostimulator,” and “cold laser,” It has role in the management of RAS, it has a wide spectrum of clinical applications which include herpes labialis, angular cheilitis, trismus, paresthesia, dentin hypersensitivity, temporomandibular joint pain, and in the postoperative phase.Materials and Method: Forty five normal healthy males and females children aged from (4-10 years) suffering from aphthous lesions were used in this study. Children were examined in Outpatient clinic pediatric Dentistry Department, Faculty of Dentistry, Suez canal University by a clinician. Each patient had one minor RAS of less than 72 h duration or two nearby minor aphthous lesions of less than 72 h at the same side of oral cavity. Patients were evenly divided into three groups (15 patients in each) with the method of simple randomization, Patients of group I were treated with topical application of hyaluronic acid gel , those of group II were treated with diode laser and group III patients were treated with diode laser followed by topical application of hyaluronic acid gel. The patients were evaluated at (0, 2nd, 4th and 6th) days, for measuring ulcer size and pain score. Results: At the 2nd, 4th and 6th days there was statistical significance decrease in mean size of the ulcer of group III when compared to both groups (I) and (II) . On other hands, at days 2 and 6 there was statistical significance decrease in mean of pain score in group III when compared to group I. There was also statistical significance decrease in mean of pain score in group II when compared to group I at the 4th day of evaluation.Conclusion: Hyaluronic acid gel combined with diode laser are effective in treatment of RAS.

Reproductive performance after the application of hyaluronic acid gel after dilation and curettage in women who have experienced at least one previous curettage: long-term results of a multicenter prospective randomized trial

To examine whether intrauterine application of auto-cross-linked hyaluronic acid (ACP) gel after dilation and curettage (D&C) improves reproductive performance. Multicenter prospective randomized trial. One university and seven university-affiliated teaching hospitals. A total of 149 women who have experienced a miscarriage at <14weeks of gestation, with at least one previous D&C for miscarriage or termination of pregnancy, were randomly assigned to either D&C plus ACP gel (intervention group) or D&C alone (control group). A hysteroscopy was performed 8-12weeks after the procedure. Where intrauterine adhesions (IUAs) were found, adhesiolysis was executed. Participants received questionnaires 3, 6, and 12months after the initial D&C procedure with questions regarding menstrual pattern, conception, and reproductive outcome. Reproductive outcomes during the 12months after the D&C procedure. Outcomes were available for 149 women: 77 in the intervention group and 72 in the control group. The conception rates were, respectively, 71% (46/64) and 59.7% (40/67). There was no significant difference in the miscarriage, ongoing pregnancy, and live birth rates. The median times to conception were 5.5 and 7.1months, respectively. Reproductive performance was similar in both groups although there was a significant difference in the prevalence of IUAs. Given the favorable reproductive outcome in this underpowered study and the fact that adhesiolysis was executed, no solid conclusion can be drawn. Future studies are needed to evaluate the effect of ACP gel on fertility and reproductive outcomes. NTR3120.

Prevalence of intrauterine adhesions after the application of hyaluronic acid gel after dilatation and curettage in women with at least one previous curettage: short-term outcomes of a multicenter, prospective randomized controlled trial

To examine whether intrauterine application of auto-crosslinked hyaluronic acid (ACP) gel, after dilatation and curettage (D&C), reduces the incidence of intrauterine adhesions (IUAs). Multicenter; women and assessors blinded prospective randomized trial. University and university-affiliated teaching hospitals. A total of 152 women with a miscarriage of <14weeks with at least one previous D&C for miscarriage or termination of pregnancy. Women were randomly assigned to either D&C plus ACP gel (intervention group) or D&C alone (control group). A follow-up diagnostic hysteroscopy was scheduled 8-12weeks after the D&C procedure. The primary outcome was the number of women with IUAs and the secondary outcome was the severity of IUAs. Outcomes were available for 149 women: 77 in the intervention group and 72 in the control group. The IUAs were observed in 10 (13.0%) and 22 women (30.6%), respectively (relative risk, 0.43; 95% confidence interval 0.22-0.83). Mean adhesion score and the amount of moderate-to-severe IUAs were significantly lower in the intervention group according to the American Fertility Society (AFS) and European Society of Gynecological Endoscopy classifications systems of adhesions. Intrauterine application of ACP gel after D&C for miscarriage in women with at least one previous D&C seems to reduce the incidence and severity of IUAs but does not eliminate the process of adhesion formation completely. Future studies are needed to confirm our findings and to evaluate the effect of ACP gel on fertility and reproductive outcomes. NTR3120.

Topical ozonated oil versus hyaluronic gel for the treatment of partial- to full-thickness second-degree burns: A prospective, comparative, single-blind, non-randomised, controlled clinical trial

Introduction and aimSeveral studies have demonstrated that ozonated oil is effective on cutaneous wound healing. This in vivo study has been conducted to evaluate the clinical effect of the topical application of ozonated oil for 12 weeks on second-degree skin burns. MethodA total of 30 patients suffering from second-degree skin burns in the phase of re-epithelisation were included in this study.Every skin burn was subdivided in two symmetrical parts. One part was treated with occlusive application of ozonated oil; the contralateral part of the lesion was treated with topical application of hyaluronic acid gel, once a day for 12 weeks. A clinical evaluation and an intra-vital video-capillaroscopy were performed on every patient at baseline, 6 and 12 weeks after. ResultsAll treated lesions improved regardless of the treatment used. Ozonated oil was as effective as hyaluronic acid in improving erythema, tension, itching and burning sensation reported by patients, and it does not exert a specific anti-angiogenic effect compared to hyaluronic acid. However it seems more effective than hyaluronic acid in reducing post-lesional hyperpigmentation. ConclusionOzonated oil, topically applied for 12 weeks, seems to be as effective as hyaluronic acid in reducing symptoms related to skin burns, but it could be more effective in preventing the post-lesional hyperpigmentation.

Articular cartilage regeneration with microfracture and hyaluronic acid

Microfracture used to treat articular cartilage injuries can facilitate access to stem cells in the bone marrow and stimulate cartilage regeneration. However, the regenerated cartilage is fibrocartilage as opposed to hyaline articular cartilage and is thinner than native cartilage. Following microfracture in rabbit knee cartilage defects, application of hyaluronic acid gel resulted in regeneration of a thicker, more hyaline-like cartilage. The addition of transforming growth factor-beta3, an inducer of chondrogenic differentiation in mesenchymal stem cells, to the treatment with microfracture and hyaluronic acid did not significantly benefit cartilage regeneration.

Intérêt du gel d’acide hyaluronique dans la prévention des synéchies intra-utérines après hystéroscopie opératoire

To evaluate the efficacy of auto-cross-linked hyaluronic acid gel in the prevention of adhesions after operative hysteroscopy using a case-control study.Fifty-four patients with an intrauterine lesion (myoma, polyp, uterine septa and adhesions) undergoing hysteroscopic surgery were divided into two groups: group A (30 patients) with intrauterine application of hyaluronic acid gel at the end of the surgical procedure and group B, which was considered as control (24 patients). The rate of adhesion formation, the score and the adhesion severity were estimated for each group using American Fertility Society (AFS) classification, by diagnostic hysteroscopy two months after surgery. No other treatment was associated.Age, weight, parity, hysterometry were comparable in the two groups. Surgery indications were polyp(s), myoma(s), uterine septa, and adhesions (11, 8, 1, and 10 patients in group A and 6, 6, 4, and 8 patients in group B, respectively). No difference was observed in intrauterine adhesion formation between the two groups (33.3% for group A and B; p = NS). The median adhesion scores using AFS were comparable in the two groups (1.30+/-2.35 vs 1.42+/-2.47; respectively, p = NS). The severity of the adhesions showed no significant difference between the two (70% stage I, mild adhesions; 20% stage II, moderate adhesions; 10% stage III, severe adhesions and 62.5% stage I; 25% stage II; 12.5% stage III in the group A and B, respectively). No adverse effect with the ACP gel was detected.ACP gel does not reduce the incidence and the severity of intrauterine adhesions after hysteroscopic surgery.