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 Table of Contents  
Year : 2013  |  Volume : 5  |  Issue : 5  |  Page : 309-315

Hyaluronic acid: A boon in periodontal therapy

1 Department of Periodontics and Implantology, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour, India
2 Department of Oral Pathology, Himachal Pradesh Government Dental College, Shimla, Himachal Pradesh, India

Date of Web Publication27-May-2013

Correspondence Address:
Parveen Dahiya
Department of Periodontics and Implantology, Himachal Institute of Dental Sciences and Research, Paonta Sahib, Sirmour - 173 025, Himachal Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1947-2714.112473

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Hyaluronic acid is a naturally occurring linear polysaccharide of the extracellular matrix of connective tissue, synovial fluid, and other tissues. Its use in the treatment of the inflammatory process is established in medical areas such as orthopedics, dermatology, and ophthalmology. The Pubmed/Medline database was searched for keywords "Hyaluronic acid and periodontal disease" and "Hyaluronic acid and gingivitis" which resulted in 89 and 22 articles respectively. Only highly relevant articles from electronic and manual search in English literature were selected for the present review article. In the field of dentistry, hyaluronic acid has shown anti-inflammatory and anti-bacterial effects in the treatment of periodontal diseases. Due to its tissue healing properties, it could be used as an adjunct to mechanical therapy in the treatment of periodontitis. Further studies are required to determine the clinical efficacy of hyaluronic acid in healing of periodontal lesion. The aim of the present review, article is to discuss the role of hyaluronic acid in periodontal therapy.

Keywords: Gingivitis and periodontitis, Hyaluronic acid, Periodontal healing

How to cite this article:
Dahiya P, Kamal R. Hyaluronic acid: A boon in periodontal therapy. North Am J Med Sci 2013;5:309-15

How to cite this URL:
Dahiya P, Kamal R. Hyaluronic acid: A boon in periodontal therapy. North Am J Med Sci [serial online] 2013 [cited 2023 Feb 1];5:309-15. Available from: https://www.najms.org/text.asp?2013/5/5/309/112473

  Introduction Top

Hyaluronic acid (HA) is a naturally occurring linear polysaccharide of the extracellular matrix of connective tissue, synovial fluid, and other tissues. It possesses various physiological and structural functions, which include cellular and extracellular interactions, interactions with growth factors and regulation of the osmotic pressure, and tissue lubrication. All these functions help in maintaining the structural and homeostatic integrity of the tissue. Extensive studies on the chemical and physicochemical properties of HA and its physiological role in humans have proved that it is an ideal biomaterial for cosmetic, medical, and pharmaceutical applications.

In the field of dentistry, preliminary clinical trials have been conducted by Pagnacco and Vangelisti in 1997. [1] HA has shown anti-inflammatory, anti-oedematous, and anti-bacterial effects for the treatment of periodontal disease, which is mainly caused by the microorganisms present in subgingival plaque. It has been found that the equilibrium between the free radicals/reactive oxygen species (ROS) and antioxidants is the major prerequisite for healthy periodontal tissue. Individuals suffering from the periodontitis might be at higher risk of developing other systemic inflammatory diseases like cardiovascular diseases and diabetes. [2] Sardi suggested that the co-existence of periodontal disease and diabetes could pathologically increase the effect of oxidative stress. [3] While, Pendyala et al. found that the total antioxidant capacity is inversely proportional to the severity of inflammation and can be used as an useful marker of periodontitis in health and diabetic patients. [4] However, it is also conceivable that HA administration to periodontal wound sites could achieve beneficial effects in periodontal tissue regeneration and periodontal disease treatment. [5]

The aim of this review, article is to discuss various physiochemical, biochemical, and pharmaco-therapeutic uses of HA, especially in relation to treatment of periodontal disease. The Pubmed/Medline database was searched for keywords "HA and periodontal disease," which resulted in 89 articles and "HA and gingivitis" revealed 22 articles. Only highly relevant articles from electronic and manual search in English literature were selected for the present review article.


HA was discovered in 1934 by Meyer et al. John Palmer, scientists at Columbia University, New York, who isolated a chemical substance from the vitreous jelly of cow's eyes. [6] They proposed the name HA as it was derived from the Greek word hyalos (glass) and contained two sugar molecules one of which was uronic acid.


The precise chemical structure of HA contains repeating units of d-glucoronic acid and N-acetyl-d-glucosamine. The primary structure of the polysaccharide comprises of an unbranched linear chain with the monosaccharides linked together through alternating β1,3 and β1,4 glycosidic bonds. [7] Hydrophobic faces exist within the secondary structure of HA, formed by the axial hydrogen atoms of about eight carbon-hydrogen (CH) groups on the alternating sides of the molecule. Such hydrophobic patches, energetically favor the formation of meshwork-like β-sheet tertiary structure as a result of molecular aggregation. The tertiary structure is stabilized by the presence of intermolecular hydrogen bonding. The hydrophobic and hydrogen bonding interactions in combination with the countering electrostatic repulsion enable large numbers of molecules to aggregate leading to the formation of molecular networks (matrices) of HA. The structural formula of HA has been explained in [Figure 1].
Figure 1: Structure of Hyaluronan. (a) Chemical structure of Hyaluronan. (b) 3D model of the Hyaluronan structure. (c) Hyaluronan is abundant, long, unsulfated glycosaminoglycan (up to 25,000 sugars), synthesized in the extra-cellular matrix by an enzyme complex in the plasma membrane

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Origin, body reservoir and metabolism of HA

HA is found in almost all vertebrate organs, but most abundantly in the extracellular matrix of soft connective tissues. In the skin, it has a protective, structure stabilizing and shock-absorbing role. The estimated total amount of HA in human skin has been reported to be 5 g, [8] about a third of the total amount of HA believed to be present within the entire human body. The highest concentrations of HA are found in soft connective tissues (umbilical cord, synovial fluid, skin) and the lowest in blood serum. [9]

Most cells of the body are capable of synthesizing HA and synthesis take place in the cell membrane. HA is synthesized in the plasma membrane by a membrane-bound protein. Synthesized HA is directly secreted into the extracellular space. It is also produced by fibroblasts in the presence of endotoxins.

HA (Hyaluronan) has been identified in all periodontal tissues, being particularly prominent in the non-mineralized tissues such as gingiva and periodontal ligament and in only low quantities in mineralized tissues such as cementum and alveolar bone. The high molecular weight hyaluronan present in the periodontal tissues is synthesized by hyaluronan synthase (HAS) enzymes (HAS1, HAS2 and HAS3) in various cells from the periodontal tissues, including fibroblasts and keratinocytes in gingiva and periodontal ligament, cementoblasts in cementum and osteoblasts in alveolar bone. [10]

The turnover of HA content in the tissues occurs either by lymphatic drainage to the blood stream or by local metabolism. In skin and joints, some 20-30% of HA turnover occurs by the local metabolism, and the rest is removed by the lymphatic pathways. Upon reaching the blood stream, about 85-90% is eliminated in the liver. The kidneys extract about 10% but excrete only 1-2% in the urine. The tissue half-life of HA ranges from half a day to 2 or 3 days, regardless of its route of elimination. [11]

  Properties of HA Top

HA has unique physiochemical and biological properties, which makes it useful in the treatment of the inflammatory process in medical areas such as orthopedics, dermatology, and ophthalmology [Figure 2].
Figure 2: Properties of hyaluronic acid

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Hygroscopic nature

HA is one of the most hygroscopic molecules known in nature. When HA is incorporated into aqueous solution, hydrogen bonding occurs between adjacent carboxyl and N-acetyl groups; this feature allows HA to maintain conformational stiffness and to retain water. One gram of HA can bind up to 6 L of water. As a physical background material, it has functions in space filling, lubrication, shock absorption and protein exclusion. [12]

Viscoelastic properties

Hyaluronan as a viscoelastic substance assists in periodontal regenerative procedures by maintaining spaces and protecting surfaces. Through recognition of its viscoelastic nature, HA can influence the cell functions that modify the surrounding cellular and the extracellular micro and macro environments. The viscoelastic properties of the material may slow the penetration of viruses, and bacteria, a feature of particular interest in the treatment of periodontal diseases. [12]

Bacteriostatic effect

Recent studies on regenerative surgical procedures indicate that reduction of bacterial burden at the wound site may improve the clinical outcome of regenerative therapy. The high concentration of medium and lower molecular weight HA has the greatest bacteriostatic effect, particularly on Aggregatibacter actinomycetemcomitans, Prevotella oris and Staphylococcus aureus strains, which are commonly found in oral gingival lesions and periodontal wounds. A clinical application of HA membranes, gels, and sponges during the surgical therapy may reduce the bacterial contamination of surgical wound site, thereby, lessening the risk of postsurgical infection and promoting more predictable regeneration. [13]

Biocompatibility and non-antigenicity

The highly biocompatible and non-immunogenic nature of HA has led to its use in a number of clinical applications, which include: The supplementation of joint fluid in arthritis; as a surgical aid in eye surgery; and to facilitate the healing and regeneration of bone, surgical wounds and periodontal tissue.

Modifications to Hyaluronan include esterification and cross-linking to provide some structure and rigidity to gel for cell-seeding purposes. These biopolymers are completely biodegradable and support the growth of fibroblasts, chondrocytes and mesenchymal stem cells.


HA has the anti-inflammatory effect, which may be due to the action of exogenous Hyaluronan as a scavenger by draining prostaglandins, metalloproteinases and other bio-active molecules. [14]


The anti-oedematous effect of HA may also be related to the osmotic activity. Due to its acceleration in tissue healing properties, it could be used as an adjunct to mechanical therapy. [15]


In a somewhat contradictory role, however, hyaluronan may regulate the inflammatory response, acting as an antioxidant by scavenging ROS. Thus, hyaluronan may help to stabilize the granulation tissue matrix. [16]

  Functions and Uses of HA Top

HA has a lot of important physiological and biological functions. It plays a structural role in cartilage and other tissues. It associates with proteins that are enriched in the other types of glycosaminoglycans to form proteoglycans. HA is directly or indirectly related to many cell functions like cell proliferation, recognition, and locomotion, which will contribute to its tissue healing properties. [17] Because of its unique physiochemical properties and most importantly the non-immunogenicity of the highly purified form, Hyaluronan has already found medical applications for many years. Some important clinical applications are:

  1. It is used as dermal filler in the field of cosmetic dermatology. [18]
  2. Scar formation in the surgical wounds can be prevented by the administration of HA during surgery. [19]
  3. Many reports have attested to the effects of exogenous Hyaluronan in producing beneficial wound healing outcomes. [20]
  4. In orthopedics, for treatment osteoarthritis of the knee and rheumatoid arthritis. [21]
  5. In ophthalmology, for treatment of cataract and xeropthalmia.
  6. Hyaluronan has also been explored in the field of tissue engineering. Because of its significant role during organogenesis, cell migration and development in general. [22]
  7. Modifications to Hyaluronan include esterification and cross-linking to provide some structure and rigidity to gel for the cell-seeding purpose. [23]
  8. More recently, HA has been investigated as a drug delivery agent for various routes of administration, including ophthalmic, nasal, pulmonary, parenteral, and topical. [24]

  HA and Periodontal Disease Top

HA is an essential component of the periodontal ligament matrix and plays various important roles in cell adhesion, migration and differentiation mediated by the various HA binding proteins and cell-surface receptors such as CD44. [25] HA has been studied as a metabolite or diagnostic marker of inflammation in the gingival crevicular fluid (GCF) as well as a significant factor in growth, development and repair of tissues. [26]

Based on current evidence in literature, it is now known that along with mechanical therapy, use of chemotherapeutic agents provide a better treatment strategy. The most common chemotherapeutic agents are antimicrobials and anti-inflammatory drugs. They are administered either systemically or topically. Topical antimicrobial agents for the treatment of periodontal diseases include chlorhexidine, tetracyclines, and metronidazole. HA is a recent addition to the local chemotherapeutic agents. It has shown a number of clinical therapeutic properties.

  Role of HA in Periodontal Wound Healing Top

Healing of periodontal wound includes a series of highly reproducible and rigidly controlled biologic events (inflammation, granulation tissue formation, epithelium formation and tissue remodelling) which begin with chemo attraction of cells that accumulate and debride the injured tissue, foreign material, and microbial cells [Figure 3]. These events end with the formation and maturation of new extracellular matrix that restore resistance of tissue to functional stress. [27]
Figure 3: Role of hyaluronic acid in wound healing

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Inflammatory phase

Hyaluronan has numerous roles in the initial inflammatory stages such as the provision of a structural framework via the interaction of Hyaluronan with the fibrin clot, which modulates host's inflammatory and extracellular matrix cell infiltration into the inflamed site . Hakansson et al. suggested role of Hyaluronan in migration and adherence of polymorphonuclear leukocytes and macrophages at the inflamed site and the phagocytosis and killing of invading microbes . Such events would allow counteraction of colonization and proliferation of anaerobic pathogenic bacteria in the gingival crevice and adjacent periodontal tissues. [28]

Hyaluronan itself may also prevent periodontal pathogen colonization by directly preventing microbial proliferation . Hyaluronan may also indirectly act to moderate inflammation and stabilize the granulation tissue by preventing degradation of the extracellular matrix proteins by serine proteinases derived from inflammatory cells as healing progresses. [29]

Hyaluronan also induces the production of proinflammatory cytokines by fibroblasts, keratinocytes, cementoblasts and osteoblasts which promote the inflammatory response and consequently stimulate hyaluronan synthesis by endothelial cells. [30]

Granulation phase and re-epithelisation

During granulation phase, Hyaluronan promotes cell proliferation, migration of matrix cells into granulation tissue matrix and granulation tissue organization. In non-mineralized inflamed tissues, Hyaluronan is transiently elevated during the formation of granulation tissue and the re-establishment of the epithelium. [31] During the granulation tissue phase, HA in mineralized tissues is gradually replaced by a provisional mineralized callus. [32]

In later stage of the granulation phase, Hyaluronan synthesis ceases and existing Hyaluronan is depolymerized by hyaluronidases resulting in the formation of lower molecular weight Hyaluronan molecules and an alteration in the composition of the granulation tissue. Low molecular weight Hyaluronan fragments formed following hyaluronidase activity promote the formation of blood vessels (angiogenesis) within wound sites, although the precise mechanism of action is unknown. [33]

Bone regeneration

HA accelerates the bone regeneration by means of chemotaxis, proliferation and successive differentiation of mesenchymal cells. HA shares bone induction characteristics with osteogenic substances such as bone morphogenetic protein-2 and osteopontin. [34]

Effect on angiogenesis

It has been found that low molecular weight HA has marked angiogenic effect whereas, surprisingly, high molecular weight has the opposite effect. [35]

  HA in Periodontics: Review of Literature Top

HA as a bactericidal agent is still controversial, but a study conducted by Pirnazar et al. suggested that HA in the Molecular Weight range of 1,300 kD may prove beneficial in minimizing bacterial contamination of surgical wounds when used in guided tissue regeneration surgery. Hyaluronan is identified in nearly all GCF samples, and circulating blood serum in patients with gingivitis but hyaluronan is absent in GCF samples from patients with acute necrotizing ulcerative gingivitis, owing to the high levels of bacterial enzymatic activity (hyaluronidases) associated with this condition. [13]

Engstrφm et al. investigated the anti-inflammatory effect and the effect on bone regeneration of Hyaluronan in surgical and non-surgical groups. No statistical difference was found on radiographs in the non-surgical group, whereas the decrease in bone height was found for both groups after scaling. Probing depth (PD) reduced after the surgical treatment as well as after scaling and root planning (SRP). Hyaluronan in contact with bone and soft tissues had no influence on the immune system. [36]

Hyaluronan gel is effective in controlling inflammation and gingival bleeding. Studies have documented reduction in the depth of gingival pockets along with a significant reduction in epithelial and lymphocyte cell proliferation with the use of HA gel. [37] 0.2% Hyaluronan containing gel has a beneficial effect in the treatment of plaque induced gingivitis. All studied sites had a significant decrease in peroxidase and lysozyme activities after 7, 14, and 21 days. [15] Hyaluronan gel is also effective in controlling inflammation and gingival bleeding.

The topical application of an HA-containing preparation represents a potentially useful adjunct in the therapy of gingivitis, although its use does not diminish the need for plaque reduction as a primary therapeutic measure. [38] These results were in contradiction with the previous study carried out by Xu et al. who evaluated potential benefits of local subgingival application of HA gel adjunctive to SRP. They did not find any clinical or microbiological improvement by the adjunctive use of HA gel compared to SRP alone. [39] These contradictory results could be due to different inclusive criteria or different form of HA.

Pistorius Alixander evaluated the efficacy of topical application of HA for treatment of gingivitis and found that topical application of HA containing preparation was potentially useful adjunct in the therapy of gingivitis. [38]

Gengigel® (Ricerfarma S.r.l., Milano, Italy) contains high molecular weight fractions of HA in a gel formulation with 0.2% concentration for its effect in the treatment of plaque-induced gingivitis as an adjunct to SRP. [15] The adjunctive use of 0.8% Hyaluronan after thorough mechanical debridement potentially has major clinical benefits in terms of improved healing after non-surgical therapy. [40]

M de Arau'jo Nobre during the course of their study found that HA and chlorhexidine produced good results in maintaining a healthy peri-implant complex in immediate function implants for complete rehabilitations in the edentulous mandible. Statistically, significant differences were found in favour of the HA group in the modified bleeding index (BI) on the second observation. [41]

Ballini et al. found that autologous bone combined with an esterified low-molecular HA preparation seems to have good capabilities in accelerating new bone formation in the infra-bone defects. [42]

Leonardo in 2009 investigated the clinical efficacy of esterified HA (in the form of fibers) for treating deep periodontal defects. 18 infrabony and one mandibular molar furcation were selected for placing the HA fibers. After 1 year of treatment the mean probing pocket depth (PPD) was reduced by 5.8 mm and the attachment gain was 2.8 mm. [43]

Johannsen et al. conducted a split mouth design study to evaluate the adjunctive effect of local application of 0.8% Hyaluronan gel to SRP in the treatment of chronic periodontitis. They found a significant reduction in bleeding on probing (BOP) scores and PD in SRP + hyaluronan gel group as compared to SRP group. [44]

Pilloni et al., in their randomized controlled clinical pilot study, evaluated the efficacy of an esterified form of HA gel on periodontal clinical parameters. The periodontal clinical parameters were plaque index (PI), BOP, PPD, gingival index (GI), and probing attachment level. In the end of the study, they concluded that an esterified gel form of HA has shown an effect in reducing the gingival inflammation when used as an adjunct to mechanical home plaque control and that it could be successfully used to improve the periodontal clinical indexes. [45]

El-Sayed et al., in a randomized controlled trial, evaluated the effect of local application of 0.8% Hyaluronan gel in conjunction with periodontal surgery. After initial non-surgical periodontal therapy and re-evaluation, defects were randomly assigned to be treated with modified Widman flap surgery in conjunction with either 0.8% Hyaluronan gel (test) or placebo gel (control) application. Statistically, significant differences were noted for Clinical Attachment Level and gingival recession, ( P < 0.05) in favor of the test sites. But non-significant results were found regarding PD, BOP and PI values ( P > 0.05). [46]

Gontiya et al. investigated the clinical and histological outcomes of local subgingival application of 0.2% HA gel as an adjunct to SRP in chronic periodontitis patients. Clinical parameters such as GI, BI, PPD, and Relative Attachment Level were recorded at baseline (0 day), 4 th , 6 th , and 12 th week. Finally, they concluded that subgingival placement of 0.2% HA gel along with SRP provides a significant improvement in gingival parameters, but no additional benefits were found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrates, but the results were not statistically significant. [47]

  Conclusion Top

Thus, it is evident that Hyaluronan has a multifunctional role in the wound healing process with a similar mechanism of healing potentially existing within periodontal tissues. As a consequence of the many functions attributed to Hyaluronan during wound healing, advances have been made in the development and application of Hyaluronan-based biomaterials in the treatment of various inflammatory conditions . Hence, further long-term studies with better standards such as application time, quantity of application, different forms and concentration needs to be carried out for better understanding of therapeutic effect of HA.

  References Top

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wissen kompakt. 2023;
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2 Syringeable atorvastatin loaded eugenol enriched PEGylated cubosomes in-situ gel for the intra-pocket treatment of periodontitis: statistical optimization and clinical assessment
Heba Amin Elgendy, Amna M. A. Makky, Yara E. Elakkad, Radwa M. Ismail, Nihal Farid Younes
Drug Delivery. 2023; 30(1)
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3 Intra-socket application of Hyaluronic acid reduces pain and swelling following wisdom teeth removal
Nadia Sultana Shuborna, Lee Kian Khoo, Bishwa Prakash Bhattarai, Teeranut Chaiyasamut, Sirichai Kiattavorncharoen, Verasak Pairuchvej, Natthamet Wongsirichat
Journal of Oral Medicine and Oral Surgery. 2022; 28(1): 14
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4 Coronally advanced flap with and without hyaluronic acid (HYALOSS) for the treatment of gingival recession – a randomized clinical trial
Apoorva Saxena, Prashant Bhusari, Abhilasha Singh, Ravleen Nagi, Shailendra Singh Chaturvedi
Journal of Oral Medicine and Oral Surgery. 2022; 28(4): 48
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5 Cross-linked hyaluronic acid gel with or without a collagen matrix in the treatment of class III furcation defects: A histologic and histomorphometric study in dogs
Yoshinori Shirakata, Takatomo Imafuji, Toshiaki Nakamura, Yukiya Shinohara, Masayuki Iwata, Fumiaki Setoguchi, Kazuyuki Noguchi, Anton Sculean
Journal of Clinical Periodontology. 2022;
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6 Efficacy of hyaluronic acid, absorbable collagen sponge, and their combination in minimizing bisphosphonate-related osteonecrosis of the jaws (BRONJ) after dental extraction: a preliminary animal histomorphometric study
Farzin Sarkarat, Alireza Modarresi, Arefeh Riyahi, Pejman Mortazavi, Fatemeh Tabandeh, Vahid Rakhshan
Maxillofacial Plastic and Reconstructive Surgery. 2022; 44(1)
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7 Photoprotective, Anti-Fungal Activity and Cytotoxicity of Capsanthin from Capsicum Annum Fruits on Mouse Skin Melanoma and AQP-3 Gene Expression in Human Keratinocyte HaCaT Cells
Velmurugan Shanmugham, Ravi Subban
Current Cosmetic Science. 2022; 1(2)
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8 Prolyl-hydroxylase inhibitor-induced regeneration of alveolar bone and soft tissue in a mouse model of periodontitis through metabolic reprogramming
Elan Zebrowitz, Azamat Aslanukov, Tetsuhiro Kajikawa, Kamila Bedelbaeva, Sam Bollinger, Yong Zhang, David Sarfatti, Jing Cheng, Phillip B. Messersmith, George Hajishengallis, Ellen Heber-Katz
Frontiers in Dental Medicine. 2022; 3
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9 Lidocaine- and chloramphenicol-loaded nanoparticles embedded in a chitosan/hyaluronic acid/glycerol matrix: Drug-eluting biomembranes with potential for guided tissue regeneration
Mariana Oliveira Vasconcelos, Luís Antônio Dantas Silva, Ailton Antonio Sousa-Junior, Thaís Rosa Marques dos Santos, Carla Afonso da Silva, Marize Campos Valadares, Eliana Martins Lima
Frontiers in Nanotechnology. 2022; 4
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10 Hyaluronic acid for periodontal tissue regeneration in intrabony defects. A systematic review.
A.M. Rodríguez, I Iborra, F Alpiste-Illueca, A López-Roldán
Dentistry Review. 2022; : 100057
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11 Multifunctional “Janus-Type” Bilayer Films Combine Broad-Range Tissue Adhesion with Guided Drug Release
Ceren Kimna, Maria G. Bauer, Theresa M. Lutz, Salma Mansi, Enes Akyuz, Zuleyha Doganyigit, Percin Karakol, Petra Mela, Oliver Lieleg
Advanced Functional Materials. 2022; : 2105721
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12 Clinical effects of the adjunctive use of polynucleotide and hyaluronic acid-based gel in the subgingival re-instrumentation of residual periodontal pockets: A randomized, split-mouth clinical trial
Andrea Pilloni, Mariana A. Rojas, Cinzia Trezza, Mauro Carere, Alessandro De Filippis, Rosalia L. Marsala, Lorenzo Marini
Journal of Periodontology. 2022;
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13 Hyaluronic Acid-Based Wound Dressing with Antimicrobial Properties for Wound Healing Application
Francesca Della Sala, Gennaro Longobardo, Antonio Fabozzi, Mario di Gennaro, Assunta Borzacchiello
Applied Sciences. 2022; 12(6): 3091
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14 Various Coated Barrier Membranes for Better Guided Bone Regeneration: A Review
Ji-Youn Kim, Jun-Beom Park
Coatings. 2022; 12(8): 1059
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15 Hyaluronic Acid: A New Approach for the Treatment of Gingival Recession—A Systematic Review
Vini Mehta, Gerta Kaçani, Mohammed M. Al Moaleem, Anwar Abdulkarim Almohammadi, Malak Mohammed Alwafi, Abduljabbar Khalil Mulla, Shahad Owaidh Alharbi, Abdullah Waleed Aljayyar, Etleva Qeli, Çeljana Toti, Agron Meto, Luca Fiorillo
International Journal of Environmental Research and Public Health. 2022; 19(21): 14330
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16 Hyaluronic Acid as an Adjunct to Coronally Advanced Flap Procedures for Gingival Recessions: A Systematic Review and Meta—Analysis of Randomized Clinical Trials
Mariana A. Rojas, Lorenzo Marini, Philipp Sahrmann, Andrea Pilloni
Journal of Personalized Medicine. 2022; 12(9): 1539
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17 Adjunctive Application of Hyaluronic Acid in Combination with a Sodium Hypochlorite Gel for Non-Surgical Treatment of Residual Pockets Reduces the Need for Periodontal Surgery—Retrospective Analysis of a Clinical Case Series
Daniel Diehl, Anton Friedmann, Pheline Liedloff, Rico Marvin Jung, Anton Sculean, Hakan Bilhan
Materials. 2022; 15(19): 6508
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18 Impact of Cross-Linked Hyaluronic Acid on Osteogenic Differentiation of SAOS-2 Cells in an Air-Lift Model
Bianca Nobis, Thomas Ostermann, Julian Weiler, Thomas Dittmar, Anton Friedmann
Materials. 2022; 15(19): 6528
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19 Efficiency of Hyaluronic Acid in Infrabony Defects: A Systematic Review of Human Clinical Trials
Florin Onisor, Simion Bran, Alexandru Mester, Andrada Voina-Tonea
Medicina. 2022; 58(5): 580
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20 Considerations on the Controlled Delivery of Bioactive Compounds through Hyaluronic Acid Membrane
Eugenia Eftimie Totu, Daniela Manuc, Tiberiu Totu, Corina Marilena Cristache, Roxana-Madalina Buga, Fatih Erci, Camelia Cristea, Ibrahim Isildak
Membranes. 2022; 12(3): 303
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21 Cancer Cytotoxicity of a Hybrid Hyaluronan-Superparamagnetic Iron Oxide Nanoparticle Material: An In-Vitro Evaluation
Yen-Lan Chang, Pei-Bang Liao, Ping-Han Wu, Wei-Jen Chang, Sheng-Yang Lee, Haw-Ming Huang
Nanomaterials. 2022; 12(3): 496
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22 Thermoresponsive Azithromycin-Loaded Niosome Gel Based on Poloxamer 407 and Hyaluronic Interactions for Periodontitis Treatment
Kunchorn Kerdmanee, Thawatchai Phaechamud, Sucharat Limsitthichaikoon
Pharmaceutics. 2022; 14(10): 2032
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23 Hyaluronic Acid: A Review of the Drug Delivery Capabilities of This Naturally Occurring Polysaccharide
Ciara Buckley, Emma J. Murphy, Therese R. Montgomery, Ian Major
Polymers. 2022; 14(17): 3442
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24 Grafted Microparticles Based on Glycidyl Methacrylate, Hydroxyethyl Methacrylate and Sodium Hyaluronate: Synthesis, Characterization, Adsorption and Release Studies of Metronidazole
Aurica Ionela Gugoasa, Stefania Racovita, Silvia Vasiliu, Marcel Popa
Polymers. 2022; 14(19): 4151
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25 Combined Sinus Grafting and Lateral Augmentation by a Hyaluronic Acid-Facilitated Guided Bone Regeneration Protocol – Case Series Supported by Human Histologic Analysis
Anton Friedmann, Werner Goetz
Journal of Biomedical Research & Environmental Sciences. 2022; 3(1): 065
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26 Use of Hyaluronic Acid in Periodontal Disease Treatment: A Systematic Review
Sotiria Davidopoulou, Sotirios Kalfas, Panagiotis Karakostas
The Journal of Contemporary Dental Practice. 2022; 23(3): 355
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27 Correlation of level bone metabolism biomarker Osteocalcin in serum with periodontal treatment outcome
Gagik Hakobyan, Lazar Yessayan, Liana Vardevanyan, Tatevik Kocharyan, Yevgenya Tovmasyan, Gagik Khachatryan
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28 Polysaccharide-Based Micro- and Nanosized Drug Delivery Systems for Potential Application in the Pediatric Dentistry
Plamen Katsarov,Maria Shindova,Paolina Lukova,Ani Belcheva,Cédric Delattre,Bissera Pilicheva
Polymers. 2021; 13(19): 3342
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29 Effect of Hyaluronic Acid Gel on Healing of Simple Dental Extraction Sockets: A Pilot Study
Diana Mostafa,Maram Alzahrani,Jawharah Atiah Alatawi,Samar Farhan Alsirhani,Afrah Alshehri,Afnan Mazyed Almutiri
Open Access Macedonian Journal of Medical Sciences. 2021; 9(D): 190
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30 Influence of Materials Properties on Bio-Physical Features and Effectiveness of 3D-Scaffolds for Periodontal Regeneration
Nicola d’Avanzo,Maria Chiara Bruno,Amerigo Giudice,Antonia Mancuso,Federica De Gaetano,Maria Chiara Cristiano,Donatella Paolino,Massimo Fresta
Molecules. 2021; 26(6): 1643
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31 Polymeric Scaffolds for Dental, Oral, and Craniofacial Regenerative Medicine
David T. Wu, Jose G. Munguia-Lopez, Ye Won Cho, Xiaolu Ma, Vivian Song, Zhiyue Zhu, Simon D. Tran
Molecules. 2021; 26(22): 7043
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32 Anti-Inflammatory and Anti-Allergic Effects of Saponarin and Its Impact on Signaling Pathways of RAW 264.7, RBL-2H3, and HaCaT Cells
Seon-Young Min,Che-Hwon Park,Hye-Won Yu,Young-Jin Park
International Journal of Molecular Sciences. 2021; 22(16): 8431
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33 Development and Evaluation of Thermosensitive Hydrogels with Binary Mixture of Scutellariae baicalensis radix Extract and Chitosan for Periodontal Diseases Treatment
Justyna Chanaj-Kaczmarek, Tomasz Osmalek, Emilia Szymanska, Katarzyna Winnicka, Tomasz M. Karpinski, Magdalena Dyba, Marta Bekalarska-Debek, Judyta Cielecka-Piontek
International Journal of Molecular Sciences. 2021; 22(21): 11319
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34 Biomolecules in Dental Applications: Randomized, Controlled Clinical Trial Evaluating the Influence of Hyaluronic Acid Adjunctive Therapy on Clinical Parameters of Moderate Periodontitis
Iwona Olszewska-Czyz, Kristina Kralik, Jelena Prpic
Biomolecules. 2021; 11(10): 1491
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35 Hyaluronic Acid: A Key Ingredient in the Therapy of Inflammation
Andreia Marinho, Cláudia Nunes, Salette Reis
Biomolecules. 2021; 11(10): 1518
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36 Hyaluronic Acid Is an Effective Dermal Filler for Lip Augmentation: A Meta-Analysis
László Márk Czumbel,Sándor Farkasdi,Noémi Gede,Alexandra Mikó,Dezso Csupor,Anita Lukács,Valéria Gaál,Szabolcs Kiss,Péter Hegyi,Gábor Varga
Frontiers in Surgery. 2021; 8
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37 Treatment of Residual Periodontal Pockets Using a Hyaluronic Acid-Based Gel: A 12 Month Multicenter Randomized Triple-Blinded Clinical Trial
Andrea Pilloni,Blerina Zeza,Davor Kuis,Domagoj Vrazic,Tomislav Domic,Iwona Olszewska-Czyz,Christina Popova,Kamen Kotsilkov,Elena Firkova,Yana Dermendzieva,Angelina Tasheva,Germano Orrů,Anton Sculean,Jelena Prpic
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38 Management of Gingival Bleeding in Periodontal Patients with Domiciliary Use of Toothpastes Containing Hyaluronic Acid, Lactoferrin, or Paraprobiotics: A Randomized Controlled Clinical Trial
Andrea Butera,Simone Gallo,Carolina Maiorani,Camilla Preda,Alessandro Chiesa,Francesca Esposito,Maurizio Pascadopoli,Andrea Scribante
Applied Sciences. 2021; 11(18): 8586
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39 Development of a Mouthwash Using Freeze-Drying Technique: An Optimization Study
Sonia M. Iurian, Diana-Roxana Adespei, Anca Pop, Ionel Fize?an, Rahela Carpa, Mirela L. Moldovan, Felicia Loghin, Marcela Achim, Catalina Bogdan
Applied Sciences. 2021; 11(20): 9609
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40 Effects of hyaluronic acid and deproteinized bovine bone mineral with 10% collagen for ridge preservation in compromised extraction sockets
Jun-Beom Lee,Seoyoon Chu,Heithem Ben Amara,Hyun-Young Song,Min-Jung Son,Jungwon Lee,Hae-Young Kim,Ki-Tae Koo,In-Chul Rhyu
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41 Healing of intrabony defects following regenerative surgery by means of single-flap approach in conjunction with either hyaluronic acid or an enamel matrix derivative: a 24-month randomized controlled clinical trial
Andrea Pilloni,Mariana A. Rojas,Lorenzo Marini,Paola Russo,Yoshinori Shirakata,Anton Sculean,Roberta Iacono
Clinical Oral Investigations. 2021;
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42 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
Alefiya S. Mamajiwala,Kunal S. Sethi,Chetan P. Raut,Prerna A. Karde,Batul S. Mamajiwala
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43 Combination of enamel matrix derivative and hyaluronic acid inhibits lipopolysaccharide-induced inflammatory response on human epithelial and bone cells
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44 Microbial production of hyaluronic acid: the case of an emergent technology in the bioeconomy
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45 Preparation and characterization of poly (lactic-co-glycolic acid) nanofibers containing simvastatin coated with hyaluronic acid for using in periodontal tissue engineering
Zahra Malekpour,Vajihe Akbari,Jaleh Varshosaz,Azade Taheri
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46 Characterization of a hyaluronic acid-based hydrogel containing an extracellular oxygen carrier (M101) for periodontitis treatment: An in vitro study
Hayriye Özçelik,Fareeha Batool,Maďwenn Corre,Alexandre Garlaschelli,Guillaume Conzatti,Céline Stutz,Catherine Petit,Eric Delpy,Franck Zal,Elisabeth Leize-Zal,Olivier Huck
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47 Formulation Development and Evaluation of Lidocaine Hydrochloride Loaded in Chitosan-Pectin- Hyaluronic acid Polyelectrolyte Complex for Dry Socket Treatment
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48 Nanohybrid composed of graphene oxide functionalized with sodium hyaluronate accelerates bone healing in the tibia of rats
Paulo César de Lacerda Dantas,Paulo Antônio Martins-Júnior,Danielle Carvalho Oliveira Coutinho,Vanessa Barbosa Andrade,Thalita Marcolan Valverde,Erick de Souza Ávila,Tatiane Cristine Silva Almeida,Celso Martins Queiroz-Junior,Marcos Augusto Sá,Alfredo Miranda Góes,Luiz Orlando Ladeira,Anderson José Ferreira,Leandro Silva Marques
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M. V. Anisimov, S. A. Shnaider, L. V. Anisimova, O. E. Reyzvikh, N. I. Molchanyuk
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50 Clinical and microbiological evaluation of hyaluronic acid and chlorhexidine mouthwash in the treatment of peri-implant mucositis
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Stomatologiya. 2021; 100(6): 24
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51 Healing of buccal gingival recessions following treatment with coronally advanced flap alone or combined with a cross-linked hyaluronic acid gel. An experimental study in dogs
Yoshinori Shirakata,Toshiaki Nakamura,Yoshiko Kawakami,Takatomo Imafuji,Yukiya Shinohara,Kazuyuki Noguchi,Anton Sculean
Journal of Clinical Periodontology. 2021;
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52 Clinical Comparison of MEBO and Hyaluronic Acid Gel in the Management of Pain after Free Gingival Graft Harvesting: A Randomized Clinical Trial
Ahmed Hassan,Enji Ahmed,Dalia Ghalwash,Azza Ezz Elarab,Vincenzo Iorio Siciliano
International Journal of Dentistry. 2021; 2021: 1
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53 The Effect of Anadara granosa Shell’s–Stichopus hermanni Scaffold on CD44 and IL-10 Expression to Decrease Osteoclasts in Socket Healing
Rima Parwati Sari,Syamsulina Revianti,Dwi Andriani,Widyasri Prananingrum,Retno Pudji Rahayu,Sri Agus Sudjarwo
European Journal of Dentistry. 2021;
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54 Hyaluronic acid versus dexamethasone for the treatment of recurrent aphthous stomatitis in children: efficacy and safety analysis
Zheng Yang,Miaojuan Li,Lin Xiao,Zhiming Yi,Min Zhao,Shengjie Ma
Brazilian Journal of Medical and Biological Research. 2020; 53(8)
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Dmytro Orlenko,Volodymyr Yakovenko,Vyacheslav Plastun,Liliia Vyshnevska
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56 Effect of root conditioning agents hyaluronic acid, EDTA and chlorhexidine on the attachment of human gingival fibroblasts to healthy root surface
Walaa Babgi,Mashael Alhajaji,Lujain Al-Mehmadi,Rokaia Elbaqli,Noha Khayat,Salwa Aldahlawi,Abdel-Rahman Youssef
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57 Role of hyaluronan in regulating self-renewal and osteogenic differentiation of mesenchymal stromal cells and pre-osteoblasts
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58 Hyaluronic Acid Scaffolds and Injectable Gels for Healing of Induced Arthritis in Rat Knee: Effect of Prednisolone Revisited
Farhad Mohammadi,Azad Vosough,Nader Tanideh,Soliman Mohammadi Samani,Fatemeh Ahmadi
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59 Association of hyaluronic acid with a deproteinized bovine graft improves bone repair and increases bone formation in critical-size bone defects
Henrique R Matheus,Edilson Ervolino,David Jonathan Rodrigues Gusman,Breno Edson Sendăo Alves,Luiz Guilherme Fiorin,Priscilla Aparecida Pereira,Juliano Milanezi de Almeida
Journal of Periodontology. 2020;
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60 Effect of Hyaluronic Acid Filler Injection on the Interdental Papilla in a Mouse Model of Open Gingival Embrasure
Soo-Bin Kim,Jaehun Cho,Seong-Suk Jue,Jae Hyun Park,Ji- Youn Kim
International Journal of Environmental Research and Public Health. 2020; 17(14): 4956
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61 Effects of Apigenin on RBL-2H3, RAW264.7, and HaCaT Cells: Anti-Allergic, Anti-Inflammatory, and Skin-Protective Activities
Che-Hwon Park,Seon-Young Min,Hye-Won Yu,Kyungmin Kim,Suyeong Kim,Hye-Ja Lee,Ji-Hye Kim,Young-Jin Park
International Journal of Molecular Sciences. 2020; 21(13): 4620
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62 Improved Surface Display of Human Hyal1 and Identification of Testosterone Propionate and Chicoric Acid as New Inhibitors
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Pharmaceuticals. 2020; 13(4): 54
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63 Hyaluronic acid reduces inflammation and crevicular fluid IL-1ß concentrations in peri-implantitis: a randomized controlled clinical trial
Elena Sánchez-Fernández,Antonio Magán-Fernández,Francisco OćValle,Manuel Bravo,Francisco Mesa
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65 Medical Application of Polymer-Based Composites
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66 A 3D “In Vitro” Model to Study Hyaluronan Effect in Nasal Epithelial Cell Line Exposed to Double-Stranded RNA Poly(I:C)
Giusy Daniela Albano,Anna Bonanno,Daniela Giacomazza,Luca Cavalieri,Martina Sammarco,Eleonora Ingrassia,Rosalia Gagliardo,Loredana Riccobono,Monica Moscato,Giulia Anzalone,Angela Marina Montalbano,Mirella Profita
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67 Derma fillers: Ray of light in black triangles – A pilot study
Shalini Kapoor,Anjali Dudeja
Contemporary Clinical Dentistry. 2020; 11(1): 55
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68 Gamma-Irradiation-Prepared Low Molecular Weight Hyaluronic Acid Promotes Skin Wound Healing
Marta Huang,Marta Huang,Marta Lew,Marta Fan,Marta Chang,Marta Huang
Polymers. 2019; 11(7): 1214
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69 Combination of Zinc Hyaluronate and Metronidazole in a Lipid-Based Drug Delivery System for the Treatment of Periodontitis
Attila Léber,Mária Budai-Szucs,Edit Urbán,Péter Vályi,Attila Gácsi,Szilvia Berkó,Anita Kovács,Erzsébet Csányi
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70 Hyaluronic Acid: Molecular Mechanisms and Therapeutic Trajectory
Ramesh C. Gupta,Rajiv Lall,Ajay Srivastava,Anita Sinha
Frontiers in Veterinary Science. 2019; 6
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71 Short-term effects of hyaluronic acid on the subgingival microbiome in peri-implantitis: A randomized controlled clinical trial
Ana Soriano-Lerma,Antonio Magán-Fernández,Juan Gijón,Elena Sánchez-Fernández,Miguel Soriano,José A. García-Salcedo,Francisco Mesa
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72 Gelatin-polysaccharide composite scaffolds for 3D cell culture and tissue engineering: Towards natural therapeutics
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73 Surgical Treatment of a Cemental Tear-Associated Bony Defect Using Hyaluronic Acid and a Resorbable Collagen Membrane. A 2-Year Follow-Up
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74 Hyaluronic acid as adjunctive to non-surgical and surgical periodontal therapy: a systematic review and meta-analysis
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75 Hyaluronic acid for advanced therapies: Promises and challenges
Nunzia Gallo,Heba Nasser,Luca Salvatore,Maria Lucia Natali,Lorena Campa,Mohamed Mahmoud,Loredana Capobianco,Alessandro Sannino,Marta Madaghiele
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76 LVFFARK conjugation to poly (carboxybetaine methacrylate) remarkably enhances its inhibitory potency on amyloid ß-protein fibrillogenesis
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Reactive and Functional Polymers. 2019; 140: 72
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77 Hyaluronic Acid: The Reason for Its Variety of Physiological and Biochemical Functional Properties
Rami Al-Khateeb,Jelena Prpic
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78 Effectiveness of Anadara granosa shell-Stichopus hermanni granules at accelerating woven bone formation fourteen days after tooth extraction
Rima Parwati Sari,Hansen Kurniawan
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?????? ???????,Marina Nagaeva,???????? ????????????,Viktoriya Miroshnichenko,???? ??????,Ivan Petrov,????? ???????,olga Frolova,????? ?????,Elena Dzyuba
Actual problems in dentistry. 2019; 15(1): 38
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80 Implantable hyaluronic acid-deferoxamine conjugate prevents nonunions through stimulation of neovascularization
Alexis Donneys,Qiuhong Yang,Marcus Laird Forrest,Noah S. Nelson,Ti Zhang,Russell Ettinger,Kavitha Ranganathan,Alicia Snider,Sagar S. Deshpande,Mark S. Cohen,Steven R. Buchman
npj Regenerative Medicine. 2019; 4(1)
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81 Effects of hot water extract of Curcuma longa on human epidermal keratinocytes in vitro and skin conditions in healthy participants: A randomized, double-blind, placebo-controlled trial
Kazuki Asada,Tatsuya Ohara,Koutarou Muroyama,Yoshihiro Yamamoto,Shinji Murosaki
Journal of Cosmetic Dermatology. 2019;
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82 Clinical efficacy of a chlorhexidine-based mouthrinse containing hyaluronic acid and an antidiscoloration system in patients undergoing flap surgery: A triple-blind, parallel-arm, randomized controlled trial
Leonardo Trombelli,Anna Simonelli,Mattia Pramstraller,Maria Elena Guarnelli,Chiara Fabbri,Elisa Maietti,Roberto Farina
International Journal of Dental Hygiene. 2018;
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83 Biopolymers – Calcium phosphates composites with inclusions of magnetic nanoparticles for bone tissue engineering
Florina D. Ivan,Vera Balan,Ionel M. Popa,Andrei Lobiuc,Aurora Antoniac,Iulian Vasile Antoniac,Liliana Verestiuc
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