Evaluation of hyaluronan-nano hydroxyapatite in periodontal defects
Journal name: Journal of Indian Society of Periodontology
Original article title: Clinicoradiographic evaluation of hyaluronan-nano hydroxyapatite composite graft in the management of periodontal infrabony defects
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Eeshita Bhowmik, Deepika Pawar Chandrashekara Rao
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Clinicoradiographic evaluation of hyaluronan-nano hydroxyapatite composite graft in the management of periodontal infrabony defects
Year: 2021 | Doi: 10.4103/jisp.jisp_453
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Chronic periodontitis is a significant global health concern and the leading cause of tooth loss, negatively impacting quality of life. Various treatment modalities have been employed to restore periodontal attachment, including drug delivery agents and bone graft materials. Nano hydroxyapatite (NHA) is favored for its similarity to natural bone but lacks antibacterial properties and osteogenic potential. In this study, hyaluronan was combined with NHA to create a composite graft (H-NHA) aimed at enhancing regeneration in infrabony defects amongst chronic periodontitis patients.
Enhanced Regeneration with H-NHA Composite Graft
The study evaluated clinical and radiographic outcomes of H-NHA in comparison to NHA alone in a cohort of eight patients treated over 12 months. Key clinical parameters, such as probing pocket depth (PPD) and clinical attachment level (CAL), alongside radiographic metrics like defect depth reduction (DDR), were analyzed at multiple intervals. Results showed that the H-NHA group experienced significant improvements across all measured parameters, with a notable reduction in PPD (2.00 mm compared to 3.50 mm in the NHA group) and enhanced gain in CAL. The composite graft also exhibited superior handling characteristics, promising improved outcomes for periodontal regenerative therapy.
Conclusion
The findings of this study suggest that the H-NHA composite graft is an effective periodontal regenerative material, demonstrating significant clinical and radiographic improvements in the treatment of infrabony defects in chronic periodontitis patients. Hyaluronan's properties not only enhance the regenerative potential of NHA grafts but also contribute to better patient outcomes. However, further research with larger sample sizes and more comprehensive assessments, including histological evaluations, is warranted to confirm these findings and potential benefits.
FAQ section (important questions/answers):
What is the purpose of the H-NHA composite graft study?
The study aims to evaluate the efficacy of the hyaluronan-nano hydroxyapatite composite graft in treating infrabony defects in patients with chronic periodontitis.
What are the main findings regarding clinical parameters after 12 months?
At 12 months, the H-NHA group showed significant improvements in probing pocket depth reduction, clinical attachment gain, and overall bone defect reduction compared to the NHA group.
How was the effectiveness of H-NHA graft measured in this study?
The effectiveness was assessed through clinical parameters like probing pocket depth and clinical attachment levels, along with radiographic measurements of defect depth reduction and changes in alveolar crest levels.
What does hyaluronan add to the NHA bone graft?
Hyaluronan provides antibacterial and osteogenic properties, enhances handling characteristics, and helps prevent the scattering of graft particles when mixed with nano hydroxyapatite.
What were the study's limitations according to the authors?
The limitations included only visual assessment of radiographic changes and the inability to perform histological evaluations to determine the true nature of the healing process.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Evaluation of hyaluronan-nano hydroxyapatite in periodontal defects”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In research, a 'table' refers to a systematic arrangement of data, often in rows and columns, which facilitates easy comparison and interpretation. Tables are essential for presenting findings clearly, summarizing results from experiments, and enabling easy access to numerical data, particularly in clinical studies involving parameters like probing depths and clinical attachment levels.
2) Study (Studying):
A 'study' signifies a comprehensive investigation or analysis aimed at understanding specific phenomena or validating hypotheses. In the context of this abstract, the study examines the efficacy of hyaluronan-nano hydroxyapatite composite grafts in treating periodontal defects, providing insights into clinical outcomes and contributing to advancements in dental regenerative practices.
3) Composite:
The term 'composite' refers to a material formed by combining two or more different substances to achieve enhanced properties. In this research, the composite is the hyaluronan-nano hydroxyapatite graft, designed to leverage the antibacterial and osteogenic benefits of hyaluronan alongside the structural support of nano hydroxyapatite, improving periodontal treatment outcomes.
4) Measurement:
Measurement involves the process of quantifying attributes using specific tools or techniques. In this context, measurements pertain to clinical parameters like probing pocket depth and clinical attachment level, which are crucial for assessing the effectiveness of the treatment and tracking changes over time in the patients' periodontal conditions.
5) Antibiotic (Antibacterial):
Antibiotics are substances used to treat bacterial infections by killing or inhibiting the growth of bacteria. In the context of this study, antibiotics are often prescribed post-surgery to prevent infection, which is critical in the healing process, especially when invasive procedures like grafting are performed.
6) Aureus:
Staphylococcus aureus, often referred to simply as 'aureus,' is a type of bacteria known for being both pathogenic and opportunistic, commonly associated with infections. In the context of this study, its significance lies in hyaluronan's bacteriostatic effects against this and other bacteria, suggesting its role in promoting periodontal healing.
7) Filling (Filled):
The term 'filled' is used to describe the action of placing a substance into a space or cavity to achieve a desired effect. In this study, 'filled' refers to how grafts, specifically the H-NHA composite, were inserted into tooth defects to enhance healing and regeneration of periodontal tissue.
8) Rules:
Rules refer to guidelines or principles governing conduct or procedures. In scientific research, rules dictate the methodology of studies, ensuring standards for ethical treatment, data collection, and statistical analysis, thereby enhancing the reliability and validity of results, such as those seen in clinical trials.
9) Wall:
In dentistry and periodontology, 'wall' often refers to the sides of a bone defect. Different types of bony defects (two-walled, three-walled) impact treatment outcomes, making it crucial for studies to differentiate and analyze how grafting affects various wall structures in periodontal regeneration.
10) Bleeding:
The term 'bleeding' pertains to the loss of blood from the circulatory system, often assessed in clinical settings to gauge surgical or healing processes. In periodontal studies, measuring bleeding during probing or following surgery is vital to evaluate patient recovery and the success of grafting procedures.
11) Disease:
In a medical context, 'disease' refers to a pathological condition characterized by a specific set of symptoms. Chronic periodontitis is a significant oral disease implicating the health of the supporting structures of teeth, making understanding its treatment critical for enhancing dental health outcomes among affected individuals.
12) India:
India is the country where this study was conducted. The country's diverse population and varied health care settings provide a relevant context for studying the effectiveness of new treatments, like hyaluronan-NHA composites, tailored for the management of diseases such as chronic periodontitis prevalent within the region.
13) Male:
'Male' is a term denoting the gender of individuals. In clinical studies, understanding the gender distribution among participants can influence outcomes, as systemic health factors and hormonal differences may contribute to the variability in responses to treatments, thereby aiding in the comprehensive analysis of data.
14) Activity:
In biological terms, 'activity' refers to the functions carried out by cells, tissues, or organisms. In the context of this study, it may relate to the osteogenic activity directed by hyaluronan, which promotes cell proliferation and differentiation, contributing to effective bone regeneration in periodontal defects.
15) Hygiene (Hygienic):
The term 'hygiene' pertains to practices that promote health through cleanliness. In periodontal health, maintaining oral hygiene is essential for preventing disease progression and ensuring successful outcomes in treatments like those studied here, underlining the need for patient education regarding hygiene post-surgery.
16) Surface:
The term 'surface' refers to the external or upper boundary of an object. In materials science and regenerative dentistry, the surface properties of graft materials can significantly affect cell attachment and proliferation, thereby impacting treatment outcomes and overall healing in periodontal regeneration procedures.
17) Nature:
'Nature' in this context could pertain to the inherent characteristics or qualities of the treatment materials used, such as the biological efficacy and compatibility of hyaluronan and nano hydroxyapatite in promoting periodontal regeneration. Understanding the natural properties of these materials is crucial in designing effective grafts.
18) Medium:
In a scientific context, 'medium' often describes the substances used as a vehicle for delivering therapeutic agents, such as hyaluronan's medium-weight forms that exhibit bacterial inhibition. These mediums play significant roles in the delivery and effectiveness of treatments targeting specific pathogens in periodontal therapy.
19) Observation:
The term 'observation' refers to the act of monitoring or measuring characteristics or outcomes. In clinical studies, careful observation of patient responses to interventions, such as changes in probing depth or attachment levels, forms the basis for evaluating the efficacy of treatments administered in periodontal cases.
20) Discussion:
'Discussion' represents a section in scientific research where findings are interpreted and contextualized. In the study, the discussion elaborates on how the results compare with existing literature, addresses clinical implications, and explores the significance of the observed outcomes, thereby enhancing understanding within the dental community.
21) Tamilnadu (Tamil-nadu):
Tamil Nadu is a state in southern India relevant to the study’s location, and it may impact the demographic results and cultural considerations in treatment acceptance and compliance. Understanding regional aspects like population characteristics can help inform more tailored approaches to periodontal disease management.
22) Jagannatha (Jagannath, Jagat-natha):
Jagannatha refers to P.S. Jagannatha, the statistician credited for conducting statistical analyses in the study. His expertise would be crucial for ensuring that the data supporting the treatment's efficacy is robust and accurately interpreted, lending credibility to the study’s findings.
23) Similarity:
'Similarity' refers to the degree to which two or more entities share characteristics. Understanding the similarities among different studies on periodontal treatments allows researchers to draw conclusions on efficacy across varied contexts, guiding practitioners on best practices regarding hyaluronan-nano hydroxyapatite graft applications.
24) Knowledge:
In this context, 'knowledge' pertains to the information and understanding gathered through research. Expanding knowledge on the effectiveness of new materials in regenerative dentistry is essential for clinicians in making informed decisions regarding treatment options for patients suffering from chronic periodontitis.
25) Substance:
The term 'substance' refers to a specific material or combination of materials with distinct properties. In the study, the substances hyaluronan and nano hydroxyapatite are evaluated for their roles in promoting healing and regeneration, emphasizing the importance of selecting effective substances in clinical treatments.
26) Dressing:
A 'dressing' is a sterile covering placed over a wound to protect it from infection and promote healing. In post-surgical periodontal procedures, the choice and application of a suitable dressing can greatly influence patient recovery, reinforcing the importance of comprehensive post-operative care strategies.
27) Pregnant:
The term 'pregnant' describes a condition in which a woman carries a developing fetus. In clinical studies, pregnant individuals are typically excluded from trials due to potential risks associated with treatments, which safeguards both maternal and fetal health, particularly in invasive procedures like periodontal surgeries.
28) Incision:
An 'incision' is a cut made during surgical procedures. In the context of periodontal surgery, precise incisions are vital for accessing the underlying tissues and ensuring effective treatment of defects, making the technique and skill involved essential components of successful surgical outcomes.
29) Chennai:
Chennai is the capital city of Tamil Nadu, India, and serves as the research location for this study. The city’s healthcare facilities and patient demographics are likely to influence the outcomes, highlighting its role in offering insights specific to the region's dental health challenges.
30) Quality:
The term 'quality' refers to the standard of something as measured against other things. In clinical research, assessing the quality of graft materials and surgical techniques is crucial for establishing their effectiveness and safety, ultimately impacting patient outcomes and satisfaction in periodontal care.
31) Mineral:
In the context of this research, 'mineral' refers to naturally occurring inorganic substances that comprise materials like hydroxyapatite, a key component of bone grafts. Understanding the role of minerals in tissue regeneration helps in developing effective strategies for periodontal disease treatment.
32) Reason:
The term 'reason' pertains to a cause or explanation for an action or phenomenon. In this study, reasons for using hyaluronan-nano hydroxyapatite composites are underscored by their potential to enhance periodontal regeneration, providing justifications for selecting these materials in clinical practice.
33) Visit:
A 'visit' refers to the scheduled appointments patients have with their healthcare providers, particularly post-treatment follow-ups. Regular visits in periodontal care are essential for monitoring healing progress, assessing clinical parameters, and ensuring timely interventions for optimal health outcomes.
34) Tamil:
Tamil refers to the ethnic and linguistic group primarily found in the Indian state of Tamil Nadu. The cultural context of Tamil speakers may influence perceptions and practices regarding oral health, which is important for tailoring effective patient education and treatment plans within diverse communities.
35) Nadu:
Nadu, part of the term Tamil Nadu, refers to the region itself, enhancing our understanding of the socio-cultural factors influencing health behaviors and treatment acceptance. Knowledge of local characteristics aids healthcare providers in customizing their approaches to effectively address the health needs of residents.
36) Silk:
'Silk' refers to the material used for sutures in surgical procedures. In periodontal surgery, such sutures provide effective wound closure, promoting healing and minimizing complications. The choice of suture material directly impacts recovery times and surgical outcomes in periodontal treatments.
37) Drug:
'Drug' pertains to any substance that alters physiological functions, typically for therapeutic purposes. In periodontal treatments, the use of therapeutic drugs, including antibiotics, is crucial for managing infections and enhancing healing post-surgery, reinforcing the significance of pharmacological interventions in comprehensive dental care.
38) Dish (Dis):
A 'dish' in a laboratory context refers to a small, shallow container used for various purposes such as mixing substances. In this study’s methodology, dishes were used to combine graft materials with hyaluronan, showcasing practical methods employed in preparing composite grafts for periodontal surgery.
39) Life:
The term 'life' encompasses the physical well-being and existence of individuals. In the context of health studies, such as those addressing chronic diseases like periodontitis, improving the quality of life through effective treatments highlights the core goal of clinical research — enhancing patient outcomes over the long term.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Evaluation of hyaluronan-nano hydroxyapatite in periodontal defects’. Further sources in the context of Science might help you critically compare this page with similair documents:
Statistical Significance, Statistical analysis used, Gingival index, Gingival Bleeding Index, Mesenchymal cells, Probing pocket depth, Clinical attachment level, Chronic periodontitis patients.