Esterified hyaluronic acid and autologous bone in the surgical correction of the infra-bone defects

Abstract

We study the osteoinductive effect of the hyaluronic acid (HA) by using an esterified low-molecular HA preparation (EHA) as a coadjuvant in the grafting processes to produce bone-like tissue in the presence of employing autologous bone obtained from intra-oral sites, to treat infra-bone defects without covering membrane. We report on 9 patients with periodontal defects treated by EHA and autologous grafting (4 males and 5 females, all non smokers, with a mean age of 43.8 years for females, 40.0 years for males and 42 years for all the group, in good health) with a mean depth of 8.3 mm of the infra-bone defects, as revealed by intra-operative probes. Data were obtained at baseline before treatment and after 10 days, and subsequently at 6, 9, and 24 months after treatment. Clinical results showed a mean gain hi clinical attachment (gCAL) of 2.6mm of the treated sites, confirmed by radiographic evaluation. Such results suggest that autologous bone combined with EHA seems to have good capabilities in accelerating new bone formation in the infra-bone defects.

Keywords: Guided tissue regeneration; Hyaluronic acid; biomaterials.; bone graft.

Fig 1

Pre-operative periapical radiography

Fig 2

Initial probing

Fig 3

Surgical flap

Fig 4

Flap elevation, intra-surgical evaluation of the parameters and surgical curettage of the intra-osseous defect

Fig 5

Autogenous bone graft harvested by a mini-bone scraper (Safescraper curve or Micross)

Fig 6

Autogenous bone graft mixed with Hyaloss® matrix

Fig 7

Flap replacement and nylon 4-0 single stitches sutures.

Fig 8

Flap replacement and nylon 4-0 single stitches sutures.

Fig 9

Clinical re-evaluation 10 days after surgery

Fig 10

Clinical re-evaluation 6 months after surgery

Fig 11

Radiographic re-evaluation 6 months from surgery

Fig 12

Clinical re-evaluation 9 months after surgery

Fig 13

Radiographic follow up at 9 months after surgery

Fig 14

Clinical re-evaluation 24 months after surgery

Fig 15

Radiographic follow up at 24 months after surgery