Early Healing of Oral Soft Tissues: a Clinical and Biomolecular Analysis. Part III
Condition: Wound Heal; Wound Surgical; Oral Soft Tissue Conditions; Hyaluronic Acid
MeSH terms: Wounds and Injuries; Surgical Wound
Study type: Interventional

Summary: 
      The purpose of the present study is to evaluate the effect of Hyaluronic acid application in
      the gene expression profile and cellular behavior in the early wound healing process -24
      hours after injury- of the oral soft tissues.
    

Detailed description: 
      Although it has been demonstrated the role of HA in many different biological process related
      with tissue repair and regeneration, specific mechanisms involved in the early wound healing
      process in the oral soft tissues remains unclear.

      A recent in vitro study evaluated the effects of two HA formulations on human oral
      fibroblasts involved in soft tissue wound healing/regeneration. The authors demonstrated that
      the investigated HA formulations maintained the viability of oral fibroblasts and increased
      their proliferative and migratory abilities. Moreover, enhanced expression of genes encoding
      type III collagen and transforming growth factor-β3, characteristic of scarless wound
      healing. Interestingly, TGFB1 remains unchanged. Moreover, compared to untreated control
      cells, either HA preparation upregulated the expression levels of COL3A1 in both HPFs and
      HGFs at 24 hour, whereas no effect on COL1A1 mRNA levels was detected The HAs upregulated the
      expression of genes encoding pro-proliferative, pro-migratory, and pro-inflammatory factors,
      with only a moderate effect on the latter in gingival fibroblasts. However, in vitro
      experiments have certain limitations. HA would undergo degradation to lower MW molecules
      following hyaluronidase activity during the post-operative period and will thus exert
      additional or even opposing effects on the wound repair process.28

      To highlight, is the fact that in the latest years, the translational medicine focuses in
      research concerning scar-free wound healing tissues repair mechanisms and regarding this, it
      has been proposed that HA plays an important role in the fast and scarless fetal wound
      healing seeing during the first and second trimester.

      Therefore, the aim of the present pilot study will be to evaluate the effect of hyaluronic
      acid application on gene expression and cellular behavior in the early wound healing process
      of gingival tissues. The second aim of the present work will be to evaluate the effect of HA
      in the wound healing clinical response.

      Our hypothesis is that HA modifies the expression of genes related with the early wound
      healing response and the behavior of the main cells involved in this biological process:
      fibroblasts; stimulating and accelerating their wound healing potential.
    

Intervention name(s): periodontal surgery + 24 hr buccal attached gingiva (G) biopsy; HA application
Intervention type(s): Procedure; Other
Intervention description(s): Periodontal surgery will be performed and 24 hr after the surgical procedure a 2mm punch biopsy will be harvested at the level of the buccal attache gingiva (G).; HA will be applied at the end of the surgical procedure, at the level of the vertical released incisions (VRIs) and over VRIs
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: split-mouth design
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Basic Science
Keywords: early wound healing; gingival tissue; wound healing; hyaluronic acid; soft tissue injury