Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Oral Mukozanın İnsizyonel Yara İyileşmesinde Hyaluronik Asit Jel Uygulamasının Etkileri: Deneysel Çalışma
Effects of Hyaluronic Acid Gel Application on Incisional Oral Mucosal Wound Healing: An Experimental Study
Yener OĞUZa , Nurettin DİKERb , Serap GÜLSEVERc, Eda YILMAZ AKÇAYd
aSerbest Diş Hekimi, Dubai, Birleşik Arap Emirlikleri
bBezmialem Vakıf Üniversitesi Diş Hekimliği Fakültesi ve Hastanesi, Ağız, Diş ve Çene Cerrahisi ABD, İstanbul, Türkiye
cİstanbul Medipol Üniversitesi Diş Hekimliği Fakültesi ve Hastanesi,Ağız, Diş ve Çene Cerrahisi ABD, İstanbul, Türkiye
dBaşkent Üniversitesi Tıp Fakültesi Ankara Hastanesi, Tıbbi Patoloji ABD, Ankara, Türkiye
Turkiye Klinikleri J Dental Sci. 2023;29(2):225-33
doi: 10.5336/dentalsci.2022-93774
Article Language: TR
Full Text
ÖZET
 Amaç: Hyaluronik asit (HA), ekstraselüler matrisin biyolojik olarak parçalanabilen, doğal elemanı olan bir polimeridir. Bu çalışmanın amacı, HA jel uygulamasının oral mukozanın insizyonel yara iyileşmesi üzerindeki rejeneratif etkilerinin değerlendirilmesidir. Gereç ve Yöntemler: Bu çalışmada 40 adet dişi Sprague-Dawley cinsi sıçan kullanılmıştır. Sıçanların sağ ve sol bukkal mukozalarına 10 mm uzunluğunda tam kalınlıkta mukozal kesiler yapılmıştır. Sol mukozal yaralara HA jel uygulanırken, sağ mukozal yaralar kontrol grubu olarak boş bırakılmıştır. Mukozal yaralar rezorbe olabilen süturlarla dikilmiştir. Sıçanlar takip sürelerine göre randomize olarak 4 gruba ayrılmıştır. Operasyonu takip eden 3. gün, 7. gün, 14. gün ve 21. günlerde sıçanlar sakrifiye edilip; reepitelizasyon, inflamasyon, fibroblast proliferasyonu, kollajen birikimi ve anjiyogenez histopatolojik olarak değerlendirilmiştir. Bulgular: Histopatolojik değerlendirme sonucunda, tüm iyileşme periyotlarında kontrol örneklerine kıyasla HA uygulanan örneklerinde daha yüksek fibroblast proliferasyonu ve anjiyogenez olduğu tespit edildi. Öte yandan, HA ile kontrol grubu arasında reepitelizasyon açısından istatistiksel anlamlı farklılık tespit edilememiştir. Sonuç: Histopatolojik incelemeler sonucunda elde edilen verilere göre ticari olarak temin edilebilen HA jelin, iyileşen oral mukoza yarasının bağ dokusu kalitesi ve anjiyogenezi üzerinde olumlu etkileri olduğunu ve farklı mukozal iyileşme senaryolarında faydalı olabileceğini göstermiştir. HA'nın çok sayıda potansiyel uygulama endikasyonu ve çeşitli rejeneratif özellikleri olmasına rağmen amaçlanan klinik kullanım için optimum moleküler ağırlığını, uygulama yolunu ve tedavi zamanlamasını belirlemek için daha fazla çalışma yapılmalıdır.

Anahtar Kelimeler: Anjiyogenez; hyaluronik asit; mukoz membran; yara iyileşmesi
ABSTRACT
 Objective: Hyaluronic acid (HA) is a naturally occurring biodegradable polymer of the extracellular matrix. The aim of the present study was to investigate the regenerative effects of HA gel on incisional oral mucosal wound healing. Material and Methods: Forty female Sprague-Dawley rats were used in the present study. Ten mm length, full-thickness mucosal incisions were made on the left and right buccal mucosa of the rats. Left mucosal wounds were filled with HA gel and right mucosal wounds were left empty as the control group samples. The mucosal wound was sutured with absorbable sutures. Rats were randomly divided into 4 groups according to healing time. At the end of 3. day, 7. day, 14. day and 21. days healing periods rats were euthanized. Re-epithelialization, inflammation, fibroblast proliferation, collagen deposition, and angiogenesis were investigated based on histopathological findings. Results: Histopathological analysis revealed higher fibroblast proliferation and angiogenesis in the HA samples compared with the control samples at all investigated healing periods. On the other hand, differences between re-epithelialization scores of HA samples and control samples did not reach statistical significance. Conclusion: The data and the histopathological investigations suggest that commercially available HA gel has beneficial effects of oral mucosa would healing regarding connective tissue quality, and angiogenesis of the wound. Although HA displays a great number of potential applications and regenerative properties, further studies should be carried out to define the optimum molecular weight, application route, and timing for treatment for intended clinical use.

Keywords: Angiogenesis; hyaluronic acid; mucous membrane; wound healing
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