title: The antioxidant and anti-inflammatory efficiency of hyaluronic acid after third molar extraction.
abstract: OBJECTIVE
  Hyaluronic acid (HA) has a number of clinical applications in current practice. Therefore, correlation of HA with free radicals and inflammatory cells is clinically important. The purpose of this study is to measure the efficacy of high molecular weight HA on the oxidative stress of oral wounds (glutathione (GSH) and lipid peroxidation (LPO) levels), the inflammatory reaction (leucocytes, collagen and angiogenesis content), pain (visual analogue scale (VAS) records) and trismus (maximum interincisal opening (MIO) records) after third molar (M3) extraction.
  
  
  METHODS
  40 patients were included in this study. 0.2 ml 0.8% HA was applied immediately after surgery within the HA group (n = 20). Nothing was applied to the control group (n = 20). The primary outcome variables were the changes in the inflammatory reaction (leucocyte, angiogenesis and collagen content), oxidative stress (GSH, LPO) and clinical parameters (VAS, MIO). Results were compared immediately after extraction (T0) and 1 week after surgery (T1). Bivariate analyses were used to assess the differences between the HA and control groups for each study variable.
  
  
  RESULTS
  There was a statistically significant difference of leucocyte infiltration and angiogenesis between the groups at T1. The HA group showed less leucocyte infiltration and more angiogenesis than the control group. There was no statistically significant difference in oxidative stress, VAS or MIO levels between the groups.
  
  
  CONCLUSIONS
  Our results confirm the hypothesis that HA has an anti-inflammatory effect following M3 extraction. However, the oxidative stress levels and clinical outcomes were similar after one week. Further studies examining these parameters at different times are necessary.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey. Electronic address: gocmengokhan@hotmail.com.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Gocmen
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Gonul
authors.affiliation: Department of Biochemistry, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey.
authors.forename: Nihal Sehkar
authors.initials: NS
authors.lastname: Oktay
authors.affiliation: Department of Biochemistry, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey.
authors.forename: Aysen
authors.initials: A
authors.lastname: Yarat
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Goker
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use*; D003094:Collagen / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005978:Glutathione / Q000187:drug effects; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007962:Leukocytes / Q000187:drug effects; D015227:Lipid Peroxidation / Q000187:drug effects; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D018919:Neovascularization, Physiologic / Q000187:drug effects; D018384:Oxidative Stress / Q000187:drug effects; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control; D016059:Range of Motion, Articular / Q000187:drug effects; D014081:Tooth Extraction / Q000379:methods*; D014095:Tooth, Impacted / Q000601:surgery; D016896:Treatment Outcome; D014313:Trismus / Q000517:prevention & control; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D006820:Hyaluronic Acid; D003094:Collagen; D005978:Glutathione
keywords: Hyaluronic acid; Third molar extraction; Wound healing