Hyaluronic Acid

What is hyaluronic acid?

High molecular weight hyaluronic acid (HA) is a natural physiological constituent of connective tissue. It plays a critical role in the collagen-making process. Made up mostly of collagen, it is one of the major components of the human body. HA is the most abundant high molecular weight glycosaminoglycan of healthy soft periodontal tissues.⁴ It is active in tissue regeneration and influences the migration of fibroblasts and fibrinogenesis, thus making the healing of tissue easier. It performs 3 synergistic effects: anti-inflammatory, accelerates the healing process and provides a protective barrier.

Contributing to the barrier function and tensile strength of the periodontal ligament, HA is essential for healthy gingival tissues. In the initial stage of inflammation and periodontal disease, tissue’s requirement for HA increases by 200%, demonstrating its central role in regulating cell turnover and optimizing tissue regeneration. When lacking HA, healing will be delayed and inflammation will continue

Phases of Hyaluronic Acid in Tissue Healing

1. ANTI-INFLAMMATORY PHASE
   • Enhanced inflammatory cell and extracellular matrix cell infiltration into the inflamed site
   • Elevation of pro-inflammatory cytokine production by damaged tissue
   • Stabilizes granulation tissue matrix
   • Scavenges free radicals such as superoxide (O2) and hydroxyl radical (OH)
   • Inhibition of inflammatory cell-derived proteinases
2. GRANULATION PHASE
   • Increases organisation of the granulation tissue matrix
   • Increases extracellular matrix cell proliferation
   • Increases inflammatory cell and extracellular matrix cell migration
   • Increases blood vessel formation (angiogenesis)
3. REPARATIVE PHASE
   • Increased fibroblasts and collagen
   • Fibrous tissue formation
   • Migration and proliferation of keratinocytes
   • Rapid epithelialisation and wound healing