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交联透明质酸与掺钕钇铝石榴石激光用于口腔软组织再生:一种新手术技术的提议

Cross-Linked Hyaluronic Acid and Neodymium-Doped Yttrium Aluminum Garnet Laser for Oral Soft Tissue Regeneration: A Proposal of a New Surgical Technique.

作者信息

Iaria Roberta, Vescovi Paolo, Corcione Luigi, Sala Roberto, Giovannacci Ilaria

机构信息

Department of Medicine and Surgery, University of Parma, Parma, ITA.

出版信息

Cureus. 2025 Jul 30;17(7):e89045. doi: 10.7759/cureus.89045. eCollection 2025 Jul.

DOI:10.7759/cureus.89045
PMID:40896018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12395392/
Abstract

Hyaluronic acid is an endogenous molecule that acts by regulating several cellular processes, including proliferation, migration, and morphogenesis. The positive effect of this molecule on hard tissue and soft tissue regeneration is well-documented in the literature, as it actively participates in the process of tissue inflammation, thereby minimizing the damaging effects of the immune cell response on tissues. The cross-linked form of hyaluronic acid, obtained through modifications of the chemical structure of the native form, is characterized by a high capacity to resist mechanical stress and slow biodegradation, improving the clinical performance of this molecule. This article proposes a review of the literature concerning the use of cross-linked hyaluronic acid in oral soft tissue regeneration. It also reports the clinical case of an in situ carcinoma of the tongue margin managed surgically through an innovative technique that combines the use of neodymium laser surgery, cross-linked hyaluronic acid gel, and a porcine pericardium resorbable membrane. The literature was searched through the following electronic databases: MEDLINE, Scopus, Web of Science, and Cochrane Library. Follow-ups of the clinical case described showed rapid and uniform healing of the surgical site. Although the observations are limited to a single case and do not allow for objective conclusions to be drawn about the effectiveness of the proposed surgical technique, the reported results appear favorable, apparently supporting the beneficial effect of the innovative approach on the healing of surgical wounds in the oral mucosa.

摘要

透明质酸是一种内源性分子,通过调节多种细胞过程发挥作用,包括增殖、迁移和形态发生。该分子对硬组织和软组织再生的积极作用在文献中有充分记载,因为它积极参与组织炎症过程,从而将免疫细胞反应对组织的破坏作用降至最低。通过对天然形式的化学结构进行修饰而获得的交联形式的透明质酸,具有高抗机械应力能力和缓慢生物降解的特点,改善了该分子的临床性能。本文对有关交联透明质酸在口腔软组织再生中的应用的文献进行了综述。它还报告了一例舌缘原位癌的临床病例,该病例通过一种创新技术进行手术治疗,该技术结合了钕激光手术、交联透明质酸凝胶和猪心包可吸收膜的使用。通过以下电子数据库检索文献:MEDLINE、Scopus、科学网和考克兰图书馆。对所描述临床病例的随访显示手术部位迅速且均匀地愈合。尽管观察仅限于单个病例,无法就所提议手术技术的有效性得出客观结论,但报告的结果似乎是有利的,显然支持了这种创新方法对口腔黏膜手术伤口愈合的有益作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/9fcd0d618710/cureus-0017-00000089045-i12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/51ea5276cd1d/cureus-0017-00000089045-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/7229324d3826/cureus-0017-00000089045-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/7052627abedb/cureus-0017-00000089045-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/e71f7529d438/cureus-0017-00000089045-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/26bb11aa07b8/cureus-0017-00000089045-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/cb27f70603ca/cureus-0017-00000089045-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/72cc05b7196b/cureus-0017-00000089045-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/b2b5d3d15304/cureus-0017-00000089045-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/4f791e06f8b7/cureus-0017-00000089045-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/4ece9178867e/cureus-0017-00000089045-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/3461c3687ba9/cureus-0017-00000089045-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/9fcd0d618710/cureus-0017-00000089045-i12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/51ea5276cd1d/cureus-0017-00000089045-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/7229324d3826/cureus-0017-00000089045-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/7052627abedb/cureus-0017-00000089045-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/e71f7529d438/cureus-0017-00000089045-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/26bb11aa07b8/cureus-0017-00000089045-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/cb27f70603ca/cureus-0017-00000089045-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/72cc05b7196b/cureus-0017-00000089045-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/b2b5d3d15304/cureus-0017-00000089045-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/4f791e06f8b7/cureus-0017-00000089045-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/4ece9178867e/cureus-0017-00000089045-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/3461c3687ba9/cureus-0017-00000089045-i11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7757/12395392/9fcd0d618710/cureus-0017-00000089045-i12.jpg

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本文引用的文献

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BMC Oral Health. 2025 Mar 13;25(1):378. doi: 10.1186/s12903-025-05701-3.
2
The "HAT-TRICK" technique: A modification of soft tissue grafting using volume stable collagen matrix and cross-linked hyaluronic acid. Part B: Clinical applications in the esthetic zone.“帽子戏法”技术:一种使用体积稳定的胶原基质和交联透明质酸的软组织移植改良技术。B部分:美学区域的临床应用。
J Stomatol Oral Maxillofac Surg. 2025 Sep;126(4S):102229. doi: 10.1016/j.jormas.2025.102229. Epub 2025 Jan 11.
3
RNA Sequencing Revealed a Weak Response of Gingival Fibroblasts Exposed to Hyaluronic Acid.RNA测序揭示了暴露于透明质酸的牙龈成纤维细胞的微弱反应。
Bioengineering (Basel). 2024 Dec 23;11(12):1307. doi: 10.3390/bioengineering11121307.
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Reconstructive surgical therapy of peri-implant defects with ribose cross-linked collagen matrix and crosslinked hyaluronic acid - a prospective case series.采用核糖交联胶原蛋白基质和交联透明质酸对种植体周围缺损进行重建性外科治疗 - 一项前瞻性病例系列研究。
Clin Oral Investig. 2024 Sep 20;28(10):536. doi: 10.1007/s00784-024-05942-6.
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