Hyaluronic acid (hyaluronan) is an indispensable component of intact, healthy gums and oral mucosal tissue. It is distributed in a selective, specific manner and tends to concentrate particularly in those layers of the gingival epithelium closest to the surface, where it acts as a barrier imparting stability and elasticity to the periodontal connective tissue.
As hyaluronic acid (hyaluronan) is a purely physiological substance devoid of any toxic or unpleasant accompanying phenomena, it can be used without restriction by children, pregnant women, diabetics, vegetarians and the elderly. In the case of inflammations and injuries, for example, hyaluronic acid is broken down and dissolved by the enzyme hyaluronidase. If oral hygiene is poor, hyaluronidase is produced and released by bacterial plaque.
The enzyme induces a loosening of the structure and a slackening of the tissue and facilitates fluid exchange between the tissue and the vascular system, causing mild oedemas to form. The enzymatic breakdown (catabolisation) of hyaluronic acid by hyaluronidase significantly increases the permeability of tissue and capillaries with the consequence that toxins, drugs and bacteria can propagate more easily. This in turn leads, amongst other things, to poor healing and tissue inflammation.
The Action By normalising the natural cohesive structure of the connective tissue (macro-aggregation of the proteoglycans), hyaluronic acid accelerates the rate of tissue reconstruction. The weakening of the mucosal tissue due to the influence of bacterial hyaluronidase is thus reduced. A further biological function of hyaluronic acid in tissue regeneration is its ability to influence both the migration of fibroblasts and fibrogenesis, with the result that scar tissue formation and wound healing are promoted.
Hyaluronic acid possesses an extremely high capacity to bind water (up to 200 times its own volume); thanks to this property, HA produces an anti-oedematous effect. The molecular structure of hyaluronic acid or, more exactly, the molecular chains formed by the glycosaminoglycans, binds not only water, but also specific proteins and their tissue polysaccharides, by means of hydrogen bond bridges, to form a viscous macro-aggregate.
Hyaluronic acid combats the inflammation caused by hyaluronidase-producing bacteria by inactivating the enzyme. Hyaluronic acid regulates cell permeability and reduces abnormally high capillary permeability. This helps to prevent infestation by infectious micro-organisms, thus inhibiting tissue destruction. (source : Ricerfarma.com)