Quelle est l’utilisation de l’acide hyaluronique dans les produits de soins buccodentaires?

Acide hyaluronique is a linear polysaccharide composed of D-glucuronic acid and N-acetylglucosamine units linked by glycosidic bonds. Its commercial form is primarily its sodium salt, known as ‘sodium hyaluronate.’ Hyaluronic acid is a major component of the intercellular matrix and extracellular matrix, widely distributed throughout human tissues. It is most abundant in the dermis layer of human skin and in joint synovial fluid. Due to its excellent moisturising properties, viscoelasticity, and biocompatibility, hyaluronic acid has been widely applied in the fields of medicine, cosmetics, and functional foods. In the cosmetics industry, it primarily serves functions such as moisturisation, repair, and delaying skin ageing. Currently, hyaluronic acid is being used as a new functional ingredient in oral care products such as toothpaste and mouthwash.

1 la relation entre l’acide hyaluronique et la cavité buccale

In oral tissues, the hyaluronic acid content in periodontal soft tissues, gingiva, and periodontal ligaments is higher than in hard tissues such as alveolar bone and cementum. The tissue structure of oral mucosa is similar to that of skin, consisting of epithelium and a lamina propria, with hyaluronic acid primarily present in the lamina propria [1-3]. Xing Roudong et al. [4] used an enzyme-linked immunosorbent assay (ELISA) to measure hyaluronic acid levels in saliva from healthy individuals, finding that total saliva hyaluronic acid levels ranged approximately from 136 to 587 ng/mL, while the concentration in parotid gland fluid was approximately 63–158 ng/mL. The high concentration of hyaluronic acid in saliva may facilitate rapid wound healing without scarring, as well as lubricate and protect the oral mucosa. Yang Guofeng et al. [5] found that hyaluronic acid exhibits time- and space-specific expression during tooth germ development, first appearing in the thickened tooth plate epithelium, then in the intercellular spaces of epithelial cells in the central region of tooth buds during the budding stage, followed by expression in the intercellular spaces of cells in the stellate network layer of the tooth germ and in the intercellular spaces of odontoblastic mesenchymal cells, suggesting that hyaluronic acid may be closely associated with tooth germ morphogenesis.

In recent years, with the deepening of basic Recherche sur l’acide hyaluroniqueand the accumulation of clinical experience, its anti-inflammatory, antibacterial, osteogenic, anti-edema, and wound-healing properties have been increasingly discovered and applied in the treatment of oral diseases. Numerous studies both domestically and internationally have shown that hyaluronic acid has a good auxiliary effect in the treatment of periodontal diseases, oral mucosal diseases, and dental pulp diseases [6]. and it has also found relatively widespread application in the field of oral and maxillofacial surgery [7]. However, there are few reports on the use of hyaluronic acid in oral care.

Oral care is an important means of maintaining oral hygiene, preventing or alleviating oral diseases, and improving oral health [8]. Oral care products primarily include toothpaste, toothbrushes, mouthwash, and other oral care items, with toothpaste accounting for approximately 65% of the market share, toothbrushes for approximately 25%, and mouthwash for approximately 5% [9]. Oral health is an important component of overall human health. With the continuous improvement of living standards and the upgrading of consumption awareness, the quality and functionality of oral care products have become a growing focus for consumers. Traditional products primarily emphasise the prevention of dental issues, with functions such as cleaning teeth, preventing cavities, alleviating tooth sensitivity, and inhibiting plaque formation. In recent years, products targeting oral issues such as alleviating gum problems, repairing oral mucosa, reducing oral odour, and maintaining oral health have gained greater market acceptance [10]. Hyaluronic acid, a natural active ingredient with moisturising, anti-inflammatory, and repairing properties, offers new possibilities for upgrading oral care products.

2 bienfaits pour les soins buccodentaires de l’acide hyaluronique

2.1 hydrater la cavité buccale et soulager la bouche sèche

Les adultes normaux produisent 1 000 à 1 500 mL de salive par jour. Lorsque le taux de sécrétion de salive est inférieur à la somme du taux d’absorption de la salive par la muqueuse buccale et du taux d’évaporation de la salive, le corps subit une sécheresse buccale ou une sensation [11]. La prévalence de la xérostomie varie de 5,5% à 46%, augmentant avec l’âge, et chez les personnes de plus de 65 ans, le taux d’incidence est d’environ 30% à 40% [12]. En outre, la xérostomie peut être associée à des dommages aux glandes salivaires causés par certaines maladies ou leurs traitements. La sécheresse buccale peut rendre les tissus mous buccaux comme les muqueuses buccales et les tissus gingivaux plus sensibles aux dommages physiques, chimiques ou biologiques. Une bouche sèche prolongée peut modifier l’environnement buccal, entraînant une halitose, une inflammation buccale et, dans les cas graves, peut affecter la parole et causer des difficultés à avaler.

Hyaluronic acid molecules are linear single chains, with each disaccharide unit containing a carboxyl group. Under physiological conditions, they dissociate into negative ions, which repel each other at equal distances, causing the molecules to highly extend in aqueous solutions, resembling ‘molecular sponges.’ Water molecules bind to hyaluronic acid molecules through polar bonds and hydrogen bonds within this space, enabling hyaluronic acid to absorb and retain water equivalent to 1,000 times its own weight. Wang Bing et al. [13] utilised the excellent moisture-retaining properties of hyaluronic acid for the treatment and relief of oral dryness. By comparing saliva volumes before and after use, they demonstrated that formulations containing hyaluronic acid exhibit sustained oral moisturising effects, while being non-toxic, odourless, and having a pleasant taste.

Meng Xiangjing et al. [14] utiliséhyaluronic acid as one of the active ingredients in a formulation to alleviate dry mouth symptoms, effectively reducing chronic and temporary dry mouth caused by diseases, medication use, chemotherapy, and aging, while lubricating the oral cavity and maintaining oral moisture. Colgate-Palmolive Company' S. Pielke et al. [15] ont déposé une demande de brevet pour une composition de dentifrice pour le traitement de la sécheresse buccale, l’ajout d’acide hyaluronique au dentifrice et les rinçages buccaux pour maintenir l’humidité, prévenir et améliorer la sécheresse buccale.

2.2 inhiber la plaque dentaire et améliorer la santé des gencives

La gingivite induite par la parodontite est une maladie infectieuse chronique du tissu des gencives causée par des microorganismes pathogènes qui sert de précurseur à la parodontite. Si elle n’est pas traitée rapidement et complètement, l’inflammation des gencives peut évoluer vers la parodontite sous l’influence de facteurs internes et externes, ce qui pose des risques importants pour la santé buccodentaire et générale.

Huang Jiao [16] used the paper disc diffusion method to study the antibacterial activity of hyaluronic acid against four of the most common periodontal pathogens. The results showed that at a concentration of 2 mg/mL, hyaluronic acid exhibited inhibitory effects against Porphyromonas gingivalis (P. gingivalis, P.g), Actinomyces actinomysetum (A. actinomycetemcomitans, A.a), Prevotella intermedia (P.i), and Fusobacterium nucleatum (F.n), with inhibition zones of 2 mm in diameter. At a concentration of 1 mg/mL, hyaluronic acid still inhibited P.g and P.i, but the inhibitory effect on P.i was weaker, forming only a 1 mm inhibition zone.

Munerah Bins et al. [17] conducted an in vitro antibacterial test to compare the inhibitory effects of 0.2% chlorhexidine and 0.8% hyaluronic acid on P.g. The results showed that the 0.8% hyaluronic acid group exhibited a significant decrease in P.g colony counts at 24 h, 48 h, and 72 h; the 0.2% chlorhexidine group showed a significant decrease in P.g colony counts only at 72 h, and the colony counts at 48 and 72 hours were higher than those in the 0.8% hyaluronic acid group, indicating that 0.8% hyaluronic acid has superior in vitro inhibitory activity against P.g compared to 0.2% chlorhexidine.

Chlorhexidine is the most commonly used antimicrobial component in mouthwashes, but it also has side effects such as mucosal irritation, dryness, and staining. How to use hyaluronic acid as an alternative component or reduce its dosage has attracted increasing attention from researchers. Begum Gizligoz et al. [18] selected 33 healthy participants and employed a randomised, double-blind, crossover clinical study design, using plaque index (PI), gingival index (MGI), and gingival crevicular fluid volume (GCF) as evaluation criteria to assess the oral hygiene efficacy of 0.025% hyaluronic acid mouthwash, 0.2% chlorhexidine mouthwash, and pure water. The results showed that hyaluronic acid had a slightly lower plaque-inhibiting effect than chlorhexidine; the improvement effects of hyaluronic acid on MGI and GCF were similar to those of chlorhexidine; compared with pure water and chlorhexidine mouthwash, hyaluronic acid mouthwash had a better taste and could alleviate irritation, burning sensation, dry mouth, and numbness.

Ali A. Abdulkareem et al. [19] selected 75 dental students with plaque gingivitis and evaluated three commercially available products—0.12% chlorhexidine mouthwash, 0.025% hyaluronic acid mouthwash, and an antioxidant mouthwash—and obtained similar results. All three mouthwashes significantly improved gingival bleeding. Although chlorhexidine mouthwash had the strongest inhibitory effect on plaque, participants preferred the hyaluronic acid mouthwash. Some researchers have also combined hyaluronic acid with chlorhexidine to enhance their effects. Genovesi et al. [20] added 0.12% hyaluronic acid to 0.12% chlorhexidine mouthwash and found that adding hyaluronic acid to the mouthwash significantly inhibited plaque formation compared to using chlorhexidine alone.

In the field of oral medicine, hyaluronic acid also plays an important regulatory role in the inflammatory process: inhibiting the levels of prostaglandin E2; suppressing the chemotaxis and migration of inflammatory cells; inhibiting the phagocytic activity of phagocytes; and scavenging prostaglandins, metalloproteinases, and reactive oxygen species produced by inflammatory cells [21]. Additionally, Chen et al. [22] found that hyaluronic acid with a molecular weight of 1,300 kDa at a concentration of 5 mg/mL significantly reduced the production of inflammatory factors IL-6, IL-8, IL-1β, IL-4, IL-10, with inhibition rates of 80.17%, 69.07%, 88.61%, 84.56%, and 84.66%, respectively. Zhang Huwei et al. [23] investigated the efficacy of a toothpaste containing bioactive hyaluronic acid in improving gingivitis. The results showed that a toothpaste containing 2% bioactive hyaluronic acid could significantly alleviate common symptoms of gingivitis, such as gum discomfort, swelling, and bad breath, and improve clinical signs such as gum bleeding and gum colour within a short period. Lei Xiquan et al. [24] disclosed a patent for a toothpaste containing hyaluronic acid and trehalose, with hyaluronic acid content ranging from 0.05% to 0.5%, providing a moist environment for the oral cavity and exhibiting moisturising and gum-protective effects.

2.3 favoriser la prolifération cellulaire et réparer les blessures buccales

La muqueuse buccale est un important système de protection du corps humain, qui protège contre les stimuli nocifs externes tout en maintenant l’intégrité fonctionnelle de l’épithélium. De mauvaises habitudes alimentaires, des maladies et d’autres facteurs peuvent endommager la muqueuse buccale. De plus, de mauvaises techniques de brossage peuvent entraîner des dommages mécaniques au tissu gingival.

Hyaluronic acid, as an endogenous component of the body, plays a crucial role in wound healing. During tissue repair, hyaluronic acid collaborates with collagen, fibrin, and other matrix molecules to form a temporary scaffold that supports cell migration and adhesion, regulating cell adhesion, migration, and differentiation. Additionally, hyaluronic acid can reduce the activity of serum proteases, slowing down the degradation rate of the extracellular matrix, thereby promoting wound healing [25]. Furthermore, hyaluronic acid has the function of promoting granulation tissue formation.

Chen Minshan et al. [22] used a human gingival cell mechanical injury repair model and found that the cell proliferation rates in the 300 kDa hyaluronic acid group and the 1,300 kDa hyaluronic acid group were significantly higher than those in the control group, indicating that hyaluronic acid can promote cell proliferation and repair gingival tissue damage. Hyaluronic acid [26] was found by Mmad H.M. et al. to significantly increase the content of hyaluronic acid and type III collagen in damaged tissues and maintain their stable presence for a certain period of time when applied to rat oral wound sites, thereby promoting wound healing and reducing scar tissue formation. Zhang Zhen [27] used a circular full-thickness defect model on the oral mucosa of the palate (φ3 mm) in SD rats to study the effects of exogenous hyaluronic acid on oral wound healing. The results indicated that hyaluronic acid promotes wound healing in the early stage, reduces inflammatory responses during the healing process, and promotes mucosal epithelial regeneration.

3 produits de soins buccodentaires disponibles dans le commerce contenant de l’acide hyaluronique

In 1998, Japanese company LION [28] disclosed a hyaluronic acid-containing oral care compound designed to inhibit bacteria causing periodontal issues, which could be formulated into toothpaste, tooth powder, mouthwash, and other oral care products. However, according to data from Mintel, the first hyaluronic acid-containing mouthwash—Japan' S Yoshida compagnie ' le «rince-bouche orale humide» n’a été lancé qu’en 2002; En 2007, le premier dentifrice contenant de l’acide hyaluronique, le «Sapphire Sensitive toothpaste», a été introduit aux Pays-Bas. Aujourd’hui, il existe près de 100 produits de soins buccodentaires contenant de l’acide hyaluronique. Accueil» Sunstar' S GUM et Ora2 ont lancé une série de produits d’hydratation orale contenant de l’acide hyaluronique dans plusieurs régions du monde; LACALUT et ORAL-O-SEPT ont introduit des produits de soin des gencives avec de l’acide hyaluronique comme ingrédient actif; Depuis 2020, le marché chinois a également vu le lancement de multiples produits de soins buccodentaires contenant de l’acide hyaluronique, y compris du dentifrice, du rince-bouche et des sprays buccaux dans diverses formulations (voir tableau 1).

4 tendances d’application de l’acide hyaluronique dans les produits de soins buccodentaires

4.1 Formulation de l’acide hyaluronique

Hyaluronic acid is a high-molecular-weight polysaccharide with a wide molecular weight range, from several thousand to several million. Different molecular weights

hyaluronic acid exhibit distinct characteristics and functions. Acide hyaluronique à poids moléculaire élevé has strong film-forming properties, forming a physical barrier on the oral mucosa surface to prevent moisture evaporation, moisturise the oral mucosa, isolate bacterial or foreign stimuli, and protect cells; low-molecular-weight hyaluronic acid can be absorbed through the skin, supplementing endogenous hyaluronic acid, and possesses deep moisturisation, free radical scavenging, oral mucosa repair, and beneficial effects on gum health.

Chen Minshan et al. [29] ont révélé une composition de soins buccodentaires multifonctionnelle contenant unMélange d’acide hyaluronique, combinant l’acide hyaluronique de différentes tranches de poids moléculaire comme ingrédient actif principal et coformulé avec du citrate de zinc pour obtenir un effet synergique, offrant ainsi des effets bénéfiques pour le maintien quotidien de la santé buccodentaire. Feng Ning et al. [30] ont mené une étude approfondie sur les effets de l’acide hyaluronique sur les soins buccodentaires avec différents poids moléculaires et ont développé une formulation de soins buccodentaires à l’acide hyaluronique. Cette formulation est composée des composants suivants: 30 à 40% d’acide hyaluronique hydrolysé ou de ses sels d’un poids moléculaire de 2 à 5 kDa, 35 à 45% d’acide hyaluronique ou de ses sels d’un poids moléculaire de 200 à 600 kDa, et 20 à 30% d’acide hyaluronique d’un poids moléculaire de 1 300 à 1 500 kDa ou de ses sels. Les résultats de l’évaluation de l’efficacité ont indiqué que cette formulation présente des effets hydratants buccaux importants, réduit la libération de facteurs inflammatoires des cellules gingivales et répare les cellules buccales endommagées, fournissant des soins complets pour la santé buccodentaire. Il peut être appliqué sur divers produits de soins buccodentaires tels que le dentifrice, le rince-bouche et les sprays. Xu Haiyan et al. [31] ont ajouté cette formulation au dentifrice avec différentes formulations et ont examiné les propriétés physiques et chimiques du dentifrice ainsi que la teneur en acide hyaluronique. Les résultats ont montré que les propriétés physiques et chimiques du dentifrice étaient stables, que la teneur en acide hyaluronique ne diminuait pas de façon significative et qu’il était bien compatible avec d’autres matières premières et auxiliaires.

4.2 Applications novatrices des produits de soins buccodentaires

Mintel& 's February 2020 Oral Hygiene Product Innovation Report noted that incorporating oral health into the beauty category is one of the key trends in product innovation, drawing inspiration from the cosmetics market to develop fashionable packaging designs and introduce innovative product concepts. As a star ingredient in the cosmetics industry, hyaluronic acid has garnered increasing attention from oral care product developers. According to data from Mintel GNPD (Mintel Global New Product Database), hyaluronic acid-containing oral care products have seen significant growth since 2018.

Le 29 juin 2020, China's ‘Regulations on the Supervision and Administration of Cosmetics’ were officially implemented, stipulating for the first time that ‘toothpaste shall be managed in accordance with the relevant provisions of these regulations for ordinary cosmetics.’ This policy adjustment will also promote cross-industry integration between beauty and skincare and oral care in the Chinese market, and hyaluronic acid, as a natural, multi-functional ingredient, will have greater application opportunities.

Référence:

[1] DAHIYA P, KAMAL R. Hyaluronic acid: a boon in periodontal therapy [J]. North American Journal of Medical Science, 2013 (5):309-315.

[2] IJUIN C, OHNO S, TANIMOTO K, et al. Régulation de l’expression du gène hyaluronan synthase dans les cellules du ligament parodontal humain par le facteur de nécrose tumorale alpha, l’interleukine-1beta et l’interféron - gamma [J]. Archives of Oral Biology, 2001 (46):767-772.

[3] BIAN ZHUAN. Biologie orale, pour la stomatologie, 4e édition [M]. Pékin: People' S Medical Publishing House, 2012:42-50.

[4] XING RUDONG, ZHANG SHIGUO, CHANG SHIMIN. Détection des niveaux d’acide hyaluronique dans les saliv [J] humains en bonne santé. Journal of Modern Stomatology, 2001, 15(3) :176-178.

[5] YANG GUOFENG, MO SHENZHENG, JIANG BEIZHAN. Expression temporelle et spatiale de l’acide hyaluronique dans les premiers germes molaires mandibulaires de la souris [J]. Journal of Oral Science Research, 2015, 31(7) :58-661.

[6] ZHANG YIDING, CHENG XINGQUN, WU HONGKUN. L’application d’acide hyaluronique dans le traitement des maladies buccodentaires [J]. Chinese Journal of Geriatric Dentistry, 2019, 17(2) :108-112.

[7] ZHANG ZHEN, WANG XIAOFEI. L’acide hyaluronique et sa recherche et son application en chirurgie buccale et maxillo-faciale [J]. Stomatology, 2020, 40(2) :176-179.

[8] XIANG JIANQIANG. Histoire et évolution de l’industrie des soins buccodentaires en Chine [J]. Détergent & Cosmetics, 2013, 36(2) :1-8.

[9] Science and technology information research group of China Oral Care Industry Association. Le dernier développement et la perspective de la technologie de produit dans le nettoyage oral & Industrie des soins [J]. Oral Care Industry, 2018, 28(2):37-40.

[10] XU CHUNSHENG. Situation actuelle et tendance du développement technologique des produits de soins buccodentaires en Chine [J]. Détergent & Cosmetics, 2019, 42(8) :11-16.

[11] ZHANG YING, CUI DAN. Évaluation clinique et contre-mesures de la xérostomie [J]. Chinese Journal of Practical Stomatology, 2017, 10(9) :530-534.

[12] n rhi T O. prévalence des sentiments subjectifs de bouche sèche chez les personnes âgées [J]. Journal of Dental Research, 1994, 73(1):20-25.

[13] WANG BIN, XING YANPING, FAN XUE, et al. Application d’acide hyaluronique et d’hyaluronate dans la préparation d’une composition pour traiter et atténuer la xérostomie: CN103405470A [P]. 27 septembre 2013.

[14] MENG XIANGJING, LIU SHAOYING, ZONG GONGLI, et al. Composition pour soulager la xérostomie et son procédé de préparation: CN105267234A [P]. Le 27 janvier 2016.

[15] MASTERS J G, SHIRA P. compositions Dentifrice pour traiter la xérostomie: CN101795686A [P]. Le 04 août 2010.

[16] HUANG JIAO. L’étude de l’effet du gel Gengigel dans le traitement de la gingivite induite par la peste [D]. Chengdu: université du Sichuan, 2004.

[17] MUN ERA H B, KAW THER A, FITOON A, et al. Efficacité antimicrobienne de 0,8% d’acide hyaluronique et 0,2% de chlorhexidine contre les souches de Porphyromonas gingivalis: une étude in vitro [J]. Pakistan Journal of Medical Sciences, 2020, 36(2):111-114.

[18] BEGUM G, GIZEM I K, OGUL L T et al. Effet inhibiteur de la Plaque d’un rince-bouche contenant de l’hyaluronan dans un modèle de 4 jours sans brossage [J]. Santé buccodentaire & Préventive Dentistry, 2020, 18(1):61-69.

[19] ALI AA, ZAID A M, HAYDER R A, et al. Un essai clinique randomisé en double aveugle visant à évaluer l’efficacité de la chlorhexidine, des antioxydants et des bains de bouche à l’acide hyaluronique dans la gestion de la gingivite induite par un biofilm [J]. International Journal of Dental Hygiene, 2020 (1) :1-10.

[20] GENOVESIA, BARONEA, TOTI P, et al. L’efficacité de 0,12% de chlorhexidine versus 0,12% de chlorhexidine plus acide hyaluronique rince-bouche sur la guérison des zones d’insertion submergées d’un seul implant: un essai clinique contrôlé randomisé à court terme [J]. International Journal of Dental Hygiene, 2017, 15(1) :65-72.

[21] SUN CHUNYAN, CHEN XUE, LIN LI. Application de l’acide hyaluronique à la médecine orale [J]. Chinese Journal of Practical Stomatology, 2013, 6(1) :56-59.

[22] CHEN MINSHAN, LI LIN, WANG ZHENSHI et al. L’acide hyaluronique de poids moléculaire élevé régule l’inflammation et la migration induites par P. gingivalis dans les fibroblastes gingivaux humains par la voie de signalisation MAPK et NF-kappaB [J]. Archives de biologie orale, 2019(98):75-80.

[23] ZHANG HUAWEI, WEI WANGRONG, CHENG XIFANG et al. Étudier l’effet de l’activité biologique du traitement par brossage à l’acide hyaluronique de la gingivite [J]. Journal of Clinical Medical Literature, 2015, 23(2):4808-4809.

[24] LEI XIQUAN, GUAN YUYU, PENG XIUQING. Dentifrice contenant de l’acide hyaluronique et du trehalose et son procédé de préparation: CN110123702A [P]. Le 16 septembre 2019.

[25] PROSDOCIMI M, BEVILACQUA C. L’acide hyaluronique exogène et la cicatrisation des plaies: une vision actualisée [J]. Panminerva Medica, 2012, 54(2) :129-135.

[26] HAMMAD H M, HAMMAD M, ABDELHADI I N, et al. Effets des agents appliqués localement sur la cicatrisation intra-buccale des plaies dans un modèle de rat: étude clinique et histomorphométrique [J]. International Journal of Dental Hygiene, 2011, 9(1):9-16.

[27] ZHANG ZHEN. Étude histomorphologique sur l’effet de l’acide hyaluronique sur la cicatrisation buccale des plaies chez le rat [D]. Taiyuan: université de médecine du Shanxi, 2019.

[28] MORISHIMA SEIJI, OKADA TOSHIMOCHI, YOSHIKAWA MASARU. Composition pour cavité buccale: JPH10182390A [P]. 1998-07-07.

[29] CHEN MINSHAN, WANG ZHENSHI, LI LIN et al. Composition de cavité buccale à effets multiples contenant un mélange d’acide hyaluronique et son application: CN107536725A [P]. Date de sortie: 2018-01-05.

[30] FENG NING, ZONG WENBIN, MAO HUA, et al. Composition de soins buccodentaires en acide hyaluronique ainsi que son procédé de préparation et son application: CN110585062A [P]. Le 20 décembre 2019.

[31] XU HAIYAN, WANG HAIYING, XIAO XIAOHONG, et autres. Application d’acide hyaluronique dans le dentifrice [J]. Oral Care Industry, 2019, 29(2) :6-10.