The application of hyaluronic acid (HA) in dental treatments is relatively new, and modified-HA products can be vastly different from each other. This study aims to provide a basis for bridging specific characteristics of HA with its potential applications in dental treatments, evaluating and comparing different types of HA products and for future research on HA applications in dentistry. Information from the existing literature on HA applications has been cited. Furthermore, this study is specifically oriented to provide oral health care providers with a scientific basis for HA use along with the clinical aspects of HA. Outcomes from existing and future studies cannot be generalised for HA use in dental applications. Therefore, we have proposed a scheme to bridge HA specific characteristics to its applications in dental treatments and compare different HA products used for the same clinical application to identify the most suitable one. Highlighting the use of HA in dental treatments and providing a basis for developing new methods, protocols, and products specifically oriented for dentistry.

Introduction: Many physicians may be unfamiliar with the importance of hyaluronic acid (HA) and its physiological and biochemical functions at cellular level. Despite the vast number of published studies using HA in medical treatments, it is still difficult for the reader to clearly distinguish the different types of HA employed in different medical applications. In addition, published studies do not mention the exact type of HA used or its biochemical properties. Usually, a study mentions only its molecular weight and concentration, which are insufficient to know its exact designed properties or to make a comparison with other types of HA.Methodology: This article is intended to summarise the information about native and modified HAs with a focus on explaining their different physiological and biochemical functions in the human body, their different commercially available types, and how they affect the associated medical applications. The goal is to provide a basis to researchers and physicians for distinguishing different types of HA and their properties in order to enhance physicians’ clinical practice in terms of application of different types of HA to treatments and to help the international research community to change the reporting of HA characteristics in published papers. This is necessary to enhance future acquisition of data, with the ability to create an HA data bank for further research and as a reference for different HA types and their medical applications.Conclusion: These developments should enhance the scientific and clinical knowledge about HA. Furthermore, the overall approach in this paper can be applied to other similar substances.

Purpose: The primary objective of this study was to evaluate the efficacy, safety, and duration of action of viscosupplementation with Crespine^® Gel over a 9-month period. Materials and methods: The study was a post-marketing phase IV study. A total of 109 participants with osteoarthritis of the knee (grades 1–4) in the tibio–femoral compartment were recruited in Jordan. Data were collected from each participant during the baseline visit. Each participant received Crespine^® Gel injection, and follow-up visits took place at 3 months, 6 months, and 9 months post-injection. Main outcome measure(s): An assessment of participants by phone was conducted at 1 month, 2 months, 4 months, 5 months, 7 months, and 8 months post-injection. Western Ontario and McMaster Universities Arthritis Index questionnaires were completed during each visit. A 72-hour visit questionnaire was used to assess the safety of the injection. Statistical analysis included a two-sided 95% confidence interval for the difference between pain scores across visits, and the percent change from baseline was calculated. Main results: The full analysis included 84 participants who gave their informed consent and finished the necessary baseline and follow-up visits needed to assess efficacy and safety. Peak improvement was noted at 5 months post-injection, when pain and physical performance scores had decreased to 2.60 and 9.90, respectively, and the stiffness score was 0.33. The peak improvement in stiffness was noted at 8 months post-injection, when the stiffness score had decreased to 0.32. Significant improvements were still apparent at 9 months post-injection, when the pain score was 3.36, the stiffness score was 0.42, and the physical performance score was 11.5. All side effects were local and transient, and included pain, swelling, and redness of the knee. Most side effects were treated. Conclusion: Hyaluronan should be encouraged as an alternative or adjunct treatment to oral analgesics to reduce their required doses, and delay potential future surgical intervention.

Background: Many biomedical researchers and stakeholders may be unfamiliar with clinical trial concepts, designs, and factors affecting data integrity. Complexities are further increased in multinational trials. This article is intended to summarize the clinical trial process, with emphasis on the planning and design of multinational trials. The goal is to provide insight and guidance to the international research community. Clinical trial guidelines have been generated by reviewing textbooks, published articles, regulatory guidelines, and the authors’ personal experience. The workflow reported here summarizes the literature to produce a practical template in order to guide the planning and design of multinational clinical trials. This template can be broadly useful during the planning and design steps of a nascent clinical trial. However, in-depth knowledge of each individual process of a clinical trial is essential. One is encouraged to use this template as a guide for early drafts of a clinical trial. Conclusion: Detailed research for the template components can further enhance the knowledge of biomedical research structures, improve the quality of clinical trials, and ultimately enhance the published results.