{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:01:25Z","timestamp":1787029285897,"version":"build-2736575974"},"reference-count":122,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T00:00:00Z","timestamp":1643241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>The aim of this narrative review was to present research investigating chitosan, including its general characteristics, properties, and medical and dental applications, and finally to present the current state of knowledge regarding the efficacy of chitosan in the treatment of temporomandibular disorders (TMDs) based on the literature. The PICO approach was used for the literature search strategy. The PubMed database was analyzed with the following keywords: (\u201cchitosan\u201d[MeSH Terms] OR \u201cchitosan\u201d[All Fields] OR \u201cchitosans\u201d[All Fields] OR \u201cchitosan s\u201d[All Fields] OR \u201cchitosane\u201d[All Fields]) AND (\u201ctemporomandibular joint\u201d[MeSH Terms] OR (\u201ctem-poromandibular\u201d[All Fields] AND \u201cjoint\u201d[All Fields]) OR \u201ctemporomandibular joint\u201d[All Fields] OR (\u201ctemporomandibular\u201d[All Fields] AND \u201cjoints\u201d[All Fields]) OR \u201ctemporo-mandibular joints\u201d[All Fields]). After screening 8 results, 5 studies were included in this review. Chitosan presents many biological properties and therefore it can be widely used in several branches of medicine and dentistry. Chitosan promotes wound healing, helps to control bleeding, and is used in wound dressings, such as sutures and artificial skin. Apart from its antibacterial property, chitosan has many other properties, such as antifungal, mucoadhesive, anti-inflammatory, analgesic, antioxidant, antihyperglycemic, and antitumoral properties. Further clinical studies assessing the efficacy of chitosan in the treatment of TMD are required. According to only one clinical study, chitosan was effective in the treatment of TMD; however, better clinical results were obtained with platelet-rich plasma.<\/jats:p>","DOI":"10.3390\/pharmaceutics14020305","type":"journal-article","created":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T22:00:56Z","timestamp":1643320856000},"page":"305","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["General Characteristics, Biomedical and Dental Application, and Usage of Chitosan in the Treatment of Temporomandibular Joint Disorders: A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-271X","authenticated-orcid":false,"given":"Marcin","family":"Derwich","sequence":"first","affiliation":[{"name":"ORTODENT, Specialist Orthodontic Private Practice in Grudziadz, 86-300 Grudziadz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukasz","family":"Lassmann","sequence":"additional","affiliation":[{"name":"Dental Sense, Dental Private Practice in Gdansk, 80-283 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8481-3057","authenticated-orcid":false,"given":"Katarzyna","family":"Machut","sequence":"additional","affiliation":[{"name":"Department of Endodontic Dentistry, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2667-6693","authenticated-orcid":false,"given":"Agata","family":"Zoltowska","sequence":"additional","affiliation":[{"name":"Department of Endodontic Dentistry, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5373-4783","authenticated-orcid":false,"given":"Elzbieta","family":"Pawlowska","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"T33","DOI":"10.1016\/j.jpain.2013.07.018","article-title":"Clinical orofacial characteristics associated with risk of first-onset TMD: The OPPERA prospective cohort study","volume":"14","author":"Ohrbach","year":"2013","journal-title":"J. Pain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s00784-020-03710-w","article-title":"Prevalence of temporomandibular joint disorders: A systematic review and meta-analysis","volume":"25","author":"Valesan","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1001\/archpsyc.1990.01810150039007","article-title":"Multiple pains and psychiatric disturbance. An epidemiologic investigation","volume":"47","author":"Dworkin","year":"1990","journal-title":"Arch. Gen. Psychiatry."},{"key":"ref_4","first-page":"240","article-title":"Comparing TMD diagnoses and clinical findings at Swedish and US TMD centers using research diagnostic criteria for temporomandibular disorders","volume":"10","author":"List","year":"1996","journal-title":"J. Orofac. Pain"},{"key":"ref_5","first-page":"46","article-title":"Oral health-related quality of life in patients with temporomandibular disorders","volume":"21","author":"John","year":"2007","journal-title":"J. Orofac. Pain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1600-0501.2007.01445.x","article-title":"In patients with temporomandibular disorders, do particular interventions influence oral health-related quality of life? A qualitative systematic review of the literature","volume":"18","author":"Motschall","year":"2007","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.ejpain.2005.01.012","article-title":"Review of aetiological concepts of temporomandibular pain disorders: Towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors","volume":"9","author":"Suvinen","year":"2005","journal-title":"Eur. J. Pain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1177\/154405910808700406","article-title":"Degenerative disorders of the temporomandibular joint: Etiology, diagnosis, and treatment","volume":"87","author":"Tanaka","year":"2008","journal-title":"J. Dent. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1093\/rheumatology\/40.3.336","article-title":"The role of hyaluronic acid in protecting surface-active phospholipids from lysis by exogenous phospholipase A(2)","volume":"40","author":"Nitzan","year":"2001","journal-title":"Rheumatology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1053\/joms.2001.19278","article-title":"The process of lubrication impairment and its involvement in temporomandibular joint disc displacement: A theoretical concept","volume":"59","author":"Nitzan","year":"2001","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/S0278-2391(97)90335-9","article-title":"The \u201canchored disc phenomenon\u201d: A proposed etiology for sudden-onset, severe, and persistent closed lock of the temporomandibular joint","volume":"55","author":"Nitzan","year":"1997","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S0278-2391(00)90060-0","article-title":"Iron-dependent generation of free radicals: Plausible mechanisms in the progressive deterioration of the temporomandibular joint","volume":"58","author":"Zardeneta","year":"2000","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1054\/ijom.2001.0153","article-title":"Adhesive force: The underlying cause of the disc anchorage to the fossa and\/or eminence in the temporomandibular joint\u2014A new concept","volume":"31","author":"Nitzan","year":"2002","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1159\/000070570","article-title":"\u2018Friction and adhesive forces\u2019\u2014Possible underlying causes for temporomandibular joint internal derangement","volume":"174","author":"Nitzan","year":"2003","journal-title":"Cells Tissues Organs."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.actbio.2018.11.015","article-title":"Lipid-hyaluronan synergy strongly reduces intrasynovial tissue boundary friction","volume":"83","author":"Lin","year":"2019","journal-title":"Acta Biomater."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"9845","DOI":"10.1039\/C9CP01532A","article-title":"On the interaction of hyaluronic acid with synovial fluid lipid membranes","volume":"21","author":"Smith","year":"2019","journal-title":"Phys. Chem. Chem. Phys."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"100166","DOI":"10.1016\/j.biotri.2021.100166","article-title":"A new insight into more effective viscosupplementation based on the synergy of hyaluronic acid and phospholipids for cartilage friction reduction","volume":"25","author":"Daniel","year":"2021","journal-title":"Biotribology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1016\/0278-2391(95)90675-4","article-title":"Molecular biology of temporomandibular joint disorders: Proposed mechanisms of disease","volume":"53","author":"Milam","year":"1995","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/S0278-2391(98)90872-2","article-title":"Oxidative stress and degenerative temporomandibular joint disease: A proposed hypothesis","volume":"56","author":"Milam","year":"1998","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.archoralbio.2004.06.006","article-title":"Role of hypoxia and interleukin-1beta in gene expressions of matrix metalloproteinases in temporomandibular joint disc cells","volume":"50","author":"Yamaguchi","year":"2005","journal-title":"Arch. Oral Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1016\/0278-2391(91)90143-A","article-title":"Tissue responses to degenerative changes in the temporomandibular joint: A review","volume":"49","author":"Stegenga","year":"1991","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.jcms.2016.11.006","article-title":"Chondromalacia as pathological finding in arthroscopy of the temporomandibular joint: A retrospective study","volume":"46","year":"2018","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/0278-2391(95)90632-0","article-title":"The structure, biochemistry, and metabolism of osteoarthritic cartilage: A review of the literature","volume":"53","author":"Dijkgraaf","year":"1995","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jcms.2019.10.004","article-title":"The hierarchy of different treatments for arthrogenous temporomandibular disorders: A network meta-analysis of randomized clinical trials","volume":"48","author":"Wolford","year":"2020","journal-title":"J. Craniomaxillofac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Derwich, M., Mitus-Kenig, M., and Pawlowska, E. (2020). Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis-Review of the Literature. Medicina, 56.","DOI":"10.3390\/medicina56050225"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Derwich, M., Mitus-Kenig, M., and Pawlowska, E. (2021). Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis-A Systematic Review. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22147405"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/j.actbio.2008.11.025","article-title":"Biomimetic chitosan-nanohydroxyapatite composite scaffolds for bone tissue engineering","volume":"5","author":"Misra","year":"2009","journal-title":"Acta Biomater."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4548","DOI":"10.1016\/j.bmcl.2015.08.047","article-title":"Design, synthesis and antimicrobial activity of 6-N-substituted chitosan derivatives","volume":"26","author":"Hu","year":"2016","journal-title":"Bioorg. Med. Chem. Lett."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Sukpaita, T., Chirachanchai, S., Pimkhaokham, A., and Ampornaramveth, R.S. (2021). Chitosan-Based Scaffold for Mineralized Tissues Regeneration. Mar. Drugs., 19.","DOI":"10.3390\/md19100551"},{"key":"ref_30","first-page":"411","article-title":"Chitin and Chitosan: Production and Application of Versatile Biomedical Nanomaterials","volume":"4","author":"Hamblin","year":"2016","journal-title":"Int. J. Adv. Res."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Chocholata, P., Kulda, V., and Babuska, V. (2019). Fabrication of Scaffolds for Bone-Tissue Regeneration. Materials, 12.","DOI":"10.3390\/ma12040568"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"117869","DOI":"10.1016\/j.carbpol.2021.117869","article-title":"Synthesis of carboxymethyl chitosan-strontium complex and its therapeutic effects on relieving osteoarthritis","volume":"261","author":"Liu","year":"2021","journal-title":"Carbohydr. Polym."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"115335","DOI":"10.1016\/j.carbpol.2019.115335","article-title":"Enhanced dual network hydrogels consisting of thiolated chitosan and silk fibroin for cartilage tissue engineering","volume":"227","author":"Liu","year":"2020","journal-title":"Carbohydr. Polym."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.carbpol.2018.11.050","article-title":"A novel injectable in situ forming gel based on carboxymethyl hexanoyl chitosan\/hyaluronic acid polymer blending for sustained release of berberine","volume":"206","author":"Lu","year":"2019","journal-title":"Carbohydr. Polym."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.biomaterials.2018.04.033","article-title":"Fabrication of nanofibrous microcarriers mimicking extracellular matrix for functional microtissue formation and cartilage regeneration","volume":"171","author":"Wang","year":"2018","journal-title":"Biomaterials"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Satitsri, S., and Muanprasat, C. (2020). Chitin and Chitosan Derivatives as Biomaterial Resources for Biological and Biomedical Applications. Molecules, 25.","DOI":"10.3390\/molecules25245961"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.ejpb.2015.08.004","article-title":"Chitosan as a starting material for wound healing applications","volume":"97","author":"Patrulea","year":"2015","journal-title":"Eur. J. Pharm. Biopharm."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"100476","DOI":"10.1016\/j.fbio.2019.100476","article-title":"Bile acid-binding capacity of lobster shell-derived chitin, chitosan and chitooligosaccharides","volume":"33","author":"Xu","year":"2020","journal-title":"Food Biosci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1023\/A:1012899318688","article-title":"Manufacture and evaluation of bioactive and biodegradable materials and scaffolds for tissue engineering","volume":"12","author":"Wang","year":"2001","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2775","DOI":"10.1002\/jctb.6533","article-title":"Current state of chitin purification and chitosan production from insects","volume":"95","author":"Hahn","year":"2020","journal-title":"J. Chem. Technol. Biotechnol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1080\/10408690390826473","article-title":"Production, properties, and some new applications of chitin and its derivatives","volume":"43","author":"Synowiecki","year":"2003","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5156","DOI":"10.3390\/md13085156","article-title":"Chitosan: An Update on Potential Biomedical and Pharmaceutical Applications","volume":"13","author":"Cheung","year":"2015","journal-title":"Mar. Drugs"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"243","DOI":"10.3389\/fbioe.2019.00243","article-title":"Enzymatic Modifications of Chitin, Chitosan, and Chitooligosaccharides","volume":"7","author":"Kaczmarek","year":"2019","journal-title":"Front. Bioeng. Biotechnol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Grifoll-Romero, L., Pascual, S., Aragunde, H., Biarn\u00e9s, X., and Planas, A. (2018). Chitin Deacetylases: Structures, Specificities, and Biotech Applications. Polymers, 10.","DOI":"10.3390\/polym10040352"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"110709","DOI":"10.1016\/j.eurpolymj.2021.110709","article-title":"Chemical extraction and modification of chitin and chitosan from shrimp shells","volume":"159","author":"Pakizeh","year":"2021","journal-title":"Eur. Polym. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1007\/s10311-019-00904-x","article-title":"Applications of chitosan in food, pharmaceuticals, medicine, cosmetics, agriculture, textiles, pulp and paper, biotechnology, and environmental chemistry","volume":"17","author":"Lichtfouse","year":"2019","journal-title":"Environ. Chem. Lett."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1590\/0104-1428.08316","article-title":"Review of fungal chitosan: Past, present and perspectives in Brazil","volume":"28","author":"Batista","year":"2018","journal-title":"Pol\u00edmeros"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Younes, I., and Rinaudo, M. (2015). Chitin and chitosan preparation from marine sources. Structure, properties and applications. Mar. Drugs, 13.","DOI":"10.3390\/md13031133"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.carbpol.2016.04.028","article-title":"Development of chitosan\/\u03b2-glycerophosphate\/glycerol hydrogel as a thermosensitive coupling agent","volume":"147","author":"Huang","year":"2016","journal-title":"Carbohydr. Polym."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1007\/s10924-016-0865-5","article-title":"Chitin and Chitosan: Structure, Properties and Applications in Biomedical Engineering","volume":"27","author":"Islam","year":"2017","journal-title":"J. Polym. Environ."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.foodchem.2013.10.083","article-title":"Recent developments in chitosanase research and its biotechnological applications: A review","volume":"150","author":"Thadathil","year":"2014","journal-title":"Food Chem."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"5983","DOI":"10.1016\/j.biomaterials.2005.03.016","article-title":"Chitosan: A versatile biopolymer for orthopaedic tissue-engineering","volume":"26","author":"Sittinger","year":"2005","journal-title":"Biomaterials"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ma, F., Wang, Y., and Yang, G. (2019). The Modulation of Chitosan-DNA Interaction by Concentration and pH in Solution. Polymers, 11.","DOI":"10.3390\/polym11040646"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ijbiomac.2016.03.035","article-title":"DNA\/chitosan electrostatic complex","volume":"88","author":"Soltero","year":"2016","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1758","DOI":"10.1128\/CVI.00186-12","article-title":"Oral gene application using chitosan-DNA nanoparticles induces transferable tolerance","volume":"19","author":"Goldmann","year":"2012","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/S0168-3659(00)00361-8","article-title":"Chitosan-DNA nanoparticles as gene carriers: Synthesis, characterization and transfection efficiency","volume":"70","author":"Mao","year":"2001","journal-title":"J. Control. Release"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"115839","DOI":"10.1016\/j.carbpol.2020.115839","article-title":"Wound healing and antimicrobial effect of active secondary metabolites in chitosan-based wound dressings: A review","volume":"233","author":"Moeini","year":"2020","journal-title":"Carbohydr. Polym."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1089\/ten.2005.11.101","article-title":"Potential of nanofiber matrix as tissue-engineering scaffolds","volume":"11","author":"Ma","year":"2005","journal-title":"Tissue Eng."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Aranaz, I., Alc\u00e1ntara, A.R., Civera, M.C., Arias, C., Elorza, B., Heras Caballero, A., and Acosta, N. (2021). Chitosan: An Overview of Its Properties and Applications. Polymers, 13.","DOI":"10.3390\/polym13193256"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Valachov\u00e1, K., and \u0160olt\u00e9s, L. (2021). Versatile Use of Chitosan and Hyaluronan in Medicine. Molecules, 26.","DOI":"10.3390\/molecules26041195"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Bayer, I.S. (2020). Hyaluronic Acid and Controlled Release: A Review. Molecules., 25.","DOI":"10.3390\/molecules25112649"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2452","DOI":"10.1016\/j.bbagen.2014.02.001","article-title":"Hyaluronan: Biosynthesis and signaling","volume":"1840","author":"Vigetti","year":"2014","journal-title":"Biochim. Biophys. Acta."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/jocd.12237","article-title":"Physiochemical properties and application of hyaluronic acid: A systematic review","volume":"15","author":"Salwowska","year":"2016","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Snetkov, P., Zakharova, K., Morozkina, S., Olekhnovich, R., and Uspenskaya, M. (2020). Hyaluronic Acid: The Influence of Molecular Weight on Structural, Physical, Physico-Chemical, and Degradable Properties of Biopolymer. Polymers, 12.","DOI":"10.3390\/polym12081800"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"4589","DOI":"10.1074\/jbc.R100038200","article-title":"Signaling properties of hyaluronan receptors","volume":"277","author":"Turley","year":"2002","journal-title":"J. Biol. Chem."},{"key":"ref_66","first-page":"78","article-title":"Hyaluronic Acid in Inflammation and Tissue Regeneration","volume":"28","author":"Litwiniuk","year":"2016","journal-title":"Wounds"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.biomaterials.2017.01.029","article-title":"Hyaluronate and its derivatives for customized biomedical applications","volume":"123","author":"Kim","year":"2017","journal-title":"Biomaterials"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Juncan, A.M., Moisa, D., Santini, A., Morgovan, C., Rus, L.-L., Vonica-Tincu, A.L., and Loghin, F. (2021). Advantages of Hyaluronic Acid and Its Combination with Other Bioactive Ingredients in Cosmeceuticals. Molecules, 26.","DOI":"10.3390\/molecules26154429"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1177\/0394632016652906","article-title":"Hyaluronic acid: Perspectives in dentistry. A systematic review","volume":"29","author":"Casale","year":"2016","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.archoralbio.2018.02.007","article-title":"Effects of molecular weight of hyaluronic acid on its viscosity and enzymatic activities of lysozyme and peroxidase","volume":"89","author":"Kim","year":"2018","journal-title":"Arch. Oral Biol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.ijbiomac.2018.12.074","article-title":"Preparation and applications of hyaluronic acid and its derivatives","volume":"125","author":"Huang","year":"2019","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jconrel.2009.09.010","article-title":"Target specific and long-acting delivery of protein, peptide, and nucleotide therapeutics using hyaluronic acid derivatives","volume":"141","author":"Oh","year":"2010","journal-title":"J. Control. Release"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"192","DOI":"10.3389\/fvets.2019.00192","article-title":"Hyaluronic Acid: Molecular Mechanisms and Therapeutic Trajectory","volume":"6","author":"Gupta","year":"2019","journal-title":"Front. Vet. Sci."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S0147-5975(79)80054-7","article-title":"The fungicidal effect of chitosan on fungi of varying cell wall composition","volume":"3","author":"Allan","year":"1979","journal-title":"Exp. Mycol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1080\/08905439209549838","article-title":"Antibacterial action of chitosan","volume":"6","author":"Sudarshan","year":"1992","journal-title":"Food Biotechnol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.carbpol.2003.07.009","article-title":"Study on Antimicrobial Activity of Chitosan with Different Molecular Weights","volume":"54","author":"Zheng","year":"2003","journal-title":"Carbohydr. Polym."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S1462399403005817","article-title":"Skin repair and scar formation: The central role of TGF-beta","volume":"5","author":"Beanes","year":"2003","journal-title":"Expert Rev. Mol. Med."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Uragami, T., and Tokura, S. (2006). Material Science of Chitin and Chitosan, Springer. [1st ed.].","DOI":"10.1007\/3-540-37691-7"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/1523-1747.ep12667378","article-title":"Characterization of biologic properties of wound fluid collected during early stages of wound healing","volume":"99","author":"Chen","year":"1992","journal-title":"J. Invest. Dermatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2661","DOI":"10.1016\/j.febslet.2006.04.015","article-title":"Chitooligosaccharides inhibit activation and expression of matrix metalloproteinase-2 in human dermal fibroblasts","volume":"580","author":"Kim","year":"2006","journal-title":"FEBS Lett."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"3035","DOI":"10.1021\/bm0703214","article-title":"Specific interaction between chitosan and matrix metalloprotease 2 decreases the invasive activity of human melanoma cells","volume":"8","author":"Gorzelanny","year":"2007","journal-title":"Biomacromolecules"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1136\/ard.2003.019406","article-title":"Chondroprotective activity of N-acetylglucosamine in rabbits with experimental osteoarthritis","volume":"64","author":"Shikhman","year":"2005","journal-title":"Ann. Rheum. Dis."},{"key":"ref_83","first-page":"637","article-title":"Autoimmunity and Transplantation","volume":"Volume 1","author":"Murphy","year":"2012","journal-title":"Janeway\u2019s Immunobiology"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"4786","DOI":"10.1016\/j.msec.2013.07.043","article-title":"Enhanced mechanical properties of thermosensitive chitosan hydrogel by silk fibers for cartilage tissue engineering","volume":"33","author":"Mirahmadi","year":"2013","journal-title":"Mater. Sci. Eng. C Mater. Biol. Appl."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2589","DOI":"10.1016\/S0142-9612(00)00126-5","article-title":"Application of chitosan-based polysaccharide biomaterials in cartilage tissue engineering: A review","volume":"21","author":"Suh","year":"2000","journal-title":"Biomaterials"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S1381-5148(00)00038-9","article-title":"A review of chitin and chitosan applications","volume":"46","author":"Kumar","year":"2000","journal-title":"React. Funct. Polym."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1631\/jzus.B1500036","article-title":"Repair of articular cartilage defects in rabbits through tissue-engineered cartilage constructed with chitosan hydrogel and chondrocytes","volume":"16","author":"Zhao","year":"2015","journal-title":"J. Zhejiang Univ. Sci. B."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1002\/jctb.3970","article-title":"Degradable natural polymer hydrogels for articular cartilage tissue engineering","volume":"88","author":"Zhao","year":"2013","journal-title":"J. Chem. Technol. Biotechnol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.joca.2009.08.007","article-title":"The support of matrix accumulation and the promotion of sheep articular cartilage defects repair in vivo by chitosan hydrogels","volume":"18","author":"Hao","year":"2010","journal-title":"Osteoarthr. Cartil."},{"key":"ref_90","first-page":"S209","article-title":"Chitosan: A promising polymer for cartilage repair and viscosupplementation","volume":"28","author":"Comblain","year":"2017","journal-title":"Biomed. Mater. Eng."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"2959","DOI":"10.1016\/S0142-9612(01)00042-4","article-title":"The effect of chitin and chitosan on the proliferation of human skin fibroblasts and keratinocytes in vitro","volume":"22","author":"Howling","year":"2001","journal-title":"Biomaterials"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"4243","DOI":"10.1016\/j.bmcl.2006.05.078","article-title":"In vivo antitumor activity of chitosan nanoparticles","volume":"16","author":"Qi","year":"2006","journal-title":"Bioorg. Med. Chem. Lett."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1080\/02652040801970461","article-title":"The use of chitosan formulations in cancer therapy","volume":"25","author":"Dass","year":"2008","journal-title":"J. Microencapsul."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1248\/cpb.36.784","article-title":"Growth-inhibitory effect of hexa-N-acetylchitohexaose and chitohexaose against Meth-A solid tumor","volume":"36","author":"Tokoro","year":"1988","journal-title":"Chem. Pharm. Bull."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1111\/j.1349-7006.1989.tb01728.x","article-title":"Inhibitory effect of chitin heparinoids on the lung metastasis of B16-BL6 melanoma","volume":"80","author":"Murata","year":"1989","journal-title":"Jpn. J. Cancer Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1111\/j.1349-7006.2001.tb01116.x","article-title":"Chitosan induces apoptosis via caspase-3 activation in bladder tumor cells","volume":"92","author":"Hasegawa","year":"2001","journal-title":"Jpn. J. Cancer Res."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"2339","DOI":"10.1016\/S0142-9612(03)00026-7","article-title":"Implantable applications of chitin and chitosan","volume":"24","author":"Khor","year":"2003","journal-title":"Biomaterials"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.carbpol.2018.06.114","article-title":"Chitosan based hydrogels and their applications for drug delivery in wound dressings: A review","volume":"199","author":"Hamedi","year":"2018","journal-title":"Carbohydr. Polym."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.carbpol.2008.11.002","article-title":"Chitins and chitosans for the repair of wounded skin, nerve, cartilage and bone","volume":"76","author":"Muzzarelli","year":"2009","journal-title":"Carbohydr. Polym."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"4323","DOI":"10.1016\/j.biomaterials.2008.07.034","article-title":"Development of a chitosan-based wound dressing with improved hemostatic and antimicrobial properties","volume":"29","author":"Ong","year":"2008","journal-title":"Biomaterials"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/S0142-9612(01)00189-2","article-title":"Photocrosslinkable chitosan as a dressing for wound occlusion and accelerator in healing process","volume":"23","author":"Ishihara","year":"2002","journal-title":"Biomaterials"},{"key":"ref_102","first-page":"932","article-title":"Relationship between antibacterial activity of chitosan and surface characteristics of cell wall","volume":"25","author":"Chung","year":"2004","journal-title":"Acta Pharmacol. Sin."},{"key":"ref_103","first-page":"617","article-title":"Chitosan A novel way to intervene in enamel demineralization\u2014An in vitro study","volume":"3","author":"Visveswaraiah","year":"2014","journal-title":"Int. J. Curr. Microbiol. Appl. Sci."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.carbpol.2013.09.041","article-title":"A comprehensive study into the impact of a chitosan mouthwash upon oral microorganism\u2019s biofilm formation in vitro","volume":"101","author":"Costa","year":"2014","journal-title":"Carbohydr. Polym."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"13615","DOI":"10.3390\/ijms140713615","article-title":"The Effect of a Silver Nanoparticle Polysaccharide System on Streptococcal and Saliva-Derived Biofilms","volume":"14","author":"Sancilio","year":"2013","journal-title":"Int. J. Mol. Sci."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.ijbiomac.2020.06.211","article-title":"Chitosan biomaterials application in dentistry","volume":"162","author":"Fakhri","year":"2020","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Machut, K., Zoltowska, A., Pawlowska, E., and Derwich, M. (2021). Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: Case Reports. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22179458"},{"key":"ref_108","first-page":"2280800019851771","article-title":"Antimicrobial activity of endodontic sealers and medications containing chitosan and silver nanoparticles against Enterococcus faecalis","volume":"17","year":"2019","journal-title":"J. Appl. Biomater. Funct. Mater."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"118976","DOI":"10.1016\/j.carbpol.2021.118976","article-title":"In vitro evaluation of injectable Tideglusib-loaded hyaluronic acid hydrogels incorporated with Rg1-loaded chitosan microspheres for vital pulp regeneration","volume":"278","author":"Atila","year":"2022","journal-title":"Carbohydr. Polym."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1016\/j.archoralbio.2014.08.015","article-title":"Synergistic effects of chitosan scaffold and TGF\u03b21 on the proliferation and osteogenic differentiation of dental pulp stem cells derived from human exfoliated deciduous teeth","volume":"59","author":"Farea","year":"2014","journal-title":"Arch. Oral Biol."},{"key":"ref_111","first-page":"74","article-title":"Chitosan: Applications in Dentistry","volume":"28","author":"Tanikonda","year":"2014","journal-title":"Trends Biomater. Artif. Organs"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.carbpol.2009.10.031","article-title":"Fabrication of asymmetric chitosan GTR membranes for the treatment of periodontal disease","volume":"79","author":"Ho","year":"2010","journal-title":"Carbohydr. Polym."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/j.carbpol.2010.06.045","article-title":"Biocompatibility of a chitosan-based injectable thermosensitive hydrogel and its effects on dog periodontal tissue regeneration","volume":"82","author":"Ji","year":"2010","journal-title":"Carbohydr. Polym."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/0142-9612(95)93859-C","article-title":"In vitro assessment of bioadhesion for periodontal and buccal drug delivery","volume":"16","author":"Needleman","year":"1995","journal-title":"Biomaterials"},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Sukpaita, T., Chirachanchai, S., Suwattanachai, P., Everts, V., Pimkhaokham, A., and Ampornaramveth, R.S. (2019). In Vivo Bone Regeneration Induced by a Scaffold of Chitosan\/Dicarboxylic Acid Seeded with Human Periodontal Ligament Cells. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20194883"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.msec.2014.04.048","article-title":"Osteogenic differentiation and mineralization of human exfoliated deciduous teeth stem cells on modified chitosan scaffold","volume":"41","author":"Su","year":"2014","journal-title":"Mater. Sci. Eng. C Mater. Biol. Appl."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"44","DOI":"10.46582\/jsrm.1602008","article-title":"The Osteogenetic Potential of Chitosan Coated Implant: An In Vitro Study","volume":"16","author":"Alnufaiy","year":"2020","journal-title":"J. Stem Cells Regen. Med."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.joms.2020.09.016","article-title":"Comparison of Autologous Platelet-Rich Plasma and Chitosan in the Treatment of Temporomandibular Joint Osteoarthritis: A Retrospective Cohort Study","volume":"79","author":"Li","year":"2021","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1097\/SCS.0000000000002588","article-title":"Chitosan-Based Thermosensitive Hydrogel for Controlled Drug Delivery to the Temporomandibular Joint","volume":"27","author":"Talaat","year":"2016","journal-title":"J. Craniofac. Surg."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.bjoms.2016.08.017","article-title":"Prevention of adhesions in the temporomandibular joint by the use of chitosan membrane in goats","volume":"55","author":"Li","year":"2017","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s10856-018-6109-6","article-title":"Fibro\/chondrogenic differentiation of dental stem cells into chitosan\/alginate scaffolds towards temporomandibular joint disc regeneration","volume":"29","author":"Bousnaki","year":"2018","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_122","first-page":"454021","article-title":"The pilot study of fibrin with temporomandibular joint derived synovial stem cells in repairing TMJ disc perforation","volume":"2014","author":"Wu","year":"2014","journal-title":"Biomed. Res. Int."}],"container-title":["Pharmaceutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4923\/14\/2\/305\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:09:10Z","timestamp":1760134150000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4923\/14\/2\/305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,27]]},"references-count":122,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["pharmaceutics14020305"],"URL":"https:\/\/doi.org\/10.3390\/pharmaceutics14020305","relation":{},"ISSN":["1999-4923"],"issn-type":[{"value":"1999-4923","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,27]]}}}