Abstract
The biological activity of hyaluronic acid (HA) has been well-researched during the past decades; however, there are few randomized, controlled trials of its clinical effects in periodontal therapy. The purpose of this study was to evaluate the effect of hyaluronic acid on the principal parameters of periodontal healing. A specific, commercially available formulation designed and registered for professional dental application, composed of 16 mg/mL of cross-linked and 2 mg/mL of non-cross-linked HA, was used as an adjunctive to non-surgical periodontal therapy, and clinical parameters were evaluated after 3 months. The addition of HA to periodontal therapy demonstrated more favorable clinical results regarding reduction in inflammation, measured by bleeding on probing (−6% compared to the control group) and gain in periodontal attachment (1 mm more than control group), while it had no effect on probing depth reduction. No side effects were reported. Our study demonstrated that HA is a safe and easy-to-use biological agent; due to its wide array of properties, it may significantly improve the results of periodontal therapy. However, more long-term studies are needed to investigate whether these favorable effects remain over time.
Highlights
There were slightly higher values of periodontal probing depths (PPD) in the hyaluronic acid (HA) study group before treatment, whereas no significant differences were observed for other parameters
Significant differences were observed between the two groups for bleeding on probing (BoP) and clinical attachment level (CAL) in favor of the HA study group, but no differences were found for PPD
When the absolute differences between the two treatment protocols regarding reduction in BoP, CAL, and PPD were tested, it was found that all three parameters were significantly more reduced in the HA group (Table 3)
Summary
Periodontitis is a chronic, inflammatory disease leading to pathological loss of tissues supporting the teeth. It has a multifactorial pathogenesis and involves complex interactions among dysbiotic plaque and destructive immune responses [1]. If periodontitis is treated by professional bacterial biofilm control, it can be slowed down or stopped in most cases; if any factor affects either the local environment or the host response, progression of the disease and deterioration of the therapy response may occur [5]. Some clinical studies have shown that periodontal treatment could improve other systemic conditions, for example, by better glycemic control in diabetic patients or by reducing serum inflammatory biomarkers such as C-reactive protein [3,4,5]
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