Efficiency of Hyaluronic Acid in Infrabony Defects: A Systematic Review of Human Clinical Trials

Abstract

Background and objectives: The aim of this systematic review was to assess the electronic literature about the benefits of using hyaluronic acid (HA) in the surgical periodontal treatment of infrabony defects. Materials and methods: This review was conducted under the PRISMA guidelines. The electronic search was conducted on PubMed, Scopus, Web of Science, and Cochrane databases until February 2022. The inclusion criteria consisted of human clinical trials that reported the use of HA in open-flap debridement (OFD) for infrabony defects. The assessment of risk of bias was performed using the Cochrane risk of bias tool. Statistical analysis was performed using Review Manager. Results: Overall, three RCTs were found eligible for the statistical analysis. Probing depth (PD) reduction and clinical attachment level (CAL) gain in the HA test group presented WMs of −1.11 mm (95% CI −2.38 to 0.16 mm; p = 0.09) and −1.38 mm (95% CI −2.26 to −0.49 mm; p = 0.002), respectively. However, the heterogeneity of the RCTs was high, and the risk of bias, in general, was low. Conclusions: The use of hyaluronic acid seems to have beneficial effects in periodontal surgery using OFD, in terms of PD and CAL. To draw a clear conclusion, more adapted and well-designed clinical trials are needed to assess the advantage of this product in comparison with other products.