The use of Hyaluronic Acid as an adjuvant Therapeutic Approach to Non-Surgical Periodontal Therapy for Periodontitis

Abstract

Periodontitis is a highly prevalent infectious-inflammatory disease, characterized by alveolar bone resorption. Hyaluronic acid (HA) has stood out for its anti-inflammatory and antioxidant effects. The present study evaluated, through a literature review, the use of HA as an adjunctive therapeutic approach to non-surgical periodontal therapy (NSPT) of periodontitis (PD), carried out through scaling and root planing. For this, the Pubmed and Medline databases were used with the following descriptors: Hyaluronic Acid AND Periodontitis. Among 58 manuscripts found, 11 studies were selected after analyzing their title and respective abstracts. Pre-clinical or clinical research published from 2010 to 2020, including the use of HA exclusively in the NSPT of PD, were included for this literature review. Studies using other pharmacological interventions in conjunction with HA, other literature reviews and research related to the treatment of gingivitis, periodontal or pulp regeneration, surgical periodontal therapy, apical or peri-implantitis periodontitis were excluded. The main data of the selected manuscripts were compiled in a table and, then, their results were compared and discussed among themselves. Despite a wide variety of methodological protocols carried out by prospective researches, it is noted that HA has potential healing, anti-inflammatory and antimicrobial effects, which can be interesting from the point of view of periodontal treatment, considering the infectious and inflammatory character of PD. There are also different commercial formulations of HA on the market. It is suggested, therefore, that HA can be promising as a chemical adjuvant to PD NSPT, and can be used in the form of subgingival irrigation in deep periodontal pockets.