Clinical and radiographic evaluation of 0.8% hyaluronic acid as an adjunct to open flap debridement in the treatment of periodontal intrabony defects: randomized controlled clinical trial

Feb 18, 2021Clinical oral investigations

Using 0.8% hyaluronic acid with gum surgery to treat deep bone defects around teeth: a randomized clinical trial

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Abstract

The test group receiving 0.8% hyaluronic acid gel showed a 1.05 mm greater gain in clinical attachment level compared to the control group after 12 months.

Bone defect fill was significantly greater in the test group (5.67 ± 2.01 mm) compared to the control group (4.49 ± 1.78 mm) at 12 months.
The mean reduction in probing depth was statistically significant in the test group (5.3 ± 1.2 mm) versus the control group (4.35 ± 0.81 mm) after 12 months.
The control group experienced a statistically significant increase in gingival recession (1.2 ± 0.76 mm) compared to the test group (0.7 ± 0.73 mm) at the 12-month mark.

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OBJECTIVES: Present study aimed to evaluate and compare the clinical and radiographic efficacy of 0.8% hyaluronic acid (HA) gel as an adjunct to open flap debridement (OFD) versus open flap debridement (OFD) alone in the treatment of periodontal intrabony defects.

MATERIALS AND METHODS: This randomized, controlled, split-mouth, clinical trial included 20 chronic periodontitis (stage II or III (grades A to B)) patients, having at least two contralateral intrabony defects. Forty bilateral intrabony defects (20 in each group) were randomly divided into test (0.8% HA gel + OFD) and control (OFD + placebo) groups. Clinical parameters evaluated at baseline, 6-months, and 12-months were plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and gingival recession (GR). Using cone beam computed tomography (CBCT), radiographic parameters were evaluated at baseline and 12 months. This included bone defect fill (DF), alveolar crest changes (ACC), and defect resolution (DR). CAL served as the primary outcome variable.

RESULTS: After 12 months, the test group showed significantly greater CAL gain (5.1 ± 1.2 versus 4.05 ± 1.19 mm) and bone defect fill (DF) (5.67 ± 2.01 versus 4.49 ± 1.78 mm) compared to the control group. Mean PD reduction in the test group (5.3 ± 1.2 versus 4.35 ± 0.81 mm) was statistically significant compared to the control group at 12-month period. The control group showed statistically significant increase in GR (1.2 ± 0.76 versus 0.7 ± 0.73 mm) compared to the test group after 12 months.

CONCLUSION: Application of hyaluronic acid gel in conjunction with open flap debridement resulted in enhanced clinical and radiographic outcomes compared to open flap debridement alone.

CLINICAL RELEVANCE: Adjunctive application of HA gel in open flap debridement may improve clinical and radiographic outcomes.

CLINICAL TRIAL REGISTERED NUMBER: CTRI/2018/03/012334.

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