Effect of 0.8% Hyaluronic Acid in Conventional Treatment of Moderate to Severe Chronic Periodontitis.

OBJECTIVE: The aim of this study is to evaluate the effect of the subgingival application of 0.8% hyaluronic acid (HA) gel (GENGIGEL(R)) as an adjunct to scaling and root planing (SRP) on clinical parameters and expression of human beta defensin-2 (hBD-2) in patients with moderate to severe chronic periodontitis. MATERIALS AND METHODS: In this randomized, split mouth design study, 24 participants with moderate to severe chronic periodontitis were evaluated after full mouth SRP. In the test sites 1 mL of 0.8% hyaluronan gel was applied subgingivally after SRP at baseline and 1 week post therapy. Plaque index (PI), gingival index (GI), papillary bleeding index (PBI), periodontal probing depth (PPD), and clinical attachment loss (CAL) were recorded and gingival crevicular fluid (GCF) samples were collected at baseline, after 6 and 12 weeks. Expression of human beta defensin-2 (hBD-2) was analyzed by enzyme-linked immunosorbent assay. RESULTS: At baseline, there were no statistical differences between test and control sites in all clinical parameters and hBD-2 expression. An improvement of PI, GI, PBI, PPD, and CAL was observed at 6 and 12 weeks (p < 0.05) in both groups. Clinically, it was noticed that all indices except CAL had more statistically significant reduction in test sites than control sites at 6 and 12 weeks. The hBD-2 levels were significantly higher in the test sites than in the control sites at 6 and 12 weeks. CONCLUSION: The local application of 0.8% hyaluronan gel with SRP have a positive effect on periodontal health of moderate to severe chronic periodontitis patients after 6 and 12 weeks. CLINICAL SIGNIFICANCE: Subgingival application of 0.8% HA gel following SRP has shown anti-inflammatory effect and has a beneficial effect on clinical parameters in moderate to severe chronic periodontitis patients.