Periodontal diseases are complex bacteria-induced infections characterised by an inflammatory host response to plaque microbiota and their by-products. Most of these microorganisms have virulence factors capable of causing massive tissue destruction both directly, through tissue invasion and the production of harmful substances, or indirectly, by activation of host defense mechanisms, creating an inflammatory infiltrate of potent catabolic activity that can interfere with normal host defense mechanisms. In response to the aggression, host defense mechanisms activate innate and adaptive immune responses. Our aim is to offer a general overview of the main mechanisms involved in the host response to bacterial aggression in periodontitis, such as lipopolysaccharide receptor CD14, complement system, polymorphonuclear neutrophils, antibodies and immunoglobulins.
The purpose of this review is to perform a systematic evaluation of the clinical effects of the local subgingival use of 0.8% or 0.2% hyaluronic acid (HA) as an adjunct to scaling and root planning in patients with chronic periodontitis.Methods: An electronic search was performed on PubMed, Lilacs, and Cochrane, without any time or language restrictions, on May 9, 2018, using the following keywords: "hyaluronic acid"; "periodontitis"; "treatment of periodontitis"; and "scaling." The following parameters were evaluated: clinical attachment level (CAL) gain, probing depth (PD), bleeding on probing (BOP), plaque index (PI), and gingival index (IG). This review was registered with the identification number CRD42019131541 in the PROSPERO International Prospective Register of Systematic Reviews hosted by the
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