Local delivery of hyaluronic acid as an adjunct to scaling and root planing in the treatment of chronic periodontitis in smokers and non-smokers

Abstract

Objective: The objective of the study is to assess the effects of adjunctive use of hyaluronic acid (HA), clinically and microbiologically in smokers and nonsmokers, in the management of chronic periodontitis. Material and Methods: 48 sites from 24 chronic periodontitis patients, including smokers and nonsmokers with probing depth >5 mm, were selected for the study. A split-mouth design was followed. Scaling and root planing (SRP) was performed for all the patients. The test sites received 0.8% HA gel whereas the control site received placebo gel. The clinical parameters plaque, gingival and bleeding indices, Pocket Probing Depth (PPD), and clinical attachment level (CAL) were evaluated at baseline, 1 and 3 months. Microbiological parameters were evaluated at baseline and 1 month. Results: The results showed reduction in PPD and gain in CAL in both smokers and nonsmokers at the end of 3 rd month. The improvements in the test sites were statistically significant when compared with that of control sites. The microbiological analysis showed a significant reduction in Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at the test sites when compared to the controls in both the groups. Conclusion: The findings in both groups suggest that the use of locally delivered 0.8% HA gel may be valuable as an adjunct to SRP in the treatment of chronic periodontitis.

The Effect of Adjunctive Use of Hyaluronic Acid on Prevalence of Porphyromonas gingivalis in Subgingival Biofilm in Patients with Chronic Periodontitis: A Systematic Review

“…The values were mentioned as means and standard deviations. The study from India (Vajawat et al, 2022) [41] evaluated the effect of local delivery of hyaluronic acid in treating chronic periodontitis along with scaling and root planning in smokers and non-smokers. The authors followed up on the study subjects for three months, and the prevalence of P. gingivalis was mentioned only at a onemonth follow-up.…”

“… The results of the risk of bias assessment (Engström et al, 2001 [ 37 ], Xu et al, 2004 [ 38 ], Eick et al, 2013 [ 39 ], Nguyen et al, 2021 [ 40 ], Vajawat et al, 2022 [ 41 ]). …”

“…3.1.5. Vajawat et al, 2022 [41] The most recent study was conducted in India and published in 2022. The study comprised two groups: 11 smokers and 11 non-smokers.…”

“…On the other hand, Eick et al (2013) [39] did not mask the allocation of the test and control groups. [37], Xu et al, 2004 [38], Eick et al, 2013 [39], Nguyen et al, 2021 [40], Vajawat et al, 2022 [41]).…”

“…The authors followed up on the study subjects for three months, and the prevalence of P. gingivalis was mentioned only at a onemonth follow-up. The meta-analysis was performed at three-and six-month time points; hence, the Indian study (Vajawat et al, 2022) [41] and the Vietnamese study (Nguyen et al, 2021) [40] were excluded from the final meta-analysis. Three studies (Engström et al, 2001 [37]; Xu et al, 2004 [38]; Eick et al, 2013 [39]) contributed the data for the outcome at three months (Figure 3).…”