Treatment of Intrabony Defects with a Combination of Hyaluronic Acid and Deproteinized Porcine Bone Mineral

Abstract

Background: this study evaluates the clinical outcomes of a novel approach in treating deep intrabony defects utilizing papilla preservation techniques with a combination of hyaluronic acid (HA) and deproteinized porcine bone mineral. Methods: 23 patients with 27 intrabony defects were treated with a combination of HA and deproteinized porcine bone mineral. Clinical attachment level (CAL), pocket probing depth (PPD), gingival recession (REC) were recorded at baseline and 6 months after the surgery. Results: At 6 months, there was a significant CAL gain of 3.65 ± 1.67 mm (p < 0.001) with a PPD reduction of 4.54 ± 1.65 mm (p < 0.001), which was associated with an increase in gingival recession (0.89 ± 0.59 mm, p < 0.001). The percentage of pocket resolution based on a PPD ≤4 mm was 92.6% and the failure rate based on a PPD of 5 mm was 7.4%. Conclusions: the present findings indicate that applying a combined HA and xenograft approach in deep intrabony defects provides clinically relevant CAL gains and PPD reductions compared to baseline values and is a valid new approach in treating intrabony defects.

Adjunctive Application of Hyaluronic Acid in Combination with a Sodium Hypochlorite Gel for Non-Surgical Treatment of Residual Pockets Reduces the Need for Periodontal Surgery—Retrospective Analysis of a Clinical Case Series

“…The clinical results mediated by xHyA indicated a substantial benefit, which was corroborated by both a recent RCT study and a case series [ 42 , 43 ]. Beyond the positive effects of xHyA unfolded in the surgical context, its adjunctive use in NSPT yielded inconsistent outcomes in clinical studies [ 44 , 45 , 46 ].…”

Reconstructive Peri-Implantitis Therapy by Using Bovine Bone Substitute with or without Hyaluronic Acid: A Randomized Clinical Controlled Pilot Study

“…As a matter of fact, HA’s potential role to up-regulate the CD44 marker [ 43 ] results in the stimulation of wound healing and osteogenetic cells migration, which could explain why bone gain and implant stability increased in our study group where HA was present. Similar to present outcomes, the recent clinical study showed PPD and CAL decreases (4.54 ± 1.65 mm, and 3.65 ± 1.67 mm) at 6 months when BBS was combined with HA gel following periodontitis regenerative surgery [ 44 ]. Accordingly, it could be assumed that HA in the presence of BBS increases the biological activity of human osteogenic cells, leading to their higher migration and proliferation.…”

Hyaluronic Acid with Bone Substitutes Enhance Angiogenesis In Vivo

“…Therefore, HA may be seen as a biomolecule of choice in bioregenerative medicine, including osseous regeneration, since it enhances cell adhesion, migration, and proliferation [ 58 , 59 ]. In recent clinical studies, it has been proven that hyaluronic acid has a positive effect on bone formation [ 14 , 60 ]. In our recent study, evidence was provided that HA activates osteoblasts in vitro [ 6 , 8 ].…”

“…All BSM are processed non-cellular and, consequently, exhibit mainly osteoconductive properties. To overcome the lack of osteoinductive and osteogenic properties, a variety of biofunctionalization possibilities such as the addition of growth factors, autologous platelet concentrates [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ] as well as hyaluronic acid [ 8 , 13 , 14 ] have been studied.…”