Aim: To evaluate the effect of hyaluronic acid application as adjunct to surgical periodontal therapy. Materials and methods: Literature search was performed according to PRISMA guidelines, with the following main eligibility criteria: (a) English language; (b) human controlled trials; (c) clinically evaluated effect of hyaluronic acid. Results and discussion: Four clinical trials on the surgical treatment were included. Most of the existing studies regarding the hyaluronic acid used and its application mode are highly heterogeneous, with moderate risk of bias. The majority of clinical studies described a beneficial, occasionally statistically significant effect of the hyaluronic acid on bleeding on probing (BoP) and pocket depth (PD) reduction, compared to controls, no adverse effects being reported. As most authors offered details pertaining to operator and selection bias, it can be concluded that the 3 studies included in the meta-analysis demonstrate a clinical benefit of 1.02 (-2.35, 0.31) in terms of probing depth while using hyaluronic acid as an adjunctive biomaterial in surgical periodontal therapy. Conclusions: Hyaluronic acid application as an adjunct to surgical periodontal treatment seems to have a beneficial, generally moderate effect on surrogate outcome variables of periodontal inflammation, i.e. reduction of probing depth, while offering safety. The large heterogeneity of the considered studies does not allow recommendations on the mode of application or effect size of hyaluronic acid as adjunct to surgical periodontal treatments.
Keywords:- hyaluronic acid
- periodontal regeneration
- surgical periodontal therapy