The clinical application of hyaluronic acid in gingivitis therapy. The role of viscosupplementation with hylan G-F 20 (Synvisc) in the treatment of osteoarthritis of the knee: a Canadian multicenter trial comparing hylan G-F 20 alone, hylan G-F 20 with non-steroidal anti-inflammatory drugs (NSAIDs) and NSAIDs alone. Hyaluronic Acid as an adjunct after scaling and root planing: a prospective randomized clinical trial. Effectiveness of adjunctive subgingival administration of amino acids and sodium hyaluronate gel on clinical and immunological parameters in the treatment of chronic periodontitis. Association of hyaluronic acid with a collagen scaffold may improve bone healing in critical-size bone defects. The effect of hyaluronan on bone and soft tissue and immune response in wound healing. Comparative analysis of hyaluronan gel and xanthan-based chlorhexidine gel, as adjunct to scaling and root planing with scaling and root planing alone in the treatment of chronic periodontitis: A preliminary study Effect of a new cohesive ophthalmic viscosurgical device on corneal protection and intraocular pressure in small‐incision cataract surgery Local application of hyaluronan gel in conjunction with periodontal surgery: a randomized controlled trial Antiproliferative effect of topic hyaluronic acid gel. Study in gingival biopsies of patients with periodontal disease. Treatment of infrabony periodontal defects using a resorbable biopolymer of hyaluronic acid: a randomized clinical trial. Hyaluronan-containing mouthwash as an adjunctive plaque-control agent. Treatment of gingivitis with hyaluronan. Clinical and microbiological effects of topical subgingival application of hyaluronic acid gel adjunctive to scaling and root planing in the treatment of chronic periodontitis. Hyaluronic acid stimulates neutrophil function in vitro and in vivo. A review of experimental results and a presentation of a preliminary clinical trial. Double-blind, randomized clinical study comparing hyaluronic acid cream to placebo in patients treated with radiotherapy.
OBJECTIVE The efficacy of a topical application of hyaluronic acid ( HA ) was tested for treating gingivitis . METHOD AND MATERIAL S Sixty nonsmoking out patients in good general condition , with clinical signs of gingivitis , were included in the study . Forty patients ( HA group , 20 men , 20 women ; age : 32.8 + /- 11.3 years ) used a spray containing HA 5 times daily over a period of 1 week . The control group consisted of 20 patients ( 10 men , 10 women ; age : 31.3 + /- 9.3 years ) . The clinical parameters DMF-T ( decayed , missed , filled teeth ) index , approximal plaque index , sulcus bleeding index , papilla bleeding index , and gingival crevicular fluid were measured at baseline ( T1 ) , after 3 days ( T2 ) , and after 7 days ( T3 ) . RESULTS A reduction in the sulcus bleeding index of the HA group ( T1 : 72.9 + /- 19.5 % ) to 50.3 + /- 21.1 % was noted at T2 , and at T3 the sulcus bleeding index was 40.7 + /- 23.0 % . The papilla bleeding index values of the HA group were 1.6 at T1 , 1.0 at T2 , and 0.7 at T3 . The gingival crevicular fluid showed significant reductions in the HA group . At T1 the recorded mean value was 16.3 , at T2 it was 11.8 , and at T3 it was 7.9 . Only insignificant changes were observed in the respective indices of the control group . There were no significant alterations in the plaque values of either group throughout the study period . CONCLUSION The results obtained by this study demonstrate that the topical application of an HA-containing preparation represents a potentially useful adjunct in the therapy of gingivitis , although its use does not diminish the need for plaque reduction as a primary therapeutic measure To determine the safety and efficacy of viscosupplementation with hylan G-F 20 , a cross-linked hyaluronan preparation , used either alone or in combination with continuous non-steroidal anti-inflammatory drug ( NSAID ) therapy , a r and omized , controlled , multicenter clinical trial , assessed by a blinded assessor , was conducted in 102 patients with osteoarthritis ( OA ) of the knee . All patients were on continuous NSAID therapy for at least 30 days prior to entering the study . Patients were r and omized into three parallel groups : ( 1 ) NSAID continuation plus three control arthrocenteses at weekly intervals ; ( 2 ) NSAID discontinuation but with three weekly intra-articular injections of hylan G-F 20 ; and ( 3 ) NSAID continuation plus three injections , one every week , intra-articular injections of hylan G-F 20 . Outcome measures of pain and joint function were evaluated by both the patients and an evaluator at baseline and weeks 1 , 2 , 3 , 7 and 12 , with a follow-up telephone evaluation at 26 weeks . At 12 weeks all groups showed statistically significant improvements from baseline , but did not differ from each other . A statistical test for the equivalence , the q-statistic , demonstrated that viscosupplementation with hylan G-F 20 was at least as good or better than continuous NSAID therapy for all outcome measurements except activity restriction . At 26 weeks both groups receiving hylan G-F 20 were significantly better than the group receiving NSAIDs alone . A transient local reaction was observed in three patients after hylan G-F 20 injection ; only one patient withdrew from the study as a result and all recovered without any sequela . Hylan G-F 20 is a safe and effective treatment for OA of the knee and can be used either as a replacement for or an adjunct to NSAID therapy BACKGROUND The study is design ed to determine the effect on clinical variables , subgingival bacteria , and local immune response brought about by application of hyaluronan-containing gels in early wound healing after scaling and root planing ( SRP ) . METHODS In this r and omized clinical study , data from 34 individuals with chronic periodontitis were evaluated after full-mouth SRP . In the test group ( n = 17 ) , hyaluronan gels in two molecular weights were additionally applied during the first 2 weeks after SRP . The control group ( n = 17 ) was treated with SRP only . Probing depth ( PD ) and clinical attachment level ( CAL ) were recorded at baseline and after 3 and 6 months , and subgingival plaque and sulcus fluid sample s were taken for microbiologic and biochemical analysis . RESULTS In both groups , PD and CAL were significantly reduced ( P < 0.001 ) . The changes in PD and the reduction of the number of pockets with PD ≥5 mm were significantly higher in the test group after 3 ( P = 0.014 and 0.021 ) and 6 ( P = 0.046 and 0.045 ) months . Six months after SRP , the counts of Treponema denticola were significantly reduced in both groups ( both P = 0.043 ) , as were those of Campylobacter rectus in the test group only ( P = 0.028 ) . Prevotella intermedia and Porphyromonas gingivalis increased in the control group . CONCLUSION The adjunctive application of hyaluronan may have positive effects on PD reduction and may prevent recolonization by periodontopathogens AIMS The aim of this clinical trial was to compare clinical and biochemical healing outcomes following ultrasonic mechanical instrumentation versus ultrasonic mechanical instrumentation associated with topical subgingival application of amino acids and sodium hyaluronate gel . METHODS Eleven systemically healthy subjects with moderate-severe chronic periodontitis , who had four sites with pocket probing depth and clinical attachment level greater than or equal to 5 mm were r and omly assigned to two different types of treatment : two pockets were treated with ultrasonic debridement ( Control Group ) and two pockets with ultrasonic mechanical instrumentation associated with 0,5 ml of amino acids and sodium hyaluronate gel ( Test Group ) . Probing depth , clinical attachment level , plaque index and bleeding on probing were recorded at baseline , 45 and 90 days . Levels of calprotectin and myeloperoxidase activity in gingival crevicular fluid were assessed at baseline and on day 7 and 45 . RESULTS Statistical significance was found between baseline and day 45 in relation to probing depth reduction and bleeding on probing between groups for both of the tested treatments . Significant reductions in μg/ sample of calprotectin and myeloperoxidase were found after 1-week and an increase at 45 days in both groups . There were no statistically significant differences between other variables evaluated in this study . CONCLUSIONS These data suggest that subgingival application of hyaluronic acid following ultrasonic mechanical instrumentation is beneficial for improving periodontal parameters OBJECTIVES To evaluate the effects of a 1 % hyaluronic acid ( HA ) gel in combination with an absorbable collagen sponge ( ACS ) in the healing of critical-size calvaria defects in rats . MATERIAL AND METHODS Thirty-two adult Wistar rats were used . Two 5-mm-diameter critical-size defects were created and the treatments were r and omly distributed as follows : ( 1 ) 1 % HA ; ( 2 ) 1 % HA gel-soaked ACS ; ( 3 ) control ( blood clot ) ; and ( 4 ) ACS . The animals were sacrificed 60 days post-surgery , when biopsies were collected and processed for histology and histometric analysis . Bone fill was measured as the difference between the initial and the final defect sizes . Non-parametric tests were used to analyze differences between treatments ( α=1 % ) and a t-test for body weight gain in each treatment group ( α=5 % ) . RESULTS Histological analysis showed bone formation on the edges of the defects , although very limited , and a thin layer of connective tissue occupying the midportion of the defects in the control and the ACS groups . Defects filled with a 1 % HA gel and 1 % HA gel+ACS had a thicker layer of connective tissue and more new bone formed in the margins of the defects . Linear histometric measures showed no significant differences in the initial defect sizes between the groups ( P>0.05 ) . The association 1 % HA gel+ACS ( 0.96 ± 0.14 mm ) had significantly greater bone fill than the control ( 0.5 ± 0.02 mm ) and ACS ( 0.56 ± 0.05 mm)-treated groups ( P=0.0043 and 0.0173 , respectively ) . Treatment with a 1 % HA gel ( 0.7 ± 0.14 mm ) showed no significant differences when compared with the other treatments . CONCLUSION Within the limits of this study , a 1 % HA gel associated with a collagen scaffold can improve new bone formation in critical-size defects . However , this treatment never result ed in complete closure of the defects and healing in the major portion of the defects was characterized by fibrous tissue BACKGROUND The aims of this study were to investigate the anti-inflammatory effect and the effect on bone regeneration of hyaluronan in surgical and non-surgical groups . METHODS In each of 15 individuals , 2 teeth with defects of similar character and magnitude in the upper or lower jaw were chosen . There were at least 2 teeth between the test and the control sites . In the surgical group , a bioabsorbable membrane was used for both test and control sites , and hyaluronan was placed in the intrabony pocket of the test site . In the non-surgical group , the periodontal pockets were scaled and hyaluronan was administered 3 times with an interval of 1 week in the test pockets . Alveolar bone height and bone healing patterns were analyzed using digital intraoral radiographs . Measurements of bone height were performed in the original digital black- and -white radiographs to obtain quantitative data on bone gain or loss . Bone healing patterns were studied with color-coded radiographs , using specially design ed software in a personal computer with subsequent combinations of radiographs . Gingival crevicular fluid immunoglobulin (Ig)G , C3 , and prostagl and in E2 ( PGE2 ) responses ; periodontal probing depth ; bleeding on probing ; and the presence of plaque were studied to evaluate the anti-inflammatory effect . Data were obtained at baseline before treatment , and at 2 weeks , and 1 , 3 , 6 , and 12 months after treatment . RESULTS For the surgical treatments , bone height was increased in the test group treated with hyaluronan ( mean value 2.2 % , corresponding to an average increase of approximately 0.5 mm ) and reduced in the control group ( mean value -1.8 % , corresponding to an average decrease of approximately - 0.4 mm ) ( P<0.05 ) after 12 months . For the non-surgical treatments , bone height was reduced by a mean value of -1.1 % ( corresponding to an average decrease of approximately -0.25 mm ) in the test group treated with hyaluronan and -3.3 % ( corresponding to an average decrease of approximately -0.75 mm ) in the control group after 12 months ( N.S. ) . According to the digital color-coded radiographs , the test sites in the surgical and non-surgical groups showed apposition of bone minerals . Immune responses showed no differences during the 12 months studied for the surgical and non-surgical sites . Mean periodontal probing depths were reduced between 2.5 mm and 4.1 mm in the surgical and non-surgical groups . CONCLUSIONS The observed difference in bone height between test and control sites in the surgical group after 12 months was less than 1 mm , which was only detectable on radiographs . No statistical difference was found on radiographs in the non-surgical group , where a decrease in bone height was found for both groups after scaling . Probing depth reduction after the surgical treatment , as well as after scaling and root planing , was as expected . Hyaluronan in contact with bone and soft tissues had no influence on the immune system in this study . Further studies are needed to determine the extent to which hyaluronan can lead to clinical ly significant healing of periodontal lesions Aim : The aim of this study was to evaluate the effects of hyaluronan ( HA ) and chlorhexidine ( CHX ) gels as adjunct to scaling and root planing ( SRP ) in the treatment of chronic periodontitis . Material s and Methods : Sixty patients within the age group of 30 - 65 years recruited to participate in the study were r and omly equally divided into three groups . Complete SRP and subgingival debridement were performed within 6 h in all the patients . For control ( Group I ) patients , SRP was the only treatment modality given ; for Group II and III patients , at least 8 teeth with 4 - 8 mm probing pocket depth ( PPD ) were selected for subgingival application of HA gel and CHX gel , respectively . Clinical periodontal parameters such as gingival index , PPD , and clinical attachment level ( CAL ) were recorded at baseline and 3 months , whereas plaque index was recorded at baseline , 1 month , and 3 months . For measuring systemic/hematological parameters , blood sample s for laboratory tests for total leucocyte count ( TLC ) , differential leucocyte count ( DLC ) , and C-reactive protein ( CRP ) were obtained using st and ard 2-mL syringe from each subject in all the three groups at baseline , 24 h , and on the 1 month and 3 months post-baseline . Results : In all the three groups , a significant reduction in PPD and gain in CAL were observed between baseline and 3 months follow-up ( P < 0.05 ) ; however , at 3 months , change in PPD and CAL was more in Group II than Group III , but the difference was non-significant , and Group I ( control ) showed less changes in PPD and CAL than both experimental groups . Only one patient revealed positive value for CRP at baseline only , and hence could not be statistically analyzed . In all the three groups , the peak values for TLC count were observed at 24 h. At 1-month and 3-month intervals , a significant improvement in TLC and DLC counts was observed among the experimental ( HA gel/SRP and Xan-CHX gel ) groups as compared to control group ( SRP alone ) PURPOSE : To compare the corneal protective and intraocular pressure ( IOP ) effects of a new cohesive ophthalmic viscosurgical ( OVD ) , Neocrom Cohesive ( sodium hyaluronate 1.4 % ) , with those of Healon ( sodium hyaluronate 1.0 % ) in cataract surgery . SETTING : Department of Ophthalmology , Medical University of Vienna , Vienna , Austria . METHODS : This r and omized patient‐masked examiner‐masked study with fellow‐eye comparison comprised 29 cataract surgery patients . Surgery was performed with Neocrom Cohesive in 1 eye and Healon in the other eye . Central corneal thickness ( CCT ) was measured preoperatively and 1 day and 3 months postoperatively ; endothelial cell density ( ECD ) , preoperatively and 3 months postoperatively ; and IOP , preoperatively and 6 hours and 1 day postoperatively . RESULTS : The mean CCT change from preoperatively to postoperatively in the Neocrom Cohesive , respectively , group and Healon group was + 16.0 μm ± 25.7 ( SD ) ( P<.01 ) and + 7.0 ± 17.1 μm ( P<.05 ) , respectively , at 1 day and −5.7 ± 10.8 μm ( P<.01 ) and −4.7 μm ± 9.5 μm ) ( P<.01 ) , respectively , at 3 months . The mean ECD change at 3 months was 8 ± 155 cells/mm2 in the Neocrom Cohesive group ( P = .8 ) and −46 ± 139 cells/mm2 in the Healon group ( P = .08 ) . The mean IOP increase was + 2.2 ± 3.5 mm Hg ( P<.01 ) and + 1.4 ± 4.2 mm Hg ( P = .14 ) , respectively , 6 hours postoperatively and + 0.9 ± 4.3 mm Hg ( P = .37 ) and 0.0 ± 3.5 mm Hg ( P = .77 ) , respectively , at 1 day . CONCLUSION : There was no significant difference between Neocrom Cohesive and Healon in the changes in CCT , ECD , and IOP after cataract surgery Hyaluronic acid application has been proven to be beneficial in a number of medical disciplines . The aim of the current study was to clinical ly evaluate the effect of local application of hyaluronan gel in conjunction with periodontal surgery .  Fourteen patients with chronic periodontitis having four interproximal intrabony defects ( ≥3 mm ) with probing depth values > 5 mm were included in this split-mouth study . Following initial nonsurgical periodontal therapy and re-evaluation , defects were r and omly assigned to be treated with modified Widman flap ( MWF ) surgery in conjunction with either 0.8 % hyaluronan gel ( test ) or placebo gel ( control ) application .  Clinical attachment level ( CAL ) , probing depth ( PD ) , gingival recession ( GR ) , plaque index ( PI ) , and bleeding on probing ( BOP ) values were taken at baseline and 3 and 6 months . Differences between test and control sites were evaluated using a Wilcoxon signed-rank and a McNemar test . A Friedman and a Cochran test were used to test equal ranks over time . Statistically significant differences were noted for CAL and GR ( P < 0.05 ) in favor of the test sites . No significant differences were found regarding PD , BOP , or PI values  ( P > 0.05 ) . Hyaluronan gel application in conjunction with periodontal surgery appears to result in significant improvement of CAL and in a reduction in GR . Hyaluronan gel application appears to improve the clinical outcome of MWF surgery Hyaluronic acid ( HA ) is the most abundant glycosaminoglycan of high molecular weight in the extracellular matrix of soft periodontal tissues . Our group recently demonstrated an HA-induced reduction in lymphoplasmocyte inflammatory infiltrate in periodontal disease . The objective of this study was to determine the effect of an HA gel of high molecular weight on cell proliferation , inflammation , and different periodontal lesion parameters . A double-blind clinical trial was conducted on the effect of an HA gel on cell proliferation in gingival biopsies from 28 patients with periodontal disease . A split-mouth design was used , r and omly applying the gel to one quadrant and a placebo to the contralateral one . A gingival biopsy was taken for histopathological and immunohistochemical study , in order to determine the expression of cell proliferation antigen Ki-67 and to evaluate the inflammatory infiltrate .  HA gel treatment induced a significant reduction in the proliferation index of the gingival epithelium , with 276 ( range 234 - 317 ) Ki-67-positive cells per mm2 in treated sample s versus 514 ( range 158 - 876 ) per mm2 in controls ( Mann-Whitney U test , p<0.003 ) . In 13 patients , the number of Ki-67-positive fibroblastic cells was reduced by the treatment , whereas in 6 patients no differences were found ( global difference , p=0.12 ) . In 10 patients , Ki-67-positive cells were decreased in chronic inflammatory infiltrate present in the lamina propria , whereas in 6 patients no differences were found ( global difference , p=0.054 ) . We conclude that high molecular-weight HA gel reduces cell proliferation in epithelial cells such as fibroblasts and lymphocytes , abates the inflammatory process , and improves the periodontal lesion in patients with chronic periodontitis OBJECTIVE This r and omized clinical study examined the use of hyaluronic acid to treat infrabony periodontal defects over a period of 24 months . METHOD AND MATERIAL S Forty subjects with a two-wall infrabony defect ( probing depth [ PD ] > = 7 mm ; clinical attachment level [ CAL ] > = 7 mm ) were selected . The defects were r and omly divided into two groups : sites treated with hyaluronic acid ( test group ) and those treated with open flap debridement ( control group ) . RESULTS The 12- and 24-month evaluations were based on clinical and radiographic parameters . The primary outcome variable was CAL . Test defects shows a mean CAL gain of 1.9 ± 1.8 mm , while the control defects yielded a significantly lower gain of 1.1 ± 0.7 mm . PD reduction was also significantly higher in the test group ( 1.6 ± 1.2 mm ) than in the control group ( 0.8 ± 0.5 mm ) . Frequency distribution analysis of the study outcomes indicated that hyaluronic acid increased the predictability of clinical ly significant results ( CAL gains > = 2 mm and PD reduction > = 2 mm ) in the test group compared with the controls . CONCLUSIONS The treatment of infrabony defects with hyaluronic acid offered an additional benefit in terms of CAL gain , PD reduction , and predictability compared to treatment with open flap debridement PURPOSE Hyaluronan , commonly known as hyaluronic acid , has been shown to have anti-inflammatory action , bacteriostatic effect and antioxidant properties , thus making its use as a long-term anti-plaque and anti-gingivitis agent an appealing proposition . The aim of the present study was to evaluate the efficacy of 0.025 % hyaluronan-containing mouthwash in comparison with 0.2 % chlorhexidine and a water-based mouthwash and also to evaluate its antibacterial efficacy on isolated strains of periodontopathogens . MATERIAL S AND METHODS Forty-five volunteers in a hospital setting were recruited . A single-blinded , parallel design , r and omised controlled trial was carried out and the 4-day plaque re-growth model was used to study the efficacy of the three mouthwashes . Microbiological and clinical evaluation was performed by culturing and using dental indices , respectively . The three mouthwashes used in the present study were commercially available 0.025 % sodium hyaluronate , 0.2 % chlorhexidine and a water-based rinse ( negative control ) . Effects of the three mouthwashes were tested on the growth of isolated strains of Porphyromonas gingivalis ( Pg ) , Aggregatibacter actinomycetemcomitans ( Aa ) and Prevotella intermedia ( Pi ) . RESULTS In vitro , hyaluronan had a distinct effect on the growth of Aa and Pi with no effect on the growth of Pg . In vivo , the differences between the individual rinse solutions and the water-based solution showed significantly less plaque regrowth with respect to both chlorhexidine ( P = 0.033 ) and hyaluronan ( P = 0.045 ) when compared to the negative control . The difference between chlorhexidine and hyaluronan was not statistically significant ( P = 0.69 ) . CONCLUSIONS Hyaluronan (0.025%)-containing mouthwash was comparable to chlorhexidine ( 0.2 % ) in inhibiting plaque growth in vivo , and it significantly reduced the growth of Aa and Pi in OBJECTIVES Hyaluronic acid ( hyaluronan ) is a glycosaminoglycan with anti-inflammatory and antiedematous properties . It was evaluated in a gel formulation for its effect in the treatment of plaque-induced gingivitis . METHOD In a r and omised double-blind study , 50 male subjects with plaque-induced gingivitis were divided into two groups and used a verum or placebo gel twice daily additionally to oral hygiene for a 3-week treatment period . Clinical indices ( API , Turesky index , PBI ) and crevicular fluid variables ( peroxidase , lysozyme ) were determined at baseline and after 4 , 7 , 14 and 21 days , respectively . RESULTS Significant improvements could be found for all clinical variables in both groups . The verum group showed significant improvement in the study area for the plaque indices beginning with day 4 ( P = 0.011 ) and the PBI beginning with day 7 ( P = 0.001 ) in comparison with the placebo group . The crevicular fluid variables were significantly improved in the centre of the studied inflammation area in the verum group . Here all studied sites had significant decreases in peroxidase ( 176.72 - 128.75 and 188.74 - 128.75 U/L ) and lysozyme ( 1.27 - 0.27 and 1.30 - 0.33 mg/L ) activities after 7 , 14 and 21 days ( P between 0.034 and < 0.001 ) , whereas in the placebo group only one site showed a significant decrease for lysozyme ( 1.74 - 0.75 mg/L ) after 7 and 21 days ( P = 0.048 and 0.025 ) . CONCLUSIONS These data suggest that a hyaluronan containing gel has a beneficial effect in the treatment of plaque-induced gingivitis BACKGROUND Hyaluronic acid ( HA ) has shown anti-inflammatory effects in gingivitis therapy . The potential benefits of local subgingival application of HA adjunctive to scaling and root planing ( SRP ) were evaluated in this study . METHODS Twenty patients with chronic periodontitis were included in this split-mouth study . Sulcus fluid flow rate ( SFFR ) and sulcus bleeding index were monitored at baseline and after 1 , 2 , 3 , 4 , 5 , 6 , and 12 weeks ; probing depth and clinical attachment level were monitored at baseline and 6 and 12 weeks . Subgingival plaque sample s were also taken at these same three appointments to determine the presence of Actinobacillus actinomycetemcomitans , Porphyromonas gingivalis , Prevotella intermedia , Tannerella forsythensis , and Treponema denticola . All patients were treated with full-mouth scaling and root planing ( SRP ) ; in addition , an HA gel was administered subgingivally in the test sites every week for 6 weeks . RESULTS An improvement of all clinical variables was observed ( P < 0.05 ) in both groups . Clinical ly , no difference between test and control sites could be found . No difference between test and control sites was seen in the tested microorganisms . CONCLUSIONS No clinical or microbiological improvement was achieved by the adjunctive use of HA gel compared to SRP alone . Only SFFR was affected by the use of HA in terms of a more rapid reduction of SFFR in the test sites Hyaluronic acid ( HA ) stimulates normal neutrophil function both in vitro and in vivo Stimulation was also achieved by subcutaneous administration of HA to patients with extreme susceptibility to bacterial infections .  Clinical improvement of some patients was obtained in connection to the administration . It is premature at this time to conclude any therapeutic effect of HA in patients with extreme infection propensity . The data presented here , however , for certain merit further investigation on this matter PURPOSE The effect of hyaluronic acid ( Ialugen cream ) on  acute skin reactions after radiotherapy  , was assessed in a r and omized , double-blind , placebo-controlled study . MATERIAL AND METHODS Out of the 152 patients presenting with head and neck , breast or pelvic carcinomas and registered in the study , 134 cases-70 in the Ialugen group ( IA ) and 64 in the placebo group (PBO)-completed their IA or PBO treatment . At the time of r and omisation , these two groups were balanced for sex , age , weight and height . The mean total dose of radiation given during the study was 60.6 + /- 10.9 Gy in the IA group and 64.3 + /- 10.8 Gy in the PBO group ( P = 0.47 ) . RESULTS Acute radio-epithelitis scores were significantly higher in the PBO group than in the IA group , starting from the control at week 3 and throughout the 6 weeks of treatment ( P < 0.01 from week 3 to week 7 ; P < 0.05 at weeks 8 and 10 ) . Likewise , the global efficacy judgement expressed , at the end of treatment , by both the physician and the patient showed a significant difference in favour of Ialugen ( P < 0.01 and P < 0.05 , respectively ) . There was no significant difference of tolerance between the IA and PBO treatments ( P = 0.18 according to the physician and P = 0.42 from the patient 's viewpoint ) . CONCLUSION The prophylactic use of a cream with hyaluronic acid is shown to reduce the incidence of high grade radio-epithelitis , suggesting an interesting role of the hyaluronic acid cream as supportive treatment to improve compliance and quality of life in patients undergoing radiation therapy
AIM To evaluate the effect of hyaluronan ( HY ) application as monotherapy or as adjunct to non-surgical and /or surgical periodontal therapy .