The clinical application of hyaluronic acid in gingivitis therapy. Hyaluronic acid to improve healing of surgical incisions in the oral cavity: a pilot multicentre placebo-controlled randomised clinical trial. Efficacy of hyaluronic acid spray on swelling, pain, and trismus after surgical extraction of impacted mandibular third molars. Efficacy of hyaluronic acid (hyaluronan) in root coverage procedures as an adjunct to coronally advanced flap in Millers Class I recession: A clinical study Hyaluronic Acid as an adjunct after scaling and root planing: a prospective randomized clinical trial. An evaluation of 0.2% hyaluronic acid gel (Gengigel ®) in the treatment of gingivitis: a clinical & microbiological study. Effectiveness of adjunctive subgingival administration of amino acids and sodium hyaluronate gel on clinical and immunological parameters in the treatment of chronic periodontitis. 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 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. Hyaluronic Acid as an adjunct to scaling and root planing in chronic periodontitis. A randomized clinical trail. Treatment of infrabony periodontal defects using a resorbable biopolymer of hyaluronic acid: a randomized clinical trial. Peri-implant maintenance of immediate function implants: a pilot study comparing hyaluronic acid and chlorhexidine. 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. The efficacy of topical 0.2% hyaluronic acid gel on recurrent oral ulcers: comparison between recurrent aphthous ulcers and the oral ulcers of Behçet's disease.
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 PURPOSE To evaluate the efficacy of hyaluronic acid to improve the healing of surgical incisions in the oral cavity . MATERIAL S AND METHODS Six Italian private practice s participated in this trial , each centre provided 12 patients . After suturing , patients were r and omised to receive either a single application of 0.8 % hyaluronic acid or a placebo ( the carrier ) . Outcome measures were : assessment of wound healing 10 days post-operatively on a Likert scale by the blind operators and by an independent and blinded outcome assessor on the photographs , adverse events and post-operative complications . Reproducibility was assessed by evaluating agreement between operators and the independent outcome assessor using the weighted Kappa statistic . RESULTS Thirty-six patients were evaluated in each group , at ten days none had dropped-out . No post-operative complications or adverse events occurred . There were no statistically significant differences for wound healing , assessed clinical ly by the blinded operators or on photographs evaluated by a blinded and independent outcomes assessor . There was a substantial agreement between operators and the independent outcome assessor in the wound scoring . CONCLUSIONS Hyaluronic acid placed over surgical incisions in the oral cavity does not appear to improve wound healing . Further trials are needed to better underst and the potential role of hyalulonic acid in dental applications The aim of this study was compare the efficacies of two oral sprays in reducing swelling , pain , and trismus after the extraction of impacted m and ibular third molars . This prospect i ve double-blind , r and omized , crossover clinical trial included 34 patients with bilateral symmetrically impacted m and ibular third molars of similar surgical difficulty .  Hyaluronic acid or benzydamine hydrochloride spray was applied ( two pumps ) to the extraction area , three times daily for 7 days . Swelling was evaluated using a tape measure method , pain with a visual analogue scale ( VAS ) , and trismus by measuring the maximum inter-incisal opening . Assessment s were made on the day of surgery and on days 2 and 7 after surgery . Statistically significant differences were detected for the swelling and trismus values between the two treatment groups on the second postoperative day ( P=0.002 and P=0.03 , respectively ) . However , there was no statistically significant difference in VAS scores between the two groups . The administration of hyaluronic acid spray was more effective than benzydamine hydrochloride spray in reducing swelling and trismus . Although no evidence of a reduction in pain levels was detected , hyaluronic acid appears to offer a beneficial effect in the management of swelling and trismus during the immediate postoperative period following impacted third molar surgery Background : The purpose of this study was to assess the efficacy of hyaluronic acid ( HA ) in root coverage procedures as an adjunct to coronally advanced flap ( CAF ) procedure . Material s and Methods : This was a r and omized clinical trial with split mouth design , where 10 patients with 20 sites of Millers Class I recession were treated and followed-up for a period of 6 months . CAF procedure was performed , HA was applied onto the experimental sites before suturing the flap . Recession depth ( RD ) was measured regularly at baseline 1 , 3 , 6 , 12 , and 24 weeks postoperatively . Probing pocket depth ( PPD ) and clinical attachment level ( CAL ) were also measured along with RD at baseline and 12 and 24 weeks . Results : There was a significant change in RD , PPD , CAL , and percentage of root coverage in both groups when compared to the baseline values . There was no statistically significant difference between experimental and control group in terms of RD ( P = 0.917 ) , PPD ( P = 0.917 ) and CAL ( P = 0.761 ) . RD was 3.2 mm ± 0.78 mm in experimental site and control sites 2.9 mm ± 0.73 mm reduced to 1.1 mm ± 0.99 mm in experimental sites and 1.0 mm ± 0.66 mm in control sites . Though , there is no statistically significant difference root coverage in the experimental group appeared to be clinical ly more stable compared with the control group after 24 weeks . Conclusions : This study suggests that use of HA may improve the clinical outcome of root coverage with CAF procedure 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 AIM Hyaluronic acid is a glycosaminoglycan with anti-inflammatory & anti edematous properties . This study is seeking to ascertain whether Hyaluronic acid gel formulation is clinical ly and microscopically effective in treatment of gingivitis . METHODS In longitudinal , r and omized , and placebo-controlled clinical trial , 105 patients with chronic plaque induce gingivitis were r and omly divided into three groups ; negative control group , placebo control group and test group . Patients were instructed to apply gel on inflamed gingiva twice daily in addition with routine oral hygiene maintenance . The clinical parameters Plaque Index ( PI ) , Gingival Index(GI ) and Papilla Bleeding Index ( PBI ) were determined at intervals of 1 week , 2 weeks and 4 weeks from baseline , microbiological parameters were monitored at the interval of 4 weeks from baseline . RESULTS An improvement of all clinical variables was observed ( p<0.05 ) for all treatment modalities . Clinical ly , There is significant difference ( p<0.05 ) for GI & PBI in test group as compared to other groups , but reduction in PI was non-significant . In negative control and placebo control groups , the difference between clinical parameters was non-significant . Statistically significant ( p<0.05 ) reduction in percentage of anaerobic gram negative bacilli and relative increase of gram positive coccoid cells was seen in all treatment groups at 4 weeks as compared to baseline . However , results were not statistically significant ( p>0.05 ) in pair wise comparison in between groups . CONCLUSION Local application of 0.2 % HA gel adjunct to non surgical periodontal treatment provided a significant improvement in clinical parameters than placebo control and negative control groups . Microbiologically experimental group does not showed any spastically significant results 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 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 ) 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 AIM AIM of the present study was to evaluate the adjunctive effect of local application of hyaluronon gel following scaling and root planing ( SRP ) in chronic periodontitis patients . MATERIAL S AND METHODS In this r and omized split mouth study 33 subjects with chronic periodontitis were evaluated after full mouth SRP . In the test sites hyaluronon gel was applied immediately after SRP and one week post therapy , the control sites were treated with SRP alone . Bleeding on probing ( BOP ) , probing pocket depth ( PPD ) , and clinical attachment level ( CAL ) were recorded at baseline , 4 wk and 12 wk . RESULTS Significant reduction in BOP scores was observed in both the groups at 12weeks ( p<0.001 ) . The hyaluronon group showed a greater reduction in BOP ( p<0.001 ) . In the hyaluronon group the mean PPD at baseline was 6.33±0.09 which reduced to 2.49±0.51 at 12 weeks which was statistically significant ( p<0.001 ) . In the control group the mean PPD at baseline was 6.09±1.26 which reduced to 4.36±1.29 at 12 weeks which was statistically significant ( p<0.001 ) . The CAL measurements showed a significant difference between the groups ( p<0.001 ) at 12 wk post therapy . CONCLUSION Hyaluronic Acid ( HA ) has a beneficial effect on periodontal health in patients with chronic Periodontitis .  HA appears to be a suitable c and i date as an adjunct to SRP in chronic periodontitis patients 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 INTRODUCTION In implants , maintenance assumes an important role . The role of chlorhexidine ( CHX ) is well known in maintenance , while only limited evidence exists on the practical use of hyaluronic acid ( HA ) . The objective of this study was to compare the health status of the peri-implant complex ( hard and soft tissues surrounding the implant ) during the healing period of immediate function implants , using HA or CHX gels in the patient 's maintenance protocol . STUDY POPULATION AND METHODOLOGY : Thirty complete edentulous patients , with four immediate function Brånemark System implants placed in the m and ible ( total of 120 implants ) , were r and omly assigned to two groups ( HA and CHX ) using only these two chemicals in their daily implant self-care . Both groups were followed up for 6 months , with clinical observations on the 10th day , 2 months , 4 months and 6 months post-surgically . RESULTS During the course of the study , HA and CHX produced good results in maintaining a healthy peri-implant complex in immediate function implants for complete rehabilitations in the edentulous m and ible . Statistically significant differences were found in favour of the HA group in the modified bleeding index on the second observation ( P = 0.003 ) . The difference was more marked in the axial implants placed in the fifth sextant ( P = 0.05 ) . Correlation coefficient between plaque and bleeding index revealed a potentially better result for CHX at 6 months . CONCLUSION The findings point out the importance of a maintenance protocol in immediate function implants . Both chemicals are valid tools for implant maintenance . The authors suggest that it might be advantageous to administer HA in the first 2 months and CHX between 2 and 6 months 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 BACKGROUND Hyaluronic acid ( HA ) is a primary component of the extracellular matrix , and the efficacy of HA on oral ulcers is rarely reported . OBJECTIVE To observe the efficacy and safety of the topical application of 0.2 % HA gel on recurrent oral ulcers and to compare its effects in patients with recurrent aphthous ulcers ( RAU ) and the oral ulcers of Behçet 's disease ( BD ) . MATERIAL S AND METHODS Thirty-three out patients with recurrent oral ulcers were included in the study ( 17 patients : BD , 16 patients : RAU ) . The patients used topical 0.2 % HA gel twice daily for 2 weeks . The subjective parameters of patients [ number of ulcers , healing period , visual analogue scale ( VAS ) for pain ] were investigated and objective assessment s ( number of ulcers , maximal area of ulcer and inflammatory signs ) were inspected by a physician . RESULTS A subjective reduction in the number of ulcers was observed in 72.7 % of the patients . A decrease in the ulcer healing period was observed in 72.7 % of the patients ; 75.8 % experienced improvement in VAS for pain . Objective inspection of the ulcers showed a reduction of numbers in 57.6 % of the patients , and 78.8 % of the ulcers showed a decrease in area . Among the inflammatory signs , swelling and local heat were significantly improved after treatment . No significant differences were found between the BD group and RAU group in subjective and objective parameters , except for inflammatory signs . No side-effects were observed . CONCLUSIONS The topical application of 0.2 % HA gel seems to be an effective and safe therapy in patients with recurrent oral ulcers ; the study supports the use of HA in BD with oral ulcers
To date , topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the soft periodontal tissue , gingiva , and periodontal ligament as well as to the hard tissue such as alveolar bone and cementum .
Topical hyaluronic acid ( HA ) has recently been recognized as an adjuvant treatment for chronic inflammatory disease in addition to its use to improve healing after dental procedures .
The aim of our work was to systematic ally review the published literature about potential effects of HA as an adjuvant treatment for chronic inflammatory disease , in addition to its use to improve healing after common dental procedures .