Tolerability and efficacy of an hyaluronic acid-based periodontal biogel

Objectives: to evaluate the tolerability and possible positive effects of an esterified form of HA on gingival tissues in mild chronic periodontitis patients as measured by the reduction of periodontal disease clinical parameters [PLI (Plaque Index), BOP (Bleeding on Probing), PPD (Probing Pocket Depth), GI (Gingival Index), and PAL (Probing Attachment Level) . Methods: The study is an open, intra-patient, controlled, single center pilot clinical trial of 19 adult patients with mild chronic periodontitis and shallow pockets (< 4 mm) in at least two different quadrants. One quadrant was treated with HA gel after regular toothbrushing (test), the other without (control). Results: Although oral hygiene alone had a similar positive influence on the improvement of all the clinical indexes for both test and control quadrants, treatment with HA gel showed a statistically significant greater effect. BOP in the HA gel treated areas had a decrease of 92.7% and GI of 96.5%, whereas controls decreased by 75.8% and 79.0% respectively. The reduction in PPD in both test and control areas was statistically significant (p<0.01) with the HA gel treated zone showing a statistically significant difference as compared to the controls. PAL and Pl were also reduced to a greater extent with the gel than with oral hygiene alone, although the difference was not statistically significant. Conclusion: an esterified gel form of HA may reduce gingival inflammation when used as an adjunct to mehcanical home plaque control and that it could be successfully used to improve the periodontal clinical indexes. Further study with a larger patient sample and the addition of other biological parameters such as immunocytochemistry and histology will be required to confirm these findings.