Crevicular fluid variables after adjunctive treatment with hyaluronan of periodontitis

Objectives: Hyaluronan has positive effects on the immune response and reduces the inflammatory tissue destruction. The aim of the present study was to verify if the adjuctive use of hyaluronan during the initial therapy of chronic periodontitis has a beneficial effect reflected by crevicular fluid variables. Methods: 49 male and female volunteers with generalized moderate chronic periodontitis (mean age 47.9±9.2 years) underwent a full mouth SRP within 24 hours. In the test group (T, n= 23, mean age 48.5±9.4 years) in addition Gengigel^® (Merz Dental, Lütjenburg, Germany) was used during SRP and in the following 14 days. In the control group (C, n=26, mean age 47.3±9.15 years) no placebo was used. Probing depth, clinical attachment level and bleeding on probing were recorded in a 6-point-measurement at baseline, after 3 and 6 months. GCF- and subgingival plaque samples were collected at baseline (0) and after 6 (2) months and analysed for myeloperoxidase (MPO) and potential periodontal pathogens (A.a., P.g., T.f., T.d., F.n., C.r.) given as categories (0, <10⁴, 10⁴-10⁶, > 10⁶). The Wilcoxon and U-tests were used for statistical analysis. Results: The clinical results were previously reported. PD improvement was significantly higher in the test group after 3 and 6 months (p=0.006, 0.014). The results for MPO were as follows: T0-6.28±2.97 U; T2- 6.19±3.23 U; C0 5.85±3.45 U; C2 5.29±3.42 U. The slight improvements of MPO in both groups were not significant, also not between the groups. T.d. and C.r. were significantly reduced in the test group (p=0.044, 0.028), F.n. in the control group (0.004). At the end of the study there was a significant difference for C.r. between the groups (p=0.016). Conclusion: The slight beneficial effects of hyaluronan on PD are partially reflected by microbiological markers of the subgingival plaque. (The study was supported by Merz Dental, Lütjenburg, Germany).