IADR Abstract Archives
Hyaluronic Acid as Adjunctive for Non-Surgical and Surgical Periodontal Treatment: A Systematic Review and Meta-Analysis
Objectives: Hyaluronic acid (HA) has been shown to be beneficial in different fields of medicine and dentistry. The aim of the current systematic review and meta-analysis was to evaluate the potential additional effects of local application of HA in conjunction with either nonsurgical or surgical periodontal therapy on the clinical outcomes.
Methods: A search using the terms: "periodontal therapy", "periodontal surgery" and "hyaluronic acid" was performed in Medline, Embase, Cochrane, Web of Science, Grey literature and Scoups. Wide databases have been used to include as many studies as possible. Literature search was preformed according to PRISMA guidelines using the following criteria: 1. English language, 2. randomized controlled study, 3. Effect of HA on clinical parameters.
Results: In order to minimize the bias and to preform meta-analysis only randomizes clinical studies (RCTs) were included. Finally, 14 RCTs were included: 11 on non-surgical periodontal treatment and 3 on surgical periodontal treatment. Each study included 6-150 patients between 25-60 years old. Statistical results were recorded and Weighted Mean Differences (WMD) and Confidence Intervals (CI) calculated. Meta-analysis was performed for Probing Depth (PD) reduction, Clinical Attachment Level Gain (CAL) and Bleeding on Probing (BOP) obtained after both nonsurgical and surgical periodontal therapy with or without adjunctive HA therapy or placebo. Overall analysis of PD, CAL and BOP in non-surgical therapy with adjunctive HA presented WMD of -0.36mm (95% CI= -0.54 to -0.19; p<0.0001), -0.73 mm (95% CI= - 1.17 to -0.28; p<0.0001) and -0.15 (in percentage) (95% CI -0.22 to -0.08; p<0.001) respectively, favoring the treatment with HA. The overall analysis of PD in surgical therapy with adjunctive HA presented WMD was -0.95mm (95% CI=--1.17 to -0.20; p<0.0001) at 48 weeks and -1.17 (95% CI=--1.74 to -0.61; p<0.0001) at 92 weeks, favoring the treatment with HA. However, comparison presented considerable heterogeneity among studies and a high risk of bias.
Conclusions: The local application of HA in conjunction with periodontal surgery showed beneficial effects for PD reduction and CAL gain. However, the clinical relevance of using HA as an adjunctive to nonsurgical therapy is still unclear.
Methods: A search using the terms: "periodontal therapy", "periodontal surgery" and "hyaluronic acid" was performed in Medline, Embase, Cochrane, Web of Science, Grey literature and Scoups. Wide databases have been used to include as many studies as possible. Literature search was preformed according to PRISMA guidelines using the following criteria: 1. English language, 2. randomized controlled study, 3. Effect of HA on clinical parameters.
Results: In order to minimize the bias and to preform meta-analysis only randomizes clinical studies (RCTs) were included. Finally, 14 RCTs were included: 11 on non-surgical periodontal treatment and 3 on surgical periodontal treatment. Each study included 6-150 patients between 25-60 years old. Statistical results were recorded and Weighted Mean Differences (WMD) and Confidence Intervals (CI) calculated. Meta-analysis was performed for Probing Depth (PD) reduction, Clinical Attachment Level Gain (CAL) and Bleeding on Probing (BOP) obtained after both nonsurgical and surgical periodontal therapy with or without adjunctive HA therapy or placebo. Overall analysis of PD, CAL and BOP in non-surgical therapy with adjunctive HA presented WMD of -0.36mm (95% CI= -0.54 to -0.19; p<0.0001), -0.73 mm (95% CI= - 1.17 to -0.28; p<0.0001) and -0.15 (in percentage) (95% CI -0.22 to -0.08; p<0.001) respectively, favoring the treatment with HA. The overall analysis of PD in surgical therapy with adjunctive HA presented WMD was -0.95mm (95% CI=--1.17 to -0.20; p<0.0001) at 48 weeks and -1.17 (95% CI=--1.74 to -0.61; p<0.0001) at 92 weeks, favoring the treatment with HA. However, comparison presented considerable heterogeneity among studies and a high risk of bias.
Conclusions: The local application of HA in conjunction with periodontal surgery showed beneficial effects for PD reduction and CAL gain. However, the clinical relevance of using HA as an adjunctive to nonsurgical therapy is still unclear.