Clinical efficacy of hyaluronic acid in the treatment of periodontal intrabony defect: a systematic review and meta-analysis

Bertha Inés Ostos-Aguilar; Camila Pinheiro Furquim; Francisco Wilker Mustafa Gomes Muniz; Marcelo Faveri; Jonathan Meza-Mauricio

doi:10.1007/s00784-022-04855-6

Clinical efficacy of hyaluronic acid in the treatment of periodontal intrabony defect: a systematic review and meta-analysis

Clin Oral Investig. 2023 May;27(5):1923-1935. doi: 10.1007/s00784-022-04855-6. Epub 2023 Jan 4.

Authors

Bertha Inés Ostos-Aguilar¹, Camila Pinheiro Furquim², Francisco Wilker Mustafa Gomes Muniz³, Marcelo Faveri², Jonathan Meza-Mauricio⁴

Affiliations

¹ Department of Periodontology, School of Dentistry, Universidad Cientifica del Sur, Calle Cantuarias 398, 15048, Miraflores, Lima, Peru.
² Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil.
³ Department of Periodontology, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil.
⁴ Department of Periodontology, School of Dentistry, Universidad Cientifica del Sur, Calle Cantuarias 398, 15048, Miraflores, Lima, Peru. emezam@cientifica.edu.pe.

PMID: 36598601
DOI: 10.1007/s00784-022-04855-6

Abstract

Objective: This systematic review aimed to evaluate the effects of hyaluronic acid (HA) alone or in combination with any bone substitute for the treatment of intrabony defects (IBDs).

Material and methods: Six databases were searched up to April 2022 to find randomized clinical trials comparing the clinical effects of open flap debridement (OFD) + HA versus OFD alone (first group) or OFD + HA + bone substitutes versus OFD + bone substitutes (second group) in the treatment of IBDs with a follow-up of at least 3 months. Random effects models of mean differences were used to determine the clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic bone fill (RBF).

Results: Of the 276 studies identified, 6 were included in the qualitative synthesis, and 5 in the meta-analyses. The meta-analyses in the first group showed a statistically significant differences for CAL gain (mean difference [MD]:1.00; 95% confidence interval [CI]:0.65 - 1.35; n = 2) and PD reduction (MD: 0.76; 95%CI: 0.34 - 1.17; n = 2) favoring HA + OFD at 6 months. However, in the second group, the meta-analyses did no show additional effect of HA in association with bone substitute was demonstrated for either CAL gain (MD: 0.57; 95%CI: - 0.30 - 1.43; n = 2) or PD reduction (MD: 1.05; 95%CI: - 0.38 - 2.47; n = 2) but did show significant differences for RBF (MD: 0.57; 95%CI: 0.15 - 0.99; n = 2) at 12 months.

Conclusion: Compared with OFD alone, local application of HA in the treatment of IBDs provided a significant CAL gain and PD reduction at 6 months. However, its combination with bone substitutes showed no statistically significant differences at 12 months.

Clinical relevance: The use of OFD + HA improves the CAL and PD in the treatment of IBDs compared to OFD only after 6 months of follow-up. These results are not maintained after 12 months.

Keywords: Hyaluronic acid; Periodontal bone loss and intrabony periodontal defect; Periodontal regeneration.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Alveolar Bone Loss* / drug therapy
Alveolar Bone Loss* / surgery
Bone Substitutes* / pharmacology
Bone Substitutes* / therapeutic use
Debridement
Follow-Up Studies
Guided Tissue Regeneration, Periodontal / methods
Humans
Hyaluronic Acid / pharmacology
Hyaluronic Acid / therapeutic use
Periodontal Attachment Loss / drug therapy
Treatment Outcome

Substances

Bone Substitutes
Hyaluronic Acid