Effectiveness of Hyaluronic Acid in the Regeneration of Infrabony Defects
Condition: Intrabony Periodontal Defect
Study type: Interventional

Summary: 
      The purpose of this randomized controlled clinical trial (RCT) is to determine the efficacy
      hyaluronic acid (HA) versus enamel matrix derivatives (EMD) in the treatment of infrabony
      periodontal defects.
    

Detailed description: 
      Intrabony defects associated with periodontal pockets represent a risk factor for
      periodontitis progression and additional loss of attachment if left untreated.

      Over the years, several strategies have been implemented for their surgically reconstruction
      with the aim of pocket reduction and clinical attachment level gain.

      Grafting of intrabony periodontal defects has been used extensively over the years
      incorporating various materials, including autogenic bone, demineralized allogenic bone,
      xenogenic and alloplastic materials. Controlled clinical studies have shown a significantly
      higher gain of clinical attachment and radiographic bone gain in intra-bony periodontal
      defects treated with open flap debridement combined with EMD when compared with open flap
      debridement alone.

      Hyaluronic acid (HAc) is a naturally occurring linear polysaccharide of the extracellular
      matrix of connective tissue, synovial fluid, and other tissues. It possesses various
      physiological and structural functions, which include cellular and extracellular
      interactions, interactions with growth factors and regulation of the osmotic pressure, and
      tissue lubrication. All these functions help in maintaining the structural and homeostatic
      integrity of the tissue.

      In the field of dentistry, in vitro and animal studies have demonstrated that hyaluronic acid
      prevents oxygen free-radical damage to granulation tissue, stimulates the clot formation ,
      induces angiogenesis and does not interfere in the calcification nodule during bone
      formation.

      A randomized controlled trial evaluated the effect of local application of 0.8% Hyaluronan
      gel in conjunction with periodontal surgery. After initial non-surgical periodontal therapy
      and re-evaluation, defects were randomly assigned to be treated with modified Widman flap
      surgery in conjunction with either 0.8% Hyaluronan gel (test) or placebo gel (control)
      application. Statistically, significant differences were noted for Clinical Attachment Level
      and gingival recession, (P < 0.05) in favor of the test sites. But non-significant results
      were found regarding PD, BOP and PI values (P > 0.05).

      At the present time no comparative data are available about the use of HA versus EMD in
      treatment of infrabony defects. Therefore the aim of this study will be evaluated the
      effectiveness of hyaluronic acid versus enamel matrix derivatives alone in the regeneration
      of infrabony defects.
    

Intervention name(s): enamel matrix derivative (EMD); hyaluronic acid (HA)
Intervention type(s): Device; Device
Intervention description(s): periodontal regenerative surgery with enamel matrix derivative (EMD) (control); periodontal regenerative surgery with hyaluronic acid (HA) (test)
Intervention MeSH terms: Hyaluronic Acid
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment