## 3 Results
### Microbiological Analysis  
[PERSON] et al. [22] analyzed six periodonopathogenicic bacterial species. At 6 months after root polishing (SRP), _A. actinomycetemcomitans_ (\(p\) = 0.027) and _C. rectus_ (\(p\) = 0.008) were more prevalent in the control group. _Treponema denticola_ was decreased in the test (\(p\) = 0.043) and in the control group at 3 months (\(p\) = 0.043), while _C. rectus_ was decreased in the test group (\(p\) = 0.028). _P. intermedia_ (\(p\) = 0.043) and _P. gigivalis_ (\(p\) = 0.016) were increased in the control group. No significant changes in _T. forsythia_ were noted.  
[PERSON] et al. [32] found a statistical difference at 12 weeks only for _A. actinomycetemcomitans_ and _P. gingivalis_, with a greater reduction in the test than in the control site. [PERSON] et al. [24] reported a significant reduction in colony-forming units (CFUs) in the test compared with the control site at the 12-week follow-up (\(p\) < 0.001). The CFU/mL value decreased from 5.21 \(\times\) 10\({}^{6}\) to 2.10 \(\times\) 10\({}^{5}\) in the test and from 5.12 \(\times\) 10\({}^{6}\) to 3.55 \(\times\) 10\({}^{5}\) in the control site.  
[PERSON] et al. [30] observed a significant reduction in _T. forsythia_ after the use of 0.2% HA compared with SRP alone, but no differences in other bacterial species at the 6-week follow-up. In contrast, [PERSON] et al. [36] and [PERSON] et al. [18] reported no statistical difference between the use of 0.2% HA and SRP alone at the 12-week follow-up.  
Biochemical Analysis  
[PERSON] et al. [27] measured human beta defensin-2 levels using an enzyme-linked immunosorbent assay. At the test site, human beta defensin-2 (hBD-2) levels were significantly increased over baseline at 6 and 12 weeks (\(p\) = 0 for both comparisons). At baseline, there were no significant differences between the test and the control sites (\(p\) > 0.05). At 6 weeks, however, the test site showed significantly higher levels of hBD-2 than the control site (\(p\) = 0.012). The mean hBD-2 in the test site at 6 and 12 weeks (29.85 and 28.77) was higher than in the control site.  
In contrast, the study by [PERSON] et al. [21] measured the total leukocyte count (TLC), differential leukocyte count (DLC), and C-reactive protein (CRP). Only one patient tested positive for CRP at baseline and was not included in the final analysis. Systemic and hematologic parameters showed an increase in white blood cell (WBC) count at 24 h and a decrease at 1 month and 3 months in all groups (\(p\) < 0.05), with a greater reduction in the test group. Neutrophil, eosinophil, and monocyte counts peaked at 24 h and were decreased at 3 months, with greater reduction in the test group. WBC count decreased initially and then increased at subsequent follow-ups.  
[PERSON] et al. [29] reported a statistically significant decrease in adenosine deaminase (ADA) levels in gingival crevicular fluid (GCF) in the control and the test group. An increase in catalase (CAT) and glutathione (GSH) levels in GCF was observed in both groups at follow-up (\(p\) < 0.05). Differences between baseline and week 1, 2, and 4 were statistically significant for ADA, CAT, and GSH levels in GCF in the control and the test group already at week 1. No statistically significant differences in ADA, CAT, and GSH levels between the groups were observed at the other follow-ups.