Hyaluronic acid as adjunctive to non-surgical and surgical periodontal therapy: a systematic review and meta-analysis.

Eliezer, Meizi; Imber, Jean-Claude; Sculean, Anton; Pandis, Nikolas; Teich, Sorin (2019). Hyaluronic acid as adjunctive to non-surgical and surgical periodontal therapy: a systematic review and meta-analysis. Clinical oral investigations, 23(9), pp. 3423-3435. Springer-Verlag 10.1007/s00784-019-03012-w

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OBJECTIVES To evaluate the potential added benefit of the topical application of hyaluronic acid (HA) on the clinical outcomes following non-surgical or surgical periodontal therapy. MATERIALS AND METHODS A systematic search was performed in Medline, Embase, Cochrane, Web of Science, Scopus and Grey literature databases. The literature search was preformed according to PRISMA guidelines. The Cochrane risk of bias tool was used in order to assess the methodology of the included trials. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) between the treatment and controls were estimated using the random-effect model for amount of bleeding on probing (BOP), probing depth (PD) reduction and clinical attachment level (CAL) gain. In order to minimize the bias and to perform meta-analysis, only randomized clinical studies (RCTs) were selected. RESULTS Thirteen RCTs were included: 11 on non-surgical periodontal treatment and two on surgical periodontal treatment. Overall analysis of PD reduction, CAL gain and BOP reduction in non-surgical therapy with adjunctive HA presented WMD of - 0.36 mm (95% CI - 0.54 to - 0.19 mm; p < 0.0001), 0.73 mm (95% CI 0.28 to 1.17 mm; p < 0.0001) and - 15% (95% CI - 22 to - 8%; p < 0.001) respectively, favouring the application of HA. The overall analysis on PD and CAL gain in surgical therapy with adjunctive HA presented WMD of - 0.89 mm (95% CI - 1.42 to - 0.36 mm; p < 0.0001) for PD reduction and 0.85 mm (95% CI 0.08 to 1.62 mm; p < 0.0001) for CAL gain after 6-24 months favouring the treatment with HA. However, comparison presented considerable heterogeneity between the non-surgical studies and a high risk of bias in general. CONCLUSIONS Within their limits, the present data indicate that the topical application of HA may lead to additional clinical benefits when used as an adjunctive to non-surgical and surgical periodontal therapy. However, due to the high risk of bias and heterogeneity, there is a need for further well-designed RCTs to evaluate this material in various clinical scenarios. CLINICAL RELEVANCE The adjunctive use of HA may improve the clinical outcomes when used in conjunction with non-surgical and surgical periodontal therapy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Orthodontics
04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology
04 Faculty of Medicine > School of Dental Medicine

UniBE Contributor:

Eliezer-Shatz, Meizi; Imber, Jean-Claude; Sculean, Anton and Pandis, Nikolaos

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-6981

Publisher:

Springer-Verlag

Language:

English

Submitter:

Doris Burri

Date Deposited:

23 Dec 2019 07:51

Last Modified:

23 Dec 2019 07:51

Publisher DOI:

10.1007/s00784-019-03012-w

PubMed ID:

31338632

Uncontrolled Keywords:

Hyaluronan Hyaluronic acid Non-surgical periodontal therapy Periodontitis Surgical periodontal therapy

BORIS DOI:

10.7892/boris.137323

URI:

https://boris.unibe.ch/id/eprint/137323

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