Adjunctive Application of Hyaluronic Acid in Combination with a Sodium Hypochlorite Gel for Non-Surgical Treatment of Residual Pockets Reduces the Need for Periodontal Surgery-Retrospective Analysis of a Clinical Case Series.

Diehl, Daniel; Friedmann, Anton; Liedloff, Pheline; Jung, Rico Marvin; Sculean, Anton; Bilhan, Hakan (2022). Adjunctive Application of Hyaluronic Acid in Combination with a Sodium Hypochlorite Gel for Non-Surgical Treatment of Residual Pockets Reduces the Need for Periodontal Surgery-Retrospective Analysis of a Clinical Case Series. Materials, 15(19) MDPI 10.3390/ma15196508

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The comprehensive treatment of periodontitis stage 2 to 4 aims at the resolution of periodontal inflammation and "pocket closure", which implies a residual probing depth of ≤4 mm and a negative BoP. However, supportive periodontal therapy (SPT) regularly leaves behind persistent periodontal pockets with 5 or more mm in residual PPD and sites that often re-colonize and re-infect. Various adjunctive options for subgingival instrumentation have been proposed to enhance the antimicrobial effects to better control the re-infection of these residual sites. The locally applied adjuncts, based on their anti-inflammatory effect, are sodium hypochlorite antiseptic cleaning gel and cross-linked hyaluronic acid (xHyA). Both recently moved into the focus of clinical research on non-surgical and surgical therapy for periodontitis. The surgical use of xHyA indicates regenerative potential, supporting periodontal regeneration. This case series retrospectively analyzes the clinical benefits of the consecutive flapless application of sodium-hypochlorite-based cleaning gel and xHyA at the SPT to achieve pocket closure, thereby reducing the need for periodontal surgery. In 29 patients, 111 sites received the treatment sequence. At 6-month re-evaluation, an overall PPD reduction exceeding 2 mm was achieved, associated with a similar CAL gain (2.02 mm); the bleeding tendency (BoP) was reduced by >60%. Pocket closure occurred in almost 25% of all the sites. Within their limits, the present data suggest that the proposed combined adjunctive treatment of residual active periodontal sites yielded significant improvement in the clinical parameters. Further studies in RCT format are required to confirm these observations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine

UniBE Contributor:

Sculean, Anton

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1996-1944

Publisher:

MDPI

Language:

English

Submitter:

Pubmed Import

Date Deposited:

17 Oct 2022 13:35

Last Modified:

07 Aug 2024 15:45

Publisher DOI:

10.3390/ma15196508

PubMed ID:

36233855

Uncontrolled Keywords:

hyaluronic acid non-surgical periodontal therapy periodontitis sodium hypochlorite

BORIS DOI:

10.48350/173768

URI:

https://boris.unibe.ch/id/eprint/173768

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