Evaluation of Topical Subgingival Application of Hyaluronic Acid (Ha) Gel Adjunctive to Scaling and Root Planing (Srp) in the Treatment of Chronic Periodontitis.

Abstract

Objective: The aim of this study is to assess effect of sub-gingival application of hyaluronic acid (HA) gel .8% adjunctive to non-mechanical debridement in treatment of chronic periodontitis based on clinical scoring and microbiological study. Subjects and Methods: The present study was carried out on 20 patients with chronic periodontitis with at least two quadrants with pocket depth ≥5 mm within the same arch. Split-mouth study design was used where control side received (SRP) only and study side received both (SRP) and subgingival application of high molecular weight 0.8% hyaluronic acid gel in a 3 months follow-up study. After clinical assessment and plaque sample collection all patients received full mouth SRP in both study and control sites at the baseline, 2 nd , 4 th and 6 th weeks. Study sites additionally received 0.8% HMW HA gel sub-gingivally till the depth of pocket, this done once a week starting at the baseline then repeated at weeks 1, 2, 3, 4, 5 and 6 for a total seven applications. Subgingival plaque samples were collected prior to clinical measurements from both study and control sites at the baseline, 6 th and 12 th weeks for PCR examination. Evaluation included clinical and microbiological parameters that recorded at the base line, th 6 th and then in 12 th week. Clinical parameters included: Plaque index (PI), Gingival index(GI), Periodontal probing depths (PPD), Clinical attachment loss (CAL) and clinical attachment regain where, micriobiological assessment included qualitative polymerase chain reaction (PCR) for detection of both provotella intermedia and porphyromonus gingivalis in both sides . Results: In the present study, there were highly significant clinical improvements in all measured clinical