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
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...
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MDPI AG
2022-09-01
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| author | Daniel Diehl Anton Friedmann Pheline Liedloff Rico Marvin Jung Anton Sculean Hakan Bilhan |
| author_facet | Daniel Diehl Anton Friedmann Pheline Liedloff Rico Marvin Jung Anton Sculean Hakan Bilhan |
| author_sort | Daniel Diehl |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T21:32:16Z |
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| id | doaj.art-3e2243b1fb6249e9ba2808ecada2dc91 |
| institution | Directory Open Access Journal |
| issn | 1996-1944 |
| language | English |
| last_indexed | 2024-03-09T21:32:16Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Materials |
| spelling | doaj.art-3e2243b1fb6249e9ba2808ecada2dc912023-11-23T20:52:07ZengMDPI AGMaterials1996-19442022-09-011519650810.3390/ma15196508Adjunctive 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 SeriesDaniel Diehl0Anton Friedmann1Pheline Liedloff2Rico Marvin Jung3Anton Sculean4Hakan Bilhan5Department of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, GermanyDepartment of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, GermanyDepartment of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, GermanyDepartment of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, GermanyDepartment of Periodontology, School of Dental Medicine, University of Bern, 3012 Bern, SwitzerlandDepartment of Periodontology, Faculty of Health, Witten/Herdecke University, 58455 Witten, GermanyThe 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.https://www.mdpi.com/1996-1944/15/19/6508hyaluronic acidsodium hypochloriteperiodontitisnon-surgical periodontal therapy |
| spellingShingle | Daniel Diehl Anton Friedmann Pheline Liedloff Rico Marvin Jung Anton Sculean Hakan Bilhan 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 hyaluronic acid sodium hypochlorite periodontitis non-surgical periodontal therapy |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | hyaluronic acid sodium hypochlorite periodontitis non-surgical periodontal therapy |
| url | https://www.mdpi.com/1996-1944/15/19/6508 |
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