The Efficacy of a Combination of Hyaluronic acid and Metronidazole as a topical Adjunctive in Non- Surgical Treatment of Periodontitis (Clinical and Biochemical Study)

Abstract

Aim : This study was designed to evaluate the clinical and biochemical effects of combination of hyaluronic acid and metronidazole as an adjunctive treatment of periodontitis. Subjects and methods : Forty patients with stage I to stage II, grade A periodontitis were selected from the out-patient clinic, Oral Medicine and Periodontology Department, Faculty of Dental Medicine, Al-Azhar University, Assiut Branch. They were divided into four equal groups. Group I received conventional periodontal therapy alone, group II received conventional periodontal therapy with intra pocket application of hyaluronic acid gel (GENGIGEL) 0.2%, group III received conventional periodontal therapy with intra pocket application of metronidazole (25%) and group IV received conventional periodontal therapy with intra pocket application of combination of hyaluronic acid (0.2%) and metronidazole (25%). All patients were evaluated clinically at baseline, 3 and 6 months and biochemical evaluation was done at baseline,1 and 3 months to evaluate the IL-1β level in GCF. Results : All groups showed statistically significant differences at the different intervals in all clinical parameters (PI, GI, PD, CAL) and IL-1β level in GCF. Inter-groups comparison with respect to clinical and biochemical changes showed that Combination gel was the best. Conclusion : The combination of hyaluronic acid and metronidazole achieve superior effects as adjunctive therapy in improving the clinical and biochemical parameters in the treatment of periodontitis. periodontal disease is tooth loss (2) . Periodontopathic bacteria induce host immune response to secrete pro-inflammatory cytokines that play a role in periodontal tissue destruction (3) .