A brief overview on the applications of hyaluronic acid in periodontal therapy

Hyaluronic acid (HA) is a component of the extracellular matrix of the non-mineralized and mineralized tissues, including the periodontium. HA have important physiological and biological properties. HA maintains the tissue volume, presents bacteriostatic, anti-inflammatory, osteoinductive, and angiogenetic properties, as well as stimulates many cell functions having a role in wound healing. HA has been used as an adjunctive in the treatment of gingivitis, periodontitis, gingival recessions, or in the reconstruction of papilla deficiencies. In periodontitis patients, the association of HA with subgingival mechanical instrumentation reduces local inflammation and its use with access flap results in larger attachment level gain of infrabony defects compared to control groups non treated with HA. HA application in conjunction with advanced flaps may improve gingival recession levels. HA injection for papillary deficiency seems to be a viable treatment option that improves clinical volume, esthetic outcomes and is associated with minimal pain.