Intrabony Periodontal Defect Clinical Trial
Official title:
Effectiveness of Hyaluronic Acid Versus Enamel Matrix Derivatives in the Regeneration of Infrabony Defects. A Randomized Controlled Clinical Trial
The purpose of this randomized controlled clinical trial (RCT) is to determine the efficacy hyaluronic acid (HA) versus enamel matrix derivatives (EMD) in the treatment of infrabony periodontal defects.
Intrabony defects associated with periodontal pockets represent a risk factor for
periodontitis progression and additional loss of attachment if left untreated.
Over the years, several strategies have been implemented for their surgically reconstruction
with the aim of pocket reduction and clinical attachment level gain.
Grafting of intrabony periodontal defects has been used extensively over the years
incorporating various materials, including autogenic bone, demineralized allogenic bone,
xenogenic and alloplastic materials. Controlled clinical studies have shown a significantly
higher gain of clinical attachment and radiographic bone gain in intra-bony periodontal
defects treated with open flap debridement combined with EMD when compared with open flap
debridement alone.
Hyaluronic acid (HAc) is a naturally occurring linear polysaccharide of the extracellular
matrix of connective tissue, synovial fluid, and other tissues. It possesses various
physiological and structural functions, which include cellular and extracellular
interactions, interactions with growth factors and regulation of the osmotic pressure, and
tissue lubrication. All these functions help in maintaining the structural and homeostatic
integrity of the tissue.
In the field of dentistry, in vitro and animal studies have demonstrated that hyaluronic acid
prevents oxygen free-radical damage to granulation tissue, stimulates the clot formation ,
induces angiogenesis and does not interfere in the calcification nodule during bone
formation.
A randomized controlled trial evaluated the effect of local application of 0.8% Hyaluronan
gel in conjunction with periodontal surgery. After initial non-surgical periodontal therapy
and re-evaluation, defects were randomly assigned to be treated with modified Widman flap
surgery in conjunction with either 0.8% Hyaluronan gel (test) or placebo gel (control)
application. Statistically, significant differences were noted for Clinical Attachment Level
and gingival recession, (P < 0.05) in favor of the test sites. But non-significant results
were found regarding PD, BOP and PI values (P > 0.05).
At the present time no comparative data are available about the use of HA versus EMD in
treatment of infrabony defects. Therefore the aim of this study will be evaluated the
effectiveness of hyaluronic acid versus enamel matrix derivatives alone in the regeneration
of infrabony defects.
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