Niemczyk Wojciech, Matys Jacek, Wiench Rafał, Żurek Jacek, Dominiak Marzena
Medical Center of Innovation, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland.
Department of Dental Surgery Medical, University of Wroclaw, Krakowska 26, 50-425 Wroclaw, Poland.
Biomedicines. 2025 Apr 20;13(4):998. doi: 10.3390/biomedicines13040998.
: Periodontitis is a prevalent inflammatory condition that destroys periodontal tissues. Scaling and root planing (SRP) is the gold standard for non-surgical treatment; however, its efficacy may be limited in cases with complex dental issues. This umbrella review aims to evaluate the effectiveness of hyaluronic acid (HA) as an adjunct to scaling and root planing (SRP) in enhancing clinical outcomes for periodontitis management. : A comprehensive review of five systematic reviews, including meta-analyses where available, was conducted to synthesize evidence on the adjunctive use of HA with SRP. The studies were evaluated using the AMSTAR-2 quality assessment tool to determine methodological rigor. Data on clinical parameters such as probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), and plaque index (PI) were extracted and analyzed. : The findings indicate that HA supplementation leads to moderate improvements in PD, CAL, BOP, GI, and PI compared to SRP alone. Notable reductions in PD and gains in CAL were observed, with some meta-analyses showing statistically significant benefits. However, the heterogeneity in HA concentrations (0.2-1.4%), application methods, treatment frequencies, and follow-up durations (1 week to 12 months) limits definitive conclusions. Additionally, HA did not significantly affect the reduction in prevalence. : The use of HA in conjunction with SRP shows promise in enhancing the efficacy of non-surgical periodontal therapy. However, the heterogeneity in the quality and methodologies of the studies indicates the necessity for high-quality, standardized randomized controlled trials to establish clear clinical guidelines for the application of HA in the treatment of periodontitis.
牙周炎是一种常见的炎症性疾病，会破坏牙周组织。龈下刮治术和根面平整术（SRP）是非手术治疗的金标准；然而，在存在复杂牙齿问题的情况下，其疗效可能有限。本伞状综述旨在评估透明质酸（HA）作为龈下刮治术和根面平整术（SRP）的辅助手段在改善牙周炎治疗临床效果方面的有效性。：对五项系统评价进行了全面综述，包括在可行情况下的荟萃分析，以综合关于HA与SRP联合使用的证据。使用AMSTAR-2质量评估工具对研究进行评估，以确定方法的严谨性。提取并分析了诸如探诊深度（PD）、临床附着水平（CAL）、探诊出血（BOP）、牙龈指数（GI）和菌斑指数（PI）等临床参数的数据。：研究结果表明，与单独使用SRP相比，补充HA可使PD、CAL、BOP、GI和PI有中度改善。观察到PD显著降低，CAL有所增加，一些荟萃分析显示出统计学上的显著益处。然而，HA浓度（0.2 - 1.4%）、应用方法、治疗频率和随访持续时间（1周到12个月）的异质性限制了确定性结论。此外，HA对患病率的降低没有显著影响。：HA与SRP联合使用在提高非手术牙周治疗疗效方面显示出前景。然而，研究质量和方法的异质性表明，需要高质量、标准化的随机对照试验来为HA在牙周炎治疗中的应用建立明确的临床指南。
