Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Hyaluronic acid reduces inflammation and crevicular fluid IL-1β concentrations in peri-implantitis: a randomized controlled clinical trial

  • Sanchez-Fernandez, Elena (Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada) ;
  • Magan-Fernandez, Antonio (Department of Periodontics, School of Dentistry, University of Granada) ;
  • O'Valle, Francisco (Department of Pathology and History of Science, School of Medicine, University of Granada) ;
  • Bravo, Manuel (Department of Preventive and Community Dentistry, School of Dentistry, University of Granada) ;
  • Mesa, Francisco (Department of Periodontics, School of Dentistry, University of Granada)
  • Received : 2019.07.17
  • Accepted : 2020.09.28
  • Published : 2021.02.28
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Abstract

Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)-1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, -1.66, -0.40 mm; control 2: 95% CI, -1.07, -0.01 mm) and 90 days (control 1: 95% CI, -1.72, -0.54 mm; control 2: 95% CI, -1.13, -0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels.

Keywords

Acknowledgement

The authors are grateful to Richard Davies for editorial assistance.

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