It is available in a preformed syringe form with

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studies. It is available in a preformed syringe form with blunt cannulas for subgingival delivery for the gel. [28] Our study design was a randomized, controlled trial in accordance with the recommendations by Pihlström in 1997. [29] On the test sites, after completion of SRP, 0.2 ml of 0.8% HA gel was subgingivally placed using the preformed syringes. The hyaluronan gel was reapplied at 1 week posttreatment. This study design was similar to the study reported by Johannsen et al . [13] Periodontal pack (Coe-Pack) was given after HA application. [13] This would help retain the drug subgingivally for maximum period. The clinical parameters were assessed at baseline, 4 weeks, and 12 weeks. The difference between the mean baseline values of both the test group and the control group for all the clinical parameters was statistically insignificant. Thus, the randomization was successful. The inter-group comparison, at 4 weeks and 12 weeks, showed that the difference between the mean PI and GI was insignificant between the test and the control group. However, intra-group comparison in both the test and the control group at the recall appointments showed a highly statistically significant difference from the baseline. This reinforces the already ingrained importance of SRP in nonsurgical periodontal therapy. Hawthorne effect could also be a contributing factor where the subjects enrolled in the study maintained better oral hygiene leading to significant improvement in the PI and the GI. [30] In the intra-group comparison for PPD, in both test and the control groups, a statistically significant reduction was observed at 4 weeks and 12 weeks. However, in the inter-group comparison, a statistically significant difference was seen in the test group as compared to the control group at both 4 weeks and 12 weeks. Thus, SRP did have a significant role in PPD reduction. However, application of HA gel augmented its effects, and lead to further reduction in the PPD. Periodontal pockets are pathognomic signs of periodontal disease. A number of studies have documented significant improvement in probing depth variable when HA gel was used in conjunction with SRP. [16] Johannsen et al ., also used 0.8% HA gel in combination with SRP, found that reduction in probing depth between baseline and 12 weeks was statistically significantly greater for the test group than the control group (1.0 + 0.3 mm and 0.8 + 0.2 mm), respectively. [13] Even in studies wherein the modes of application of HA gel and the frequency differed in the treatment of chronic periodontitis patients, significant reductions in pocket depths were observed. [28,31-34] Only two studies by Xu et al . [35] and Gontiya and Galgali [28] that we found in the literature have contradictory results. However, in both the studies, the concentration of HA was 0.2%. Thus, we could infer that a higher concentration of HA is needed for better clinical outcomes.
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  • Fall '19
  • Statistical significance, SRP, Periodontitis, Hyaluronan

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