Another study by chauhan et al showed a similar gain

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Another study by Chauhan et al . showed a similar gain in the attachment level in the group where HA was used in conjunction with SRP. [32] Most of the studies have also shown an enhancement in the attachment levels wherein HA was used as an adjunct to SRP. They, however, did not find a statistically significant difference between the test and control groups. [13,27,28,31,34,35] This could be attributed to the vast difference in the study design such as the severity of the disease in the subjects, the concentration of the gel, and the mode of application, frequency. Hyaluronan has also been studied as an adjunct to periodontal surgical treatment. In a case series by Vanden Bogaerde, [38] wherein open flap debridement (OFD) was performed with adjunct use of hyaluronan for the treatment of intrabony defects, clinical attachment level (CAL) gain after 12 months was observed. CAL gains ranging from 1.9 to 3.5 mm [39,40] were observed when HA was used in adjunct to modified Widman flap or OFD. In another study, HA gel application as adjunct to guided tissue regeneration (GTR) resulted in statistically significant larger radiographic bone gain comparing to only GTR. [41] Thus, these findings support the gain in the clinical attachment we found in our study owing to the favorable properties of hyaluronan. The application of hyaluronan, thus, has an irrefutable advantage on the various gingival and periodontal clinical parameters in the treatment of periodontal disease. SUMMARY AND CONCLUSION Clinicians are challenged with managing patients with periodontitis of varying extent and severity. Treatment options range from SRP to SRP with adjunctive treatments to surgical interventions. Hyaluronan as an LDD is gaining foothold too. Due to its anti- inflammatory, anti-microbial and regenerative properties, it is being evaluated as an adjunct to both nonsurgical and surgical therapy in periodontology. In the present study, the clinical effects of subgingival application of 0.8% hyaluronan gel as an adjunct to SRP in the treatment of generalized chronic periodontitis were assessed. The following conclusions were drawn at the end of the study: There was a significant improvement in all the parameters found at different time intervals There was a significant improvement in the primary variables of the periodontal parameters, i.e., PPDs and attachment levels in the sites wherein hyaluronan was used as compared to where it was not. Within the limitations of the current study, subgingival placement of 0.8% HA gel along with SRP provided a significant improvement in periodontal parameters in the test sites after a 3-month period when compared with control sites. Thus, hyaluronan is surfacing as a promising prospect in the treatment of periodontitis. However, further studies with larger sample size are needed in this field to substantiate the assessment of the result of the said periodontal therapy.
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  • Fall '19
  • Statistical significance, SRP, Periodontitis, Hyaluronan

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