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CC BY 4.0 · Eur J Dent 2024; 18(04): 1090-1100
DOI: 10.1055/s-0044-1782188
Original Article

Effectiveness of 0.2% Hyaluronic Acid on Clinical, Biomolecular and Microbiological Parameters in Type 2 Diabetes Mellitus Patients with Periodontitis

Anggun Alfreda Devina
1   Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Felita Clarissa Halim
1   Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Meivi Meivi
1   Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Sri Lelyati C. Masulili 
2   Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Ette Soraya Shahnaz Tadjoedin
2   Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Robert Lessang
2   Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Adityo Widaryono
2   Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Boy M. Bachtiar
3   Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Benso Sulijaya 
2   Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Fatimah Maria Tadjoedin 
2   Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Natalina Haerani
2   Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Nadhia Anindhita Harsas
2   Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
,
Astrid Diana Bakker
4   Oral Cell Biology Department, Academic Centre for Dentistry Amsterdam, ACTA, Amsterdam, the Netherlands
› Author Affiliations Funding The authors thank Universitas Indonesia for the support in the publication of this study and to the Research and Development Directorates of Universitas Indonesia of the 2023 PUTI Q2 grant (grant number:NKB-1277/UN2.RST/HKP.05.00/2022).
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Abstract

Objective This double-blind randomized clinical trial assessed the effectiveness of 0.2% hyaluronic acid (HA) gel as an adjunct to scaling and root planning (SRP) in patients with periodontitis and type 2 diabetes mellitus (DM), focusing on changes in clinical periodontal parameters, the expression of inflammatory mediators, and oral pathogens.

Materials and Methods The randomized clinical trial involved 36 participants, 18 DM patients, and 18 healthy patients. The participants in each group were randomly assigned to receive placebo or HA gel after SRP. Gingival crevicular fluid and subgingival plaque samples were taken before treatment and at 4-week follow-up. Clinical parameters, interleukin-1β (IL-1β) and IL-10 levels, and proportions of Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) were evaluated at baseline and follow-up.

Statistical Analysis Paired t-test (parametric data) or Wilcoxon signed-rank test (nonparametric data) was used for intragroup comparison between baseline and follow-up, and comparisons between groups one-way analysis of variance test (parametric data) or Kruskal–Wallis test (nonparametric data).

Results At 4 weeks, most of the groups showed statistically significant decreases (p ≤ 0.05) in various clinical and biomolecular parameters. However, there were exceptions: the pocket probing depth (PPD) and clinical attachment loss (CAL) parameter did not significantly decrease for the placebo (p > 0.05) non-DM group, and the IL-10 parameter in the DM HA gel group (p = 0.108). Regarding bacterial proportions, the non-DM and DM placebo group exhibited significant test results for Pg after 4 weeks (p ≤ 0.05). In the case of Fn bacteria proportions, they decreased in all groups, but these results were not statistically significant (p ≥ 0.05). An intergroup analysis revealed no significant differences (p ≤ 0.05) for bleeding on probing (BOP), PPD, and both proinflammatory and anti-inflammatory cytokines. Only clinical attachment loss (CAL) exhibited a statistically significant intergroup difference 0.042.

Conclusion The use of 0.2% HA gel into periodontal pockets alongside SRP, for both diabetic and healthy individuals, showed no statistically significant variances in clinical, biomolecular, and microbiological measures.

Keywords

diabetes mellitus - hyaluronic acid - Porphyromonas gingivalis - Fusobacterium nucleatum - interleukin-1β - interleukin-10


Publication History

Article published online:
29 July 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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