Effects of hyaluronic acid as an adjunct to nonsurgical treatment of periodontal pockets: a narrative review.

This article reviews the adjunctive use of hyaluronic acid (HA), particularly cross-linked hyaluronic acid (xHA), in nonsurgical periodontal therapy (NSPT) for treating periodontal pockets associated with periodontitis. Analyzing eight clinical studies from 2013 to 2024, the review found that HA combined with NSPT generally improved clinical outcomes such as probing depth reduction, clinical attachment level gain, and pocket closure rates compared to NSPT alone, with no reported adverse effects. The combination of sodium hypochlorite/amino acid gel with xHA showed enhanced benefits, likely due to improved root surface detoxification and pocket sealing. While these findings suggest HA’s potential to enhance healing and reduce the need for surgical intervention, the authors note the limited number and heterogeneity of studies and recommend further large-scale randomized trials with longer follow-up to confirm efficacy.