Treatment of gingivitis with hyaluronan

Objectives: Hyaluronic acid (hyaluronan) is a glycosaminoglycan with anti-inflammatory and antiedematous properties. It was evaluated in a gel formulation for its effect in the treatment of plaque-induced gingivitis. Method: In a randomised double-blind study, 50 male subjects with plaque-induced gingivitis were divided into two groups and used a verum or placebo gel twice daily additionally to oral hygiene for a 3-week treatment period. Clinical indices (API, Turesky index, PBI) and crevicular fluid variables (peroxidase, lysozyme) were determined at baseline and after 4, 7, 14 and 21 days, respectively. Results: Significant improvements could be found for all clinical variables in both groups. The verum group showed significant improvement in the study area for the plaque indices beginning with day 4 (P = 0.011) and the PBI beginning with day 7 (P = 0.001) in comparison with the placebo group. The crevicular fluid variables were significantly improved in the centre of the studied inflammation area in the verum group. Here all studied sites had significant decreases in peroxidase (176.72-128.75 and 188.74-128.75 U/L) and lysozyme (1.27-0.27 and 1.30-0.33 mg/L) activities after 7, 14 and 21 days (P between 0.034 and < 0.001), whereas in the placebo group only one site showed a significant decrease for lysozyme (1.74-0.75 mg/L) after 7 and 21 days (P = 0.048 and 0.025). Conclusions: These data suggest that a hyaluronan containing gel has a beneficial effect in the treatment of plaque-induced gingivitis.