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CompletedNCT04319770Updated Jun 4, 2020

Effectiveness of Hyaluronic Acid in the Regeneration of Infrabony Defects

An interventional study of enamel matrix derivative (EMD) and hyaluronic acid (HA) in Intrabony Periodontal Defect, sponsored by University of Roma La Sapienza. Completed. Open to participants aged 18 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-06-04.

Sponsored by University of Roma La Sapienza · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 3 years 6 months after the study started (first participant enrolled Sep 2016, registered Mar 2020).
Phase
Not applicable
Study type
Interventional
Enrollment
32
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
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Study summary

The purpose of this randomized controlled clinical trial (RCT) is to determine the efficacy hyaluronic acid (HA) versus enamel matrix derivatives (EMD) in the treatment of infrabony periodontal defects.

Read the detailed description

Intrabony defects associated with periodontal pockets represent a risk factor for periodontitis progression and additional loss of attachment if left untreated.

Over the years, several strategies have been implemented for their surgically reconstruction with the aim of pocket reduction and clinical attachment level gain.

Grafting of intrabony periodontal defects has been used extensively over the years incorporating various materials, including autogenic bone, demineralized allogenic bone, xenogenic and alloplastic materials. Controlled clinical studies have shown a significantly higher gain of clinical attachment and radiographic bone gain in intra-bony periodontal defects treated with open flap debridement combined with EMD when compared with open flap debridement alone.

Hyaluronic acid (HAc) is a naturally occurring linear polysaccharide of the extracellular matrix of connective tissue, synovial fluid, and other tissues. It possesses various physiological and structural functions, which include cellular and extracellular interactions, interactions with growth factors and regulation of the osmotic pressure, and tissue lubrication. All these functions help in maintaining the structural and homeostatic integrity of the tissue.

In the field of dentistry, in vitro and animal studies have demonstrated that hyaluronic acid prevents oxygen free-radical damage to granulation tissue, stimulates the clot formation , induces angiogenesis and does not interfere in the calcification nodule during bone formation.

A randomized controlled trial evaluated the effect of local application of 0.8% Hyaluronan gel in conjunction with periodontal surgery. After initial non-surgical periodontal therapy and re-evaluation, defects were randomly assigned to be treated with modified Widman flap surgery in conjunction with either 0.8% Hyaluronan gel (test) or placebo gel (control) application. Statistically, significant differences were noted for Clinical Attachment Level and gingival recession, (P \< 0.05) in favor of the test sites. But non-significant results were found regarding PD, BOP and PI values (P > 0.05).

At the present time no comparative data are available about the use of HA versus EMD in treatment of infrabony defects. Therefore the aim of this study will be evaluated the effectiveness of hyaluronic acid versus enamel matrix derivatives alone in the regeneration of infrabony defects.

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Conditions studied

  • Intrabony Periodontal Defect
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In context

Lead sponsor

University of Roma La Sapienza is the lead sponsor of 397 studies on the registry; 56 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Patient related:

  • adults aged 18-65 years with periodontal disease
  • sites with infrabony defects and persisting pockets [probing pocket depth (PPD) ≥ 5 mm and bleeding on probing (BOP)] at re-evaluation 6 weeks after non-surgical periodontal therapy
  • full-mouth plaque score (FMPS)1 and full-mouth bleeding score (FMBS)2 \< 20% before surgery
  • at least one radiographically detectable infrabony lesion,3
  • good physical health.

Site-specific:

  • Interproximal angular defects on single-rooted teeth
  • radiographic infrabony component ≥ 3 mm
  • PPD ≥ 6 mm and CAL ≥ 7 mm.

Exclusion criteria

Exclusion Criteria:

  • relevant medical conditions contraindicating surgical interventions
  • pregnancy or lactation
  • tobacco smoking
  • untreated periodontal conditions
  • any condition associated with poor compliance or failure to maintain good oral hygiene
  • acute infectious lesions in areas intended for surgery
  • teeth with grade 2 or higher mobility
  • restorations or carious lesions on root surfaces that are associated with the intrabony defect.
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
32 participants (actual)

Study arms

  • Active comparator
    periodontal regenerative surgery + EMD (control)

    periodontal regenerative surgery with enamel matrix derivative

    Device: enamel matrix derivative (EMD)

  • Experimental
    periodontal regenerative surgery + HA (test)

    periodontal regenerative surgery with hyaluronic acid

    Device: hyaluronic acid (HA)

Interventions

  • Deviceenamel matrix derivative (EMD)

    periodontal regenerative surgery with enamel matrix derivative (EMD) (control)

  • Devicehyaluronic acid (HA)

    periodontal regenerative surgery with hyaluronic acid (HA) (test)

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What researchers measure

Primary outcomes

  1. clinical attachment level (CAL)

    Changes in CAL between initial and final. Measured in mm

    Time frame: baseline, 12, 28 and 24 months

Secondary outcomes

  1. probing pocket depth (PPD)

    Changes in PPD between initial and final. Measured in mm

    Time frame: baseline, 12, 28 and 24 months

  2. gingival recession (GR)

    Changes in GR between initial and final. Measured in mm

    Time frame: baseline, 12, 28 and 24 months

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Study locations

No study locations are listed for this record.

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References and documents

Publications

  • Cortellini P, Pini Prato G, Tonetti MS. Periodontal regeneration of human infrabony defects. I. Clinical measures. J Periodontol. 1993 Apr;64(4):254-60. doi: 10.1902/jop.1993.64.4.254. PubMed 8483087 ↗
  • Esposito M, Grusovin MG, Papanikolaou N, Coulthard P, Worthington HV. Enamel matrix derivative (Emdogain(R)) for periodontal tissue regeneration in intrabony defects. Cochrane Database Syst Rev. 2009 Oct 7;2009(4):CD003875. doi: 10.1002/14651858.CD003875.pub3. PubMed 19821315 ↗
  • Cortellini P, Prato GP, Tonetti MS. The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures. J Periodontol. 1995 Apr;66(4):261-6. doi: 10.1902/jop.1995.66.4.261. PubMed 7782979 ↗
  • Cortellini P, Prato GP, Tonetti MS. The simplified papilla preservation flap. A novel surgical approach for the management of soft tissues in regenerative procedures. Int J Periodontics Restorative Dent. 1999 Dec;19(6):589-99. PubMed 10815597 ↗
  • Zhao N, Wang X, Qin L, Guo Z, Li D. Effect of molecular weight and concentration of hyaluronan on cell proliferation and osteogenic differentiation in vitro. Biochem Biophys Res Commun. 2015 Sep 25;465(3):569-74. doi: 10.1016/j.bbrc.2015.08.061. Epub 2015 Aug 15. PubMed 26284973 ↗
  • Vanden Bogaerde L. Treatment of infrabony periodontal defects with esterified hyaluronic acid: clinical report of 19 consecutive lesions. Int J Periodontics Restorative Dent. 2009 Jun;29(3):315-23. PubMed 19537471 ↗
  • Fawzy El-Sayed KM, Dahaba MA, Aboul-Ela S, Darhous MS. Local application of hyaluronan gel in conjunction with periodontal surgery: a randomized controlled trial. Clin Oral Investig. 2012 Aug;16(4):1229-36. doi: 10.1007/s00784-011-0630-z. Epub 2011 Oct 20. PubMed 22012469 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 4, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04319770
Responsible party
Andrea Pilloni MD DDS MS (Chairman Section of Periodontics Director of Master Program in Periodontics, University of Roma La Sapienza) — Principal investigator
First posted
Mar 24, 2020
Start date
Sep 6, 2016
Primary completion
Oct 21, 2019
Completion
Oct 21, 2019
Last update
Jun 4, 2020

Study contacts

Andrea Pilloni, MD,DDS,MS
study director · University of Roma La Sapienza

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2020. You cannot join it, but the record below documents what was studied.

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