Clinical Evaluation of 0.2% Hyaluronic Acid and its Effect on the Level of Interleukine-1β in Gingival Crevicular Fluid Before and After Treatment of Plaque Induced Gingivitis

One of the most prevalent periodontal diseases is plaqueinduced gingivitis. Hyaluronic acid is linear polysaccharide found in the extracellular matrix of connective tissues, synovial fluid and other tissues. Hyaluronic acid was used as adjunct to the mechanical plaque control because of its anti-inflammatory and bacteriostatic properties. Gengigel (0.2% Ricerfarma-Italy) is a gel form of Hyaluronic acid used in dentistry for treatment of gingivitis and acceleration of wound healing as in treatment of mouth ulcers. Interleukin 1 beta is a pro-inflammatory cytokine which has an important function in immunity and inflammation. Current study was aimed to evaluate the clinical and biochemical outcome of 0.2% of Hyaluronic acid gel and its effects on IL-1β in gingival crevicular fluid (GCF) in patient with plaque-induced gingivitis and to compare, clinically, between the effects of scaling and the gel in treatment of gingivitis.

Sample population consisted of (25) subjects; 11 females and 14 males who had plaque-induced gingivitis. A split-mouth procedure was used in this study so that the mouth was subdivided into two division, left and right sides of maxillary arch only. The right side received scaling and then collection of GCF to determine the concentration of IL-1β in the first visit. In the same manner, the scaling was done on the left side and GCF was picked and then the patient was informed to put a Gengigel on the upper right side only three times daily for 1 week. The second visit presented with only collection of GCF from both sides to provide the calculation of the volume of GCF and the concentration of IL-1β.

Intra-group comparison of IL-1β concentration showed non-significant difference in both sides but there was a decrease in the IL-1β concentration in the gel side other than the scaling side. Inter-group comparison at second visits of IL-1β concentration showed no significant difference between scaling and gel sides.

The split-mouth procedure used in this research had the advantage of allowing paired comparisons to be made. There was a slight positive decrease in the interleukin 1β after topical application of HA after one week but the duration of application must be continued more than 1 week to reach a good decrease of IL-1β in GCF which is a sign of less periodontal destruction because HA inhibits the expression of mRNA for proinflammatory cytokines (IL-1β).