# Evaluation of the effects of a gel containing green tea and hyaluronic acid on clinical and Microbiological outcomes following periodontal surgery. A randomized, controlled, double-blinded, noninferiority trial

**Authors:** Laura Sanches Gonçalves, Stéffany Souza Melo, Guilherme José Pimentel Lopes de Oliveira, Luciene Cristina Figueiredo, Fabio José Barbosa Bezerra, Flávia Aparecida Chaves Furlaneto, Sérgio Luís Scombatti de Souza

PMC · DOI: 10.1007/s00784-026-06792-0 · Clinical Oral Investigations · 2026-02-24

## TL;DR

A new gel made with green tea and hyaluronic acid works as well as chlorhexidine gel after periodontal surgery, with fewer side effects.

## Contribution

GT/HA gel is shown to be noninferior to chlorhexidine gel in post-surgical periodontal outcomes with better tolerability.

## Key findings

- GT/HA gel showed noninferior clinical and microbiological outcomes compared to chlorhexidine gel.
- GT/HA gel caused fewer adverse effects like taste alteration and staining.
- Both gels improved patient-reported quality of life after surgery.

## Abstract

To evaluate the clinical and microbiological effects of a gel containing green tea and hyaluronic acid (GT/HA) following open-flap debridement surgery in comparison with those of a chlorhexidine-based gel.

This randomized, controlled, double-blind, noninferiority trial included 38 patients with stage 3 periodontitis. After undergoing surgery, participants were randomly assigned to receive either GT/HA gel or chlorhexidine gel three times daily for 14 days. Clinical parameters (plaque index, probing depth, bleeding on probing, and clinical attachment level) were evaluated at baseline and 60 days postoperatively. Subgingival biofilm samples were collected at baseline and after 14 and 30 days and analyzed using checkerboard DNA–DNA hybridization for 40 bacterial species. Patient-reported outcomes included postoperative pain, analgesic consumption, and quality of life assessed by the OHIP-14 questionnaire.

Both groups showed statistically significant clinical improvements from baseline to 60 days, with no significant differences between treatments. Temporary reductions in some bacterial species were observed during the 14-day gel application period in both groups, followed by regrowth after discontinuation. GT/HA gel was associated with fewer adverse effects, particularly regarding taste alteration and tooth or tissue staining. A reduction in OHIP-14 scores was observed in both groups, with statistically significant differences between baseline and 30 days after surgery.

GT/HA gel was noninferior to chlorhexidine gel in terms of clinical and microbiological outcomes and showed greater patient tolerability.

GT/HA gel may represent a safe and effective alternative to chlorhexidine in postoperative care in periodontal surgery.

## Linked entities

- **Chemicals:** chlorhexidine (PubChem CID 9552079)
- **Diseases:** periodontitis (MONDO:0005076)

## Full-text entities

- **Genes:** BOP [NCBI Gene 100294715], AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, VEGFA (vascular endothelial growth factor A) [NCBI Gene 7422] {aka L-VEGF, MVCD1, VEGF, VPF}
- **Diseases:** PD (MESH:D007222), pain (MESH:D010146), gingival inflammation (MESH:D007249), oral condition (MESH:D020763), Periodontitis (MESH:D010518), trauma (MESH:D014947), tooth loss (MESH:D016388), gingivitis (MESH:D005891), cytotoxic (MESH:D064420), pigmentation (MESH:D010859), bone loss (MESH:D001847), edema (MESH:D004487), irritation of the oral mucosa (MESH:C565008), infection (MESH:D007239), calculus (MESH:D002137), CAL (MESH:D019962), postoperative pain (MESH:D010149), Plaque (MESH:D003773), diabetes (MESH:D003920), allergy (MESH:D004342), Bleeding (MESH:D006470), periodontal disease (MESH:D010510)
- **Chemicals:** acid (MESH:D000143), cyclosporine (MESH:D016572), glycerin (MESH:D005990), green tea extract (MESH:C045651), TE (MESH:D013691), nylon (MESH:D009757), Dipyrone Sodium (-), phenytoin (MESH:D010672), sodium benzoate (MESH:D020160), saccharin (MESH:D012439), EDTA (MESH:D004492), tetrasodium pyrophosphate (MESH:C003319), catechins (MESH:D002392), water (MESH:D014867), polyphenols (MESH:D059808), sorbitol (MESH:D013012), carboxymethylcellulose (MESH:D002266), xylitol (MESH:D014993), Hyaluronic acid (MESH:D006820), NaOH (MESH:D012972), Chlorhexidine (MESH:D002710)
- **Species:** Treponema denticola (species) [taxon 158], Porphyromonas gingivalis (species) [taxon 837], Neisseria mucosa (species) [taxon 488], Cutibacterium acnes (species) [taxon 1747], Leptotrichia buccalis (species) [taxon 40542], Actinomyces naeslundii (species) [taxon 1655], Capnocytophaga gingivalis (species) [taxon 1017], Tannerella forsythia (species) [taxon 28112], Homo sapiens (human, species) [taxon 9606], Streptococcus oralis (species) [taxon 1303], Streptococcus gordonii (species) [taxon 1302], Streptococcus mitis (species) [taxon 28037], Prevotella intermedia (species) [taxon 28131], Camellia sinensis (black tea, species) [taxon 4442], Veillonella parvula (species) [taxon 29466], Fusobacterium periodonticum (species) [taxon 860], Prevotella nigrescens (species) [taxon 28133], Centipeda noxia (species) [taxon 135083]
- **Mutations:** C31G

## Full text

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## Figures

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Source: https://tomesphere.com/paper/PMC12929323