Hyaluronic Acid as an Adjunctive Therapy in Periodontal and Dental Treatment of Medically Compromised Patients: A Narrative Review

TL;DR

This review explores the use of hyaluronic acid in dental treatments for patients with health conditions, showing it may help with healing and inflammation.

Contribution

The paper evaluates the safety and efficacy of hyaluronic acid in medically compromised patients through a narrative review of recent studies.

Findings

Hyaluronic acid reduced macrophage infiltration and delayed collagen membrane degradation in diabetic models.

Adjunctive HA use showed modest improvements in clinical attachment level and soft tissue healing in type 2 diabetes patients.

HA application was linked to reduced inflammation and improved symptoms in peri-implantitis and oncology-related oral complications.

Abstract

Hyaluronic acid (HA) is a biologically active glycosaminoglycan with recognized roles in wound healing and inflammation modulation, and its adjunctive use in dental and periodontal therapy has gained interest, particularly in medically compromised patients. This narrative review critically evaluated preclinical and clinical evidence on locally applied HA in periodontal, oral surgical, peri-implant, and oral medicine treatments in patients with systemic conditions. A literature search of PubMed/MEDLINE, Scopus, and Web of Science (January 2015–December 2025) identified in vivo translational studies, randomized and controlled clinical trials, and selected systematic reviews involving medically compromised populations. Qualitative synthesis focused on biological plausibility, clinical outcomes, and safety. Nine core studies were included, comprising two preclinical in vivo investigations and seven clinical trials. In diabetic models, cross-linked high-molecular-weight HA reduced macrophage infiltration and delayed collagen membrane degradation without impairing angiogenesis. Clinically, adjunctive HA use in patients with type 2 diabetes mellitus was associated with modest but statistically significant short-term improvements in clinical attachment level (CAL) and enhanced early soft tissue healing following tooth extraction. In peri-implantitis therapy and oncology-related oral complications, HA application was linked to reduced inflammatory markers, decreased lesion severity, and improved patient-reported symptoms. No systemic adverse effects were reported. Overall, HA appears to be a locally safe adjunct that may support early healing and inflammation control in medically compromised patients, although its effects are primarily short-term and do not indicate disease-modifying potential.