ORIGINAL ARTICLE Local application of hyaluronan gel in conjunction with periodontal surgery: a randomized controlled trial Karim M. Fawzy El-Sayed & Moushira A. Dahaba & Shadw Aboul-Ela & Mona S. Darhous Received: 15 May 2010 / Accepted: 5 October 2011 / Published online: 20 October 2011 # Springer-Verlag 2011 Abstract Hyaluronic acid application has been proven to be beneficial in a number of medical disciplines. The aim of the current study was to clinically evaluate the effect of local application of hyaluronan gel in conjunction with periodontal surgery. Fourteen patients with chronic perio- dontitis having four interproximal intrabony defects (≥3 mm) with probing depth values >5 mm were included in this split-mouth study. Following initial nonsurgical periodontal therapy and re-evaluation, defects were ran- domly assigned to be treated with modified Widman flap (MWF) surgery in conjunction with either 0.8% hyaluronan gel (test) or placebo gel (control) application. Clinical attachment level (CAL), probing depth (PD), gingival recession (GR), plaque index (PI), and bleeding on probing (BOP) values were taken at baseline and 3 and 6 months. Differences between test and control sites were evaluated using a Wilcoxon signed-rank and a McNemar test. A Friedman and a Cochran test were used to test equal ranks over time. Statistically significant differences were noted for CAL and GR (P <0.05) in favor of the test sites. No significant differences were found regarding PD, BOP, or PI values (P >0.05). Hyaluronan gel application in conjunction with periodontal surgery appears to result in significant improvement of CAL and in a reduction in GR. Hyaluronan gel application appears to improve the clinical outcome of MWF surgery. Keywords Periodontal surgery . Hyaluronic acid . Clinical attachment level . Gingival recession Introduction The ultimate goal of periodontal treatment is the regeneration of the supporting tissues lost due to periodontal disease [1]. Regeneration refers to the reproduction or reconstitution of a lost or injured part, in contrast to repair, which describes the healing by tissues that do not fully restore the architecture or the function of the lost part [2]. In periodontitis, as destruction reaches the deeper structures, regeneration becomes unpredictable. However, in contrast to regeneration, periodontal repair remains a readily attainable goal. A variety of surgical procedures have been advocated to enhance periodontal tissue reparative response and to provide an environment, in which new attachment can readily occur. These include the modified Widman flap (MWF) [3], the excisional new Electronic supplementary material The online version of this article (doi:10.1007/s00784-011-0630-z) contains supplementary material, which is available to authorized users. K. M. Fawzy El-Sayed : M. S. Darhous Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt K. M. Fawzy El-Sayed (*) Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, Haus 26, 24105 Kiel, Germany e-mail: karim.fawzy@gmail.com M. A. Dahaba Department of Oral Radiology, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt S. Aboul-Ela Department of Orthodontics, Misr University for Science and Technology, Cairo, Egypt Clin Oral Invest (2012) 16:1229–1236 DOI 10.1007/s00784-011-0630-z