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After subgingival instrumentation, test or control substance was applied subgingivally, then daily supragingivally for 3 months, and if required a second time after subgingival re-instrumentation after 3 months. Clinical and patient reported outcome parameters were recorded every 3 months for 12 months. Pocket closure [probing pocket depth (PPD)\u2009\u2264\u20094mm with absence of bleeding on probing (BoP) at PPD\u2009=\u20094mm] was the main outcome parameter.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fifty-six patients (221 experimental sites) were analysed. Pocket closure was achieved in 56.8 and 46.6% of the experimental sites in the test and control group, respectively (p\u2009&gt;\u20090.05), while median PPD and PPD distribution (&lt;\u20095mm\/5mm\/\u2009&gt;\u20095mm) differed significantly between groups in favour of the test group, at 12 months. Further, significantly fewer sites in the HyA group required re-instrumentation at 3 months, and sites in the HyA group showed a tendency for lower odds to remain diseased compared to the control group (OR 0.48, 95%CI 0.22\u20131.06). The odds for a site to remain diseased after 12 months increased significantly in the presence of plaque (OR 7.94, 95%CI 4.12\u201315.28), but in general, decreased significantly over time (OR 0.48, 95%CI 0.28\u20130.81).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Re-instrumentation of residual pockets in SPC patients, per se<jats:italic>,<\/jats:italic> leads to a significant increase in pocket closure over time; this was impeded by poor plaque control. Repeated local application of HyA results in fewer sites requiring re-instrumentation and might slightly improve the rate of pocket closure. (clinicaltrials.gov registration nr. NCT04792541).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance<\/jats:title>\n                <jats:p>HyA gel is easy to apply, well accepted by patients, and may have some positive effect in terms of fewer sites requiring re-instrumentation at 3 months and higher pocket closure rate at 12 months.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00784-024-05505-9","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T10:02:38Z","timestamp":1708423358000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Repeated local delivery of hyaluronic acid gel as adjunctive treatment of residual pockets in periodontitis patients undergoing supportive periodontal care. 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