{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:48:59Z","timestamp":1782215339500,"version":"3.54.5"},"reference-count":53,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Periodontology 2000"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the clinical and radiographic efficacy of the adjunctive use of hyaluronic acid (HA) in regenerative periodontal surgery for the treatment of intrabony defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A systematic search identified randomized controlled trials (RCTs) involving adult patients with intrabony defects who underwent regenerative periodontal surgery with adjunctive HA. The primary outcome was probing pocket depth (PPD) reduction; secondary outcomes included clinical attachment level (CAL) gain, gingival recession (REC), and radiographic defect depth (RDD) reduction. Meta\u2010analysis according to the regenerative protocol was performed using random\u2010effects models, with subgroup analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen RCTs met the inclusion criteria. Compared to controls, adjunctive HA resulted in an additional PPD reduction of approximately 0.7\u20131.2\u2009mm and CAL gain of 0.7\u20131.1\u2009mm, with more consistent effects at 12\u2009months. Subgroup analyses indicated significant benefits when HA was applied alone or with membranes, whereas no added benefit was observed with bone substitute materials. Radiographic outcomes showed a favorable trend for HA, with an additional RDD reduction of about 0.7\u20131.0\u2009mm, though heterogeneity was noted. Comparisons between HA and enamel matrix derivative (EMD) revealed comparable or slightly superior results for EMD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adjunctive HA may enhance clinical and radiographic outcomes in intrabony defects when used in regenerative periodontal surgery, although heterogeneity and study quality warrant cautious interpretation of the findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/prd.70063","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:59:35Z","timestamp":1782212375000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving periodontal regeneration outcomes with hyaluronic acid: A systematic review and meta\u2010analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7437-6279","authenticated-orcid":false,"given":"Abdusalam E.","family":"Alrmali","sequence":"first","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"},{"name":"Department of Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery University of Tripoli School of Dentistry  Tripoli Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6294-4048","authenticated-orcid":false,"given":"Qasim Omer","family":"Butt","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9772-765X","authenticated-orcid":false,"given":"Rami","family":"Kassar","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"},{"name":"Department of Periodontics University of Washington School of Dentistry  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8362-3208","authenticated-orcid":false,"given":"Parham","family":"Hazrati","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"},{"name":"Department of Oral Medicine, Infection, and Immunity Harvard School of Dental Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0371-303X","authenticated-orcid":false,"given":"Yousef","family":"Amrou","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"},{"name":"Department of Periodontics University of Colorado Anschutz Medical Campus School of Dental Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-5477","authenticated-orcid":false,"given":"Anton","family":"Sculean","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of Dental Medicine University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-1799","authenticated-orcid":false,"given":"Hom\u2010Lay","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/jcpe.12732","article-title":"Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action","volume":"44","author":"Tonetti MS","year":"2017","journal-title":"J Clin Periodontol"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jcpe.13290","article-title":"Treatment of stage I\u2010III periodontitis\u2010the EFP S3 level clinical 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