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At baseline, three- and six-months clinical attachment level (CAL; primary outcome), probing pocket depth (PPD), gingival recession depth (GRD), bleeding on probing (BOP), O\u2019Leary plaque index (PI), HbA1c level, radiographic bone density (RBD) and defect depth (DD; all secondary outcomes) were assessed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Although CAL, PPD, BOP, PI, DD and RBD independently significantly improved in the PMPR\u2009+\u2009HA and the PMPR groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), no significant differences were notable between both groups. HbA1c significantly decreased solely in the PMPR\u2009+\u2009HA group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Type 2 diabetic patients with stage-II periodontitis, benefit clinically from PMPR in the presence or absence of adjunctive HA gel application. Interestingly, HA as an adjunct to PMPR significantly improved HbA1c levels in controlled type 2 diabetic stage-II periodontitis patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>The study was registered in the US National Institutes of Health Clinical Trials Registry (NCT05543434) in September 2022.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12903-025-06485-2","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T15:42:03Z","timestamp":1752594123000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Non-surgical periodontal therapy with and without hyaluronic acid gel in type 2 diabetic stage-II periodontitis patients: a randomized clinical trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Reem","family":"Al-Abbadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesma","family":"Shemais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Nawwar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim M.","family":"Fawzy El-Sayed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"issue":"Suppl 1","key":"6485_CR1","first-page":"S159","volume":"89","author":"MS Tonetti","year":"2018","unstructured":"Tonetti MS, Greenwell H, Kornman KS. 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