{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:12:56Z","timestamp":1790341976805,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gels"],"abstract":"<jats:p>Hyaluronic acid in its various forms shows bacteriostatic, fungistatic, anti-inflammatory, anti-edematous, osteoinductive, and pro-angiogenetic properties. This study aimed to evaluate the effect of subgingival delivery of 0.8% hyaluronic acid (HA) gel on clinical periodontal parameters, pro-inflammatory cytokines (IL-1 beta and TNF-alpha) and biochemical markers of inflammation (C-reactive protein (CRP) and alkaline phosphatase (ALP) enzymes) in patients with periodontitis. Seventy-five patients with chronic periodontitis were divided randomly into three groups (25 in each group): group I received scaling and surface root debridement (SRD) + HA gel; group II received SRD + chlorhexidine gel; and group III received surface root debridement alone. Clinical periodontal parameter measurements and blood samples were collected to estimate pro-inflammatory and biochemical parameters at the baseline before therapy and after two months of therapy. The results show that HA gel has a significant effect on the reduction in clinical periodontal parameters (PI, GI, BOP, PPD, and CAL), IL-1 beta, TNF-alpha, CRP, and ALP after 2 months of therapy as compared to the baseline (p &lt; 0.05) with nonsignificant differences from the CHX group (p &gt; 0.05), except GI (p &lt; 0.05), and significant differences from the SRD group (p &lt; 0.05). Moreover, significant differences were found between the three groups regarding the mean improvements of GI, BOP, PPD, IL-1\u03b2, CRP, and ALP. It can be concluded that HA gel has a positive effect on clinical periodontal parameters and improvements in inflammatory mediators similar to chlorhexidine. Therefore, HA gel can be used as an adjuvant to SRD in the treatment of periodontitis.<\/jats:p>","DOI":"10.3390\/gels9040325","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T02:57:08Z","timestamp":1681268228000},"page":"325","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The Effect of Hyaluronic Acid Gel on Periodontal Parameters, Pro-Inflammatory Cytokines and Biochemical Markers in Periodontitis Patients"],"prefix":"10.3390","volume":"9","author":[{"given":"Chenar Anwar","family":"Mohammad","sequence":"first","affiliation":[{"name":"Periodontics Department, College of Dentistry, Hawler Medical University, Erbil 44001, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barzan Abdulwahab","family":"Mirza","sequence":"additional","affiliation":[{"name":"Periodontics Department, College of Dentistry, Hawler Medical University, Erbil 44001, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab Salim","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Periodontics Department, College of Dentistry, Hawler Medical University, Erbil 44001, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3650-3817","authenticated-orcid":false,"given":"Faraedon Mostafa","family":"Zardawi","sequence":"additional","affiliation":[{"name":"Dean of Faculty of Dentistry, Qaiwan International University, Sulaimani 00964, Iraq"},{"name":"Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1056\/NEJM199002083220606","article-title":"Periodontal disease","volume":"322","author":"Williams","year":"1990","journal-title":"N. 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