Efficacy of a Hyaluronic Acid‐Based Gel Versus 0.20% Chlorhexidine in Nonsurgical Periodontal Therapy: A Single‐Blind Randomized Clinical Trial

OBJECTIVE: To compare the adjunctive efficacy of a hyaluronic acid (HA) gel with 0.20% chlorhexidine (CHX) during nonsurgical periodontal therapy in periodontal patients over 6 months. METHODS: A single-blind, randomized, controlled trial included 40 healthy, nonsmoking adults with periodontitis. After supra- and subgingival debridement, patients used either HA gel (Aftoral; hyaluronic acid with glycerophosphoinositol and xylitol) or CHX mouthwash (Unidea; 0.20% chlorhexidine digluconate) once daily for 15 days at each time recall appointment. Clinical parameters-probing pocket depth (PPD, primary outcome), plaque control record (PCR), bleeding on probing (BoP), gingival recession (GR), tooth mobility (TM), clinical attachment level (CAL), and satisfaction (VAS)-were measured at baseline, 1, 3, and 6 months by a blinded examiner. Nonparametric tests were applied with significance at p < 0.05. RESULTS: HA showed greater PPD reduction than CHX at 3 and 6 months (-0.44 mm vs. -0.26 mm; p < 0.01). PCR and BoP decreased more in the HA group (p < 0.05), while CAL gain was higher (-0.43 mm vs. -0.21 mm; p < 0.05). GR, TM, and VAS showed no differences. No adverse events occurred. CONCLUSIONS: Adjunctive HA gel improved PPD, PCR, BoP, and CAL compared with CHX, confirming safety, and clinical benefit.