Liana Filip, Narcisa Ganu(Onea), Lidia Maria Condur, Sorina Mihaela Solomon
ABSTRACT
Background: Periodontal disease remains one of the most prevalent chronic inflammatory conditions globally. Conventional non-surgical periodontal therapy (scaling and root planing, SRP) often fails to completely eliminate subgingival pathogens in deep or anatomically complex sites. Modern adjunctive strategies such as hyaluronic acid (HA) and photodynamic therapy (PDT) have emerged to enhance treatment outcomes.
Aim: To critically review the clinical efficacy, mechanisms of action, and limitations of topical hyaluronic acid and photodynamic therapy as adjuncts in non-surgical periodontal therapy.
Methods: A narrative review of randomized controlled trials and meta-analyses (2019–2025) evaluating HA and PDT in conjunction with SRP was performed. Outcomes such as probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) were analyzed.
Results: Topical HA demonstrated mean improvements of 0.3–0.7 mm in PPD reduction and 0.3–1.0 mm in CAL gain compared to SRP alone. PDT showed significant antimicrobial and anti-inflammatory effects, with consistent improvements in PPD and BOP in both healthy and systemically compromised patients.
Conclusions: Both HA and PDT represent safe, effective adjuncts to conventional SRP, improving short-term periodontal outcomes and supporting tissue healing. However, variability in formulations and irradiation protocols limits cross-study comparability. Long-term, multicenter RCTs are needed to establish standardized clinical guidelines for these promising non-invasive therapies.
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