Advancements in Hyaluronic Acid Effect in Alveolar Ridge Preservation: A Narrative Review

<b>Background/Objectives</b>: Tooth extraction induces significant alveolar ridge dimensional changes and soft tissue modifications, often leading to challenges in implant placement or conventional prosthetic rehabilitation. Alveolar Ridge Preservation (ARP) strategies aim to mitigate po...

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Main Authors: Paul Andrei Nistor, Andreea Cândea, Iulia Cristina Micu, Andrada Soancă, Carmen Silvia Caloian, Alina Bârdea, Alexandra Roman
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/2/137
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author Paul Andrei Nistor
Andreea Cândea
Iulia Cristina Micu
Andrada Soancă
Carmen Silvia Caloian
Alina Bârdea
Alexandra Roman
author_facet Paul Andrei Nistor
Andreea Cândea
Iulia Cristina Micu
Andrada Soancă
Carmen Silvia Caloian
Alina Bârdea
Alexandra Roman
author_sort Paul Andrei Nistor
collection DOAJ
description <b>Background/Objectives</b>: Tooth extraction induces significant alveolar ridge dimensional changes and soft tissue modifications, often leading to challenges in implant placement or conventional prosthetic rehabilitation. Alveolar Ridge Preservation (ARP) strategies aim to mitigate post-extraction resorption of the alveolar ridge, enhancing both the quality and quantity of bone and soft tissue during healing. Hyaluronic acid (HYA) has emerged as a promising biological agent for ARP due to its osteoinductive, antimicrobial, and anti-inflammatory properties. However, the effects of HYA in ARP remain inconsistently reported. This study aims to assess current clinical and preclinical evidence regarding the biological effects of HYA and its application in ARP. Additionally, it evaluates HYA’s impact—alone or in combination with other products—on hard and soft tissue dimensional changes, early wound healing, and implant success rates. <b>Methods</b>: A comprehensive electronic literature search was conducted, and studies meeting the inclusion criteria were critically evaluated. Relevant data were extracted from the final selection of articles. <b>Results</b>: Thirteen publications were evaluated. Some studies reported a significantly improved newly formed bone following ARP with intra-socket HYA application as a single approach (<i>p</i> = 0.004). Combining HYA with a bone graft and a free palatal graft resulted in significantly greater amounts of newly formed and mature bone, reduced clinical bone width changes, lower radiographic crestal bone loss (<i>p</i> < 0.01), and diminished radiological volumetric and linear bone resorption (<i>p</i> = 0.018). Short-term follow-up data indicated improved soft tissue healing associated with HYA-based ARP. While HYA appears to have a protective effect on ridge dimensional changes in ARP, other studies reported no significant differences in radiographic bone dimensional changes or soft tissue improvement. <b>Conclusions</b>: The addition of HYA to bone grafts may enhance some ARP outcomes. However, the variability in outcomes and methodologies across the evaluated studies precludes drawing definitive clinical conclusions. Further robust research is needed to clarify HYA’s role in ARP. With respect to clinical significance enhancing the understanding of ARP management strategies and their effects on post-extraction sockets empowers clinicians to make more informed decisions. The knowledge of HYA effects facilitates the selection of personalized ARP approaches tailored to optimize outcomes for subsequent interventions.
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spelling doaj-art-8c0887d933554ecc8ef44e71633596292025-01-24T13:28:51ZengMDPI AGDiagnostics2075-44182025-01-0115213710.3390/diagnostics15020137Advancements in Hyaluronic Acid Effect in Alveolar Ridge Preservation: A Narrative ReviewPaul Andrei Nistor0Andreea Cândea1Iulia Cristina Micu2Andrada Soancă3Carmen Silvia Caloian4Alina Bârdea5Alexandra Roman6Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, RomaniaDepartment of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, RomaniaDepartment of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, RomaniaDepartment of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, RomaniaDepartment of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, RomaniaDepartment of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, RomaniaDepartment of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania<b>Background/Objectives</b>: Tooth extraction induces significant alveolar ridge dimensional changes and soft tissue modifications, often leading to challenges in implant placement or conventional prosthetic rehabilitation. Alveolar Ridge Preservation (ARP) strategies aim to mitigate post-extraction resorption of the alveolar ridge, enhancing both the quality and quantity of bone and soft tissue during healing. Hyaluronic acid (HYA) has emerged as a promising biological agent for ARP due to its osteoinductive, antimicrobial, and anti-inflammatory properties. However, the effects of HYA in ARP remain inconsistently reported. This study aims to assess current clinical and preclinical evidence regarding the biological effects of HYA and its application in ARP. Additionally, it evaluates HYA’s impact—alone or in combination with other products—on hard and soft tissue dimensional changes, early wound healing, and implant success rates. <b>Methods</b>: A comprehensive electronic literature search was conducted, and studies meeting the inclusion criteria were critically evaluated. Relevant data were extracted from the final selection of articles. <b>Results</b>: Thirteen publications were evaluated. Some studies reported a significantly improved newly formed bone following ARP with intra-socket HYA application as a single approach (<i>p</i> = 0.004). Combining HYA with a bone graft and a free palatal graft resulted in significantly greater amounts of newly formed and mature bone, reduced clinical bone width changes, lower radiographic crestal bone loss (<i>p</i> < 0.01), and diminished radiological volumetric and linear bone resorption (<i>p</i> = 0.018). Short-term follow-up data indicated improved soft tissue healing associated with HYA-based ARP. While HYA appears to have a protective effect on ridge dimensional changes in ARP, other studies reported no significant differences in radiographic bone dimensional changes or soft tissue improvement. <b>Conclusions</b>: The addition of HYA to bone grafts may enhance some ARP outcomes. However, the variability in outcomes and methodologies across the evaluated studies precludes drawing definitive clinical conclusions. Further robust research is needed to clarify HYA’s role in ARP. With respect to clinical significance enhancing the understanding of ARP management strategies and their effects on post-extraction sockets empowers clinicians to make more informed decisions. The knowledge of HYA effects facilitates the selection of personalized ARP approaches tailored to optimize outcomes for subsequent interventions.https://www.mdpi.com/2075-4418/15/2/137hyaluronic acidtooth extractionwound healingtooth socketalveolar bone loss
spellingShingle Paul Andrei Nistor
Andreea Cândea
Iulia Cristina Micu
Andrada Soancă
Carmen Silvia Caloian
Alina Bârdea
Alexandra Roman
Advancements in Hyaluronic Acid Effect in Alveolar Ridge Preservation: A Narrative Review
Diagnostics
hyaluronic acid
tooth extraction
wound healing
tooth socket
alveolar bone loss
title Advancements in Hyaluronic Acid Effect in Alveolar Ridge Preservation: A Narrative Review
title_full Advancements in Hyaluronic Acid Effect in Alveolar Ridge Preservation: A Narrative Review
title_fullStr Advancements in Hyaluronic Acid Effect in Alveolar Ridge Preservation: A Narrative Review
title_full_unstemmed Advancements in Hyaluronic Acid Effect in Alveolar Ridge Preservation: A Narrative Review
title_short Advancements in Hyaluronic Acid Effect in Alveolar Ridge Preservation: A Narrative Review
title_sort advancements in hyaluronic acid effect in alveolar ridge preservation a narrative review
topic hyaluronic acid
tooth extraction
wound healing
tooth socket
alveolar bone loss
url https://www.mdpi.com/2075-4418/15/2/137
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