Non-Cochrane · intervention · PM42752698
Comparison of Hyaluronic Acid Versus Enamel Matrix Derivative in the Treatment of Intrabony Periodontal Defects: A Systematic Review and Meta-Analysis.
Mahintach Théo, Bechina Camille, Galina Sofiya, et al. · Oral health & preventive dentistry · 2026 · PubMed · doi:10.3290/j.ohpd.c_2808
Findings
Population Adults with intrabony periodontal defects requiring regeneration
12 findings
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Bleeding on probing (%) 18 months · 18-month follow-up | MD -0.13 [-0.32, 0.05] GRADE not reported 2 studies · 85 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Clinical attachment level gain (mm) 6 months · 6-month follow-up | MD 0.01 [-0.66, 0.67] GRADE not reported 2 studies · 107 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Probing pocket depth (mm) 6 months · 6-month follow-up | MD 0.03 [-0.47, 0.53] GRADE not reported 2 studies · 107 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Bleeding on probing (%) 12 months · 12-month follow-up | MD -0.08 [-0.24, 0.08] GRADE not reported 2 studies · 85 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Gingival recession (mm) 6 months · 6-month follow-up | MD 0.04 [-0.47, 0.55] GRADE not reported 2 studies · 107 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Probing pocket depth (mm) 18 months · 18-month follow-up | MD 0.7 [-0.41, 1.8] GRADE not reported 2 studies · 85 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Clinical attachment level gain (mm) 18 months · 18-month follow-up | MD 0.53 [-0.17, 1.24] GRADE not reported 2 studies · 85 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Gingival recession (mm) 12 months · 12-month follow-up | MD -0.4 [-0.79, -0.01] GRADE not reported 2 studies · 85 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Probing pocket depth (mm) 12 months · 12-month follow-up | MD 0.71 [-0.11, 1.54] GRADE not reported 2 studies · 85 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Clinical attachment level gain (mm) 12 months · 12-month follow-up | MD 0.51 [-0.08, 1.11] GRADE not reported 2 studies · 85 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Radiological defect depth (mm) 6 months · 6-month follow-up | MD 0.12 [-0.19, 0.43] GRADE not reported 2 studies · 107 participants |
| Hyaluronic acid during periodontal surgery | Enamel matrix derivative during periodontal surgery | Gingival recession (mm) 18 months · 18-month follow-up | MD -0.23 [-0.62, 0.15] GRADE not reported 2 studies · 85 participants |
Included primary studies 3
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Rodriguez 2025 Comparision of crosslinked hyaluronic acid vs. enamel matrix derivative for periodontal regeneration: an 18-month follow-up randomized… PMID:40106008 | 2025 | 1 other review | not stated | not extracted yet |
| Pilloni 2021 Healing of intrabony defects following regenerative surgery by means of single-flap approach in conjunction with either hyaluronic acid or… PMID:33565017 | 2021 | this review only | not stated | not extracted yet |
| Vela 2024 Clinical and Radiographic Evaluation of Intrabony Periodontal Defects Treated with Hyaluronic Acid or Enamel Matrix Proteins: A 6-Month… PMID:38994786 | 2024 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Clinical efficacy of different biomaterials for the regenerative treatment of periodontal intrabony defects: a systematic review and… (2026) | 1 | 0.02 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult patients with intrabony periodontal defects in need of periodontal regeneration | 139 adults with 139 intrabony defects (depth > 3 mm, at least two walls) (n=3) |
| Intervention | Hyaluronic acid as the sole biomaterial during regenerative surgery | Cross-linked hyaluronic acid HyaDENT BG (n=3) |
| Comparison | Enamel matrix derivative | Enamel matrix derivative, Emdogain (n=3) |
| Outcomes | CAL gain (primary; non-inferiority margin 0.5 mm); PPD, REC, BOP, radiographic defect depth (exploratory); suppuration on probing, marginal bone loss, percentage of defect fill also collected | CAL gain (n=3); PPD (n=3); REC (n=3); BOP (n=2); radiographic defect depth (n=2) |
| Study designs | Randomized controlled trials in adults, published 2010 or later, English full text | RCTs (n=3) |
| Timing | Different follow-up periods analysed as separate time points | 6 months (n=2); 12 months (n=2); 18 months (n=2); 24 months (n=1) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | No | no |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | RCT: Yes · NRSI: N/A | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | RCT: Yes · NRSI: N/A | yes |
| 12Impact of risk of bias on the pooled results | Yes | No | no |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | No | No | yes |
| Overall | Critically Low | Critically Low | yes |