Hyaluronic acid gel as a nonsurgical approach for the interdental papillary defects: A systematic review

Objetive

This systematic review aimed to evaluate whether the use of HA could be considered an effective treatment approach for the restoration of papillary defects.

Material and methods

This study was registered on the PROSPERO. A systematic search was performed on five electronic databases for articles published up to May 2022. The meta-analysis was performed using the R program. The risk of bias and quality was assessed using the RoB 2.0 and National Institutes of Health, respectively.

Results

Eighteen studies were included with a total of 213 participants with 696 interdental papillary defects. All included studies reported promising results on the reconstruction of the deficient interdental papilla after injection of HA. Single-arm meta-analysis indicated a proportion of 47% (confidence interval [CI]:35–59%) of sites evaluated with complete interdental papilla reconstruction (100% of reconstruction). Partial interdental papilla reconstruction (range from: 2.1% to 96% reconstruction) was reported by 49% (CI:40–59%) of sites evaluated. Five studies evaluated patient-reported outcome measures. An increased satisfaction was observed after the injection of HA without significant pain after the evaluation periods. Randomized controlled trials (RCT) studies presented a low and unclear risk of bias, while uncontrolled studies were classified as having good quality.

Conclusion

The short-term analysis indicated that the injection of HA for the treatment of papillary defects is considered a feasible treatment achieving esthetic satisfactory results with minimum pain. However, further well-conducted RCT studies with standardized parameters and long-term follow-up should be recommended.