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.