Dentist № 2 (61) – 2026, pp. 35-20                                                                                                                        REVIEWS, EDUCATIONAL ARTICLES


Evaluation of the effectiveness of hyaluronic acid application in plastic surgery of the soft tissues of the oral mucosa


M.S. Mutsyuka, A.A. Kabanovab

aVitebsk State Medical University, Vitebsk, Belarus
bMD, PhD, DMSci, associate professor, Vitebsk State Medical University, Vitebsk, Belarus

ABSTRACT
The aim of the study. A systematic review of current data on the applications of hyaluronic acid in plastic surgery of oral mucosal soft tissues.
Objects and methods. To systematize current data on the potential applications of hyaluronic acid in plastic surgery of oral mucosal soft tissues. An analysis of scientific publications from the Scopus, Web of Science, and PubMed databases for the period 2010–2025 was conducted. The reviewed articles focused on the use of hyaluronic acid in the surgical treatment of gingival recession and other soft tissue and bone defects of the oral cavity.
Results and discussion. Hyaluronic acid possesses unique physicochemical properties (hygroscopicity, viscoelasticity), promotes wound healing, and exhibits bacteriostatic and anti-inflammatory effects. Several clinical studies have shown that the use of hyaluronic acid in combination with a coronally advanced flap improves aesthetic outcomes and reduces postoperative discomfort. However, recent systematic reviews (Talebi Ardakani et al., 2025; Kalimeri et al., 2024) indicate heterogeneity in the evidence base. Hyaluronic acid demonstrates the greatest potential when combined with other biomaterials, as well as an alternative to enamel
matrix derivatives.
Conclusion.  Hyaluronic acid is a safe and promising agent in regenerative periodontal surgery. A key direction for future research is the standardization of application protocols, taking into account the initial tissue phenotype.

Keywords: hyaluronic acid, gingival recession, oral plastic surgery

References

  1. Dedova L.N., Denisova Yu.L., Kandrukevich O.V. [et al.] Rasprostranennost bolezney periodonta, kariesa kornya zuba, chuvstvitelnosti dentina i zubochelyustnykh deformatsiy v Respublike Belarus po rezultatam obsledovaniya naseleniya v vozrastnykh gruppakh 35–44, 45–54 i 55–64 goda [Prevalence of periodontal diseases, root caries, dentin hypersensitivity and dentoalveolar deformities in the Republic of Belarus based on the results of a survey of the population in the age groups 35–44, 45–54 and 55–64 years]. Stomatolog. Minsk. – Dentist. Minsk. 2016, no. 1, pp. 9–15.
  2. Dedova L.N., Kazeko L.A., Klenovaya T.S. [et al.] Rasprostranennost stomatologicheskikh zabolevaniy v Respublike Belarus [Prevalence of dental diseases in the Republic of Belarus]. Stomatologiya. Estetika. Innovatsii. – Dentistry. Aesthetics. Innovations. 2017, no. 2, pp. 193–202.
  3. Dedova L.N., Kandrukevich O.V., Khomich I.S. Rekonstruktivnye metody lecheniya bolezney periodonta: teoreticheskie aspekty [Reconstructive methods of treatment of periodontal diseases: theoretical aspects]. Stomatolog. Minsk. – Dentist. Minsk. 2014, no. 2(13), pp. 65–71.
  4. Dedova L.N., Kandrukevich O.V. Retsessiya desny: klinika, diagnostika. Planirovanie lecheniya [Gingival recession: clinical presentation, diagnosis. Treatment planning]. Stomatologiya. – Dentistry. 2014, no. 4, pp. 91–99.
  5. Denisova Yu.L. Kompleksnoe lechenie patsientov s retsessiey desny v sochetanii s zubochelyustnymi anomaliyami [Complex treatment of patients with gingival recession in combination with dentoalveolar anomalies]. Stomatolog. Minsk. – Dentist. Minsk. 2014, no. 1, pp. 17–30.
  6. Advances in adjunctive root coverage techniques: a narrative review of laser therapy, hyaluronic acid, and nanomaterials. Saudi Dental Journal. 2025, 37, P. 86. doi.org/10.1007/s44445-025-00094-z
  7. Boyd R.L. Mucogingival considerations and their relationship to orthodontics. Journal of Periodontology,1978, vol. 49, no. 1, pp. 67–76.
  8. Cardaropoli D., Gaveglio L., Biosse Duplan M. [et al.]. Polynucleotides and Hyaluronic Acid Mixture with Volume Stable Collagen Matrix for Coverage of Multiple Gingival Recession: A Case Series. International Journal of Periodontics and Restorative Dentistry. 2025, (Preprint). doi.org/10.11607/prd.6363752
  9. Cortellini P., Bissada N.F. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. Journal of Periodontology. 2018, vol. 89, suppl. 1, pp. S204–S213. doi.org/10.1002/JPER.16-0671
  10. Dahiya P., Kamal R. Hyaluronic Acid: a boon in periodontal therapy. North American Journal of Medical Sciences. 2013, vol. 5, no. 5, pp. 309–315. doi.org/10.4103/1947-2714.112473
  11. Górski B., Skierska I., Szerszeń M. [et al.]. Tunnel technique with cross-linked hyaluronic acid in addition to subepithelial connective tissue graft, compared with connective tissue graft alone, for the treatment of multiple gingival recessions: 6-month outcomes of a randomized clinical trial. Clinical Oral Investigations. 2023, vol. 27, no. 5, pp. 2395–2406. doi.org/10.1007/s00784-023-04887-6
  12. Jepsen S., Caton J.G., Albandar J.M. [et al.]. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Clinical Periodontology. 2018, vol. 45, suppl. 20, pp. S219–S229. doi.org/10.1111/jcpe.12951
  13. Kalimeri E. [et al.]. Adjunctive use of hyaluronic acid in the treatment of gingival recessions: a systematic review and meta-analysis. Clinical Oral Investigations. 2024, vol. 28, no. 6, art. 329. doi.org/10.1007/s00784-024-05701-7
  14. Kassab M.M., Cohen R.E. The etiology and prevalence of gingival recession. Journal of the American Dental Association. 2003, vol. 134, no. 2, pp. 220–225. doi.org/10.14219/jada.archive.2003.0137
  15. Kumar R., Srinivas M., Pai J. [et al.]. Efficacy of hyaluronic acid (hyaluronan) in root coverage procedures as an adjunct to coronally advanced flap in Millers Class I recession: A clinical study. Journal of Indian Society of Periodontology. 2014, vol. 18, no. 6, pp. 746–750. doi.org/10.4103/0972-124X.147411
  16. Laurent T.C., Fraser J.R. Hyaluronan. FASEB Journal, 1992, vol. 6, no. 7, pp. 2397–2404.
  17. Laurent T.C., Fraser J.R. The properties and turnover of hyaluronan. Ciba Foundation Symposium. 1986, vol. 124, pp. 9–29. doi.org/10.1002/9780470513385.ch2
  18. Löe H., Anerud A., Boysen H. The natural history of periodontal disease in man: prevalence, severity and extent of gingival recession. Journal of Periodontology. 1992, vol. 63, no. 6, pp. 489–495.
  19. Meza Mauricio J., Furquim C.P., Bustillos-Torrez W. [et al.]. Does enamel matrix derivative application provide additional clinical benefits in the treatment of maxillary Miller class I and II gingival recession? A systematic review and meta-analysis. Clinical Oral Investigations. 2021, vol. 25, no. 4, pp. 1613–1626. doi.org/10.1007/s00784-021-03782-2
  20. Moseley R., Waddington R.J., Embery G. Hyaluronan and its potential role in periodontal healing. Dental Update. 2002, vol. 29, no. 3, pp. 144–148. doi.org/10.12968/denu.2002.29.3.144
  21. Nandanwar J., Bhongade M.L., Puri S. [et al.]. Comparison of Effectiveness of Hyaluronic Acid in Combination with Polylactic Acid/Polyglycolic Acid Membrane and Subepithelial Connective Tissue Graft for the Treatment of Multiple Gingival Recession Defects in Human: A Clinical Study. Journal of Datta Meghe Institute of Medical Sciences University. 2018, vol. 13, no. 1, pp. 48–53. doi.org/10.4103/jdmimsu.jdmimsu_39_18
  22. Novaes A.B. Jr., Palioto D.B. Experimental and clinical studies on plastic periodontal procedures. Periodontology 2000. 2019, vol. 79, no. 1, pp. 56–80. doi.org/10.1111/prd.12247
  23. Pilloni A., Schmidlin P.R., Sahrmann P. [et al.]. Effectiveness of adjunctive hyaluronic acid application in coronally advanced flap in Miller class I single gingival recession sites: a randomized controlled clinical trial. Clinical Oral Investigations. 2019, vol. 23, no. 3, pp. 1133–1141. doi.org/10.1007/s00784-018-2537-4
  24. Rodríguez‑A M. [et al.]. Comparison of crosslinked hyaluronic acid vs. enamel matrix derivative for periodontal regeneration: an 18-month follow-up randomized clinical trial. Clinical Oral Investigations. 2025, Vol. 29, no. 4, art. 197. doi.org/10.1007/s00784-025-06278-5
  25. Soundarajan S. [et al.]. Comparison of effectiveness of hyaluronic acid and melatonin with guided tissue regeneration (GTR) membrane versus guided tissue regeneration (GTR) membrane alone in the treatment of intra-bony defects in human subjects: A split-mouth randomised controlled clinical trial. Journal of Oral Biology and Craniofacial Research. 2026, vol. 16, no. 2, art. 101397. doi.org/10.1016/j.jobcr.2026.01.001
  26. Talebi Ardakani M., Moscowchi A., Talebi A. [et al.]. Hyaluronic acid efficacy in root coverage procedures: a systematic review and meta-analysis. BMC Oral Health. 2025, vol. 25, no. 1, art. 119. doi.org/10.1186/s12903-025-05526-0
  27. Vela O.C., Boariu M., Rusu D. [et al.]. Clinical and Radiographic Evaluation of Intrabony Periodontal Defects Treated with Hyaluronic Acid or Enamel Matrix Proteins: A 6-Month Prospective Study. Oral Health and Preventive Dentistry. 2024, vol. 22, pp. 257–270. doi.org/10.3290/j.ohpd.b5569745
  28. Vela O.C., Boariu M., Rusu D. [et al.]. Healing of Periodontal Suprabony Defects following Treatment with Open Flap Debridement with or without Hyaluronic Acid (HA) Application. Medicina (Kaunas). 2024, vol. 60, no. 5, art. 829. doi.org/10.3390/medicina60050829
  29. Zucchelli G., Tavelli L., McGuire M.K. [et al.]. Autogenous soft tissue grafting for periodontal and peri-implant plastic surgical reconstruction. Journal of Periodontology. 2020, vol. 91, no. 1, pp. 9–16. doi.org/10.1002/JPER.19-0350
  30. Zucchelli G., Mounssif I. Periodontal plastic surgery. Periodontology 2000.  2015, vol. 68, no. 1, pp. 333–368. doi.org/10.1111/prd.12059.

Correspondence to:  E-mail: mmcom1992@mail.ru