Evaluation of the effect of hyaluronic acid gel applied as addition to periodontal treatment in patients with type 2 diabetes on interleukin-6 level and clinical parameters

Objective: The wound healing process is impaired in treating periodontal diseases in patients with diabetes; this process can be accelerated with some treatment alternatives. Subgingival hyaluronic acid gel application is used to support wound healing and inflammation reduction in addition to initial periodontal therapy. This thesis study aims to evaluate the effect of hyaluronic acid gel applied in addition to initial periodontal treatment on IL-6 level in gingival crevicular fluid and clinical parameters in patients with periodontitis with type 2 diabetes. Materials and Methods: Subgingival 0.8% hyaluronic acid gel was applied to the patients immediately and one week after the end of the initial periodontal treatment. Clinical periodontal parameters were recorded from the patients before the treatment and at the 1st, 4th and 12th weeks after the treatment. The gingival crevicular fluid samples were collected before the treatment and at the 4th and 12th weeks to compare IL-6 levels. The variables were examined with the Kolmogorov Smirnov test in the statistical analysis. The Mann–Whitney test was used to compare the non-normally distributed continuous variables between the two groups. The Kruskal-Wallis test was used to compare the three or more groups. Results: A statistically significant decrease was observed in the clinical periodontal parameter values of the patients in the test and control groups when all periods were examined (p˂0.001). There was no statistically significant difference in the clinical periodontal parameter values in the comparisons between the groups (p>0.05). In the intragroup comparisons of IL-6 values, a statistically significant decrease was found overtime in the test group (p˂0.020), while no statistically significant difference was found in the control group (p>963). Conclusion: The subgingival hyaluronic acid gel, in addition to the initial periodontal treatment, will improve outcomes by limiting the effects of pro-inflammatory cytokines in diabetic periodontitis patients. Keywords: Hyaluronic acid, Diabetes mellitus, Periodontitis, Interleukin-6.