Comparative Evaluation of Hyaluronic Acid (hyaDENT BG® Gel) and Enamel Matrix Proteins (Emdogain®) in the Regenerative Treatment of Angular Bone Defects Using Xenograft (Bio-Oss Collagen®)—A Clinical Trial

Abstract

Biomolecules have gained attention in recent years for their potential to enhance regenerative periodontal therapy. This study compared hyaluronic acid (HA) and enamel matrix derivative (EMD), each combined with a xenogeneic graft, in adults with periodontitis presenting vertical bone loss with an intrabony component ≥3 mm. Seventeen participants contributed 28 defects, assigned in equal numbers to Bio-Oss Collagen® plus HA gel (hyaDENT BG®) or Bio-Oss Collagen® plus EMD (Emdogain®). Outcomes included reduction in probing pocket depth (PPD), gain in clinical attachment level (CAL), and radiographic measures of residual defect and bone fill, assessed at baseline and 6 months after the surgery. Both approaches produced significant within-group improvements in PPD, CAL, and radiographic bone fill (all p = 0.001). Postoperative values and mean changes did not differ significantly between groups (all p > 0.24). Within the limitations of this small, non-randomized study, the findings indicate that HA gel can achieve clinical and radiographic outcomes comparable to EMD when both are used with a xenogeneic scaffold. These results should be considered preliminary, suggesting that HA may represent a practical and biologically compatible alternative to EMD, particularly in cases where cost, availability, or religious considerations limit its use. Confirmation through larger, randomized, and long-term studies is warranted to validate these observations.