Cross-Linked Hyaluronic Acid and Laser Photobiomodulation in Guided Bone Regeneration (GBR): A Case Report Describing a New Combined Technique.

Vescovi, Paolo; Giovannacci, Ilaria; Mortellaro, Carmen; Lucchina, Alberta Greco; Iaria, Roberta; Bortolotti, Gloria; Leão, Jair Carneiro; Meleti, Marco; Namour, Samir

doi:10.1155/crid/7424509

Article (Scientific journals)

Cross-Linked Hyaluronic Acid and Laser Photobiomodulation in Guided Bone Regeneration (GBR): A Case Report Describing a New Combined Technique.

Vescovi, Paolo; Giovannacci, Ilaria; Mortellaro, Carmen et al.

2026 • In Case Reports in Dentistry, 2026 (1), p. 7424509

Peer Reviewed verified by ORBi

Permalink
https://hdl.handle.net/2268/342696

DOI
10.1155/crid/7424509

PubMed
41695380

Files (1)Send to Details Statistics Bibliography Similar publications

Files

Full Text

Case Reports in Dentistry - 2026 - Vescovi - Cross‐Linked Hyaluronic Acid and Laser Photobiomodulation in Guided Bone.pdf

Publisher postprint (4.31 MB)

Download

All documents in ORBi are protected by a user license.

Send to

RIS BibTex APA Chicago Permalink X Linkedin

Details

Keywords :

Nd: YAG laser; cross-linked hyaluronic acid; esthetic area rehabilitation; guided bone regeneration; porcine pericardium membrane; Dentistry (all)

Abstract :

[en] Perfect maintenance of the soft tissue and bone level at the implant site substantially influences the long-term surgical success and esthetic and functional results of prosthetic rehabilitation. Hyaluronic acid (HA) is a glycosaminoglycan, that is a long linear polymer chain formed by the repetition of disaccharide units, in turn composed of alternating molecules of glucuronic acid and N-acetylglucosamine joined together by glycosidic and hydrogen bonds. HA in oral surgery improves wound healing by stimulating clot formation, inducing angiogenesis, increasing osteogenesis, preserving the viability of periodontal ligament fibroblasts and gingival fibroblasts, and accelerating bone regeneration through chemotaxis, proliferation, and subsequent differentiation of mesenchymal cells. The cross-linking process, which modifies the three-dimensional structure of the HA chains, gives the product a higher molecular weight and, consequently, a greater density, slower reabsorption, and longer lasting action. Laser photobiomodulation (laser PBMT) promotes wound healing by inducing cell proliferation, anti-inflammatory responses, pain relief, and scar formation inhibition. The present paper describes the clinical case of a 72-year-old male patient who, due to a large vestibular bone defect in Zone 1.1, required bone regeneration. The aim of this case report was to propose a combination of cross-linked hyaluronic acid (xHyA) and laser PBMT to support bone and soft tissue regeneration in areas of severe periodontal compromise and tissue defects.

Disciplines :

Dentistry & oral medicine

Author, co-author :

Vescovi, Paolo ; Department of Medicine and of Surgery, University of Parma, Parma, Italy, unipr.it

Giovannacci, Ilaria ; Department of Medicine and of Surgery, University of Parma, Parma, Italy, unipr.it ; UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy, unicamillus.org

Mortellaro, Carmen ; UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy, unicamillus.org

Lucchina, Alberta Greco ; UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy, unicamillus.org

Iaria, Roberta ; Department of Medicine and of Surgery, University of Parma, Parma, Italy, unipr.it

Bortolotti, Gloria; Department of Medicine and of Surgery, University of Parma, Parma, Italy, unipr.it

Leão, Jair Carneiro ; Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil, ufpe.br

Meleti, Marco ; Department of Medicine and of Surgery, University of Parma, Parma, Italy, unipr.it

Namour, Samir ; Université de Liège - ULiège > Département des sciences dentaires

Language :

English

Title :

Cross-Linked Hyaluronic Acid and Laser Photobiomodulation in Guided Bone Regeneration (GBR): A Case Report Describing a New Combined Technique.

Publication date :

2026

Journal title :

Case Reports in Dentistry

ISSN :

2090-6447

eISSN :

2090-6455

Publisher :

John Wiley and Sons Ltd, Egypt

Volume :

2026

Issue :

Pages :

7424509

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://onlinelibrary.wiley.com/doi/pdf/10.1155/crid/7424509

Available on ORBi :

since 13 March 2026

Statistics

Number of views

49 (2 by ULiège)

Number of downloads

35 (0 by ULiège)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

OpenAlex citations

Bibliography

Duong H. Y., Roccuzzo A., Stähli A., Salvi G. E., Lang N. P., and Sculean A., Oral Health-Related Quality of Life of Patients Rehabilitated With Fixed and Removable Implant-Supported Dental Prostheses, Periodontology 2000. (2022) 88, no. 1, 201–237, https://doi.org/10.1111/prd.12419, 35103325.
Testori T., Weinstein T., Scutellà F., Wang H. L., and Zucchelli G., Implant Placement in the Esthetic Area: Criteria for Positioning Single and Multiple Implants, Periodontology 2000. (2018) 77, no. 1, 176–196, https://doi.org/10.1111/prd.12211, 2-s2.0-85042552731, 29484714.
Mizraji G., Davidzohn A., Gursoy M., Gursoy U., Shapira L., and Wilensky A., Membrane Barriers for Guided Bone Regeneration: An Overview of Available Biomaterials, Periodontology 2000. (2023) 93, no. 1, 56–76, https://doi.org/10.1111/prd.12502, 37855164.
Calciolari E., Corbella S., Gkranias N., Viganó M., Sculean A., and Donos N., Efficacy of Biomaterials for Lateral Bone Augmentation Performed With Guided Bone Regeneration. A Network Meta-Analysis, Periodontology 2000. (2023) 93, no. 1, 77–106, https://doi.org/10.1111/prd.12531, 37752820.
Liñares A., Dopico J., Magrin G., and Blanco J., Critical Review on Bone Grafting During Immediate Implant Placement, Periodontology 2000. (2023) 93, no. 1, 309–326, https://doi.org/10.1111/prd.12516, 37658586.
Micheels P., Sarazin D., Tran C., and Salomon D., Effect of Different Crosslinking Technologies on Hyaluronic Acid Behavior: A Visual and Microscopic Study of Seven Hyaluronic Acid Gels, Journal of Drugs in Dermatology. (2016) 15, no. 5, 600–606, 27168268.
Sgorla D., Almeida A., Azevedo C., Bunhak Ÿ. J., Sarmento B., and Cavalcanti O. A., Development and Characterization of Crosslinked Hyaluronic Acid Polymeric Films for Use in Coating Processes, International Journal of Pharmaceutics. (2016) 511, no. 1, 380–389, https://doi.org/10.1016/j.ijpharm.2016.07.033, 2-s2.0-84978780335, 27436707.
Huang Y. and Yang P., Application of Cross-Linked and Non-Cross-Linked Hyaluronic Acid Nano-Needles in Cosmetic Surgery, International Journal of Analytical Chemistry. (2022) 2022, no. 1, 4565260, https://doi.org/10.1155/2022/4565260, 35651502.
Asparuhova M. B., Kiryak D., Eliezer M., Mihov D., and Sculean A., Activity of Two Hyaluronan Preparations on Primary Human Oral Fibroblasts, Journal of Periodontal Research. (2019) 54, no. 1, 33–45, https://doi.org/10.1111/jre.12602, 2-s2.0-85053920943, 30264516.
Asparuhova M. B., Chappuis V., Stähli A., Buser D., and Sculean A., Role of Hyaluronan in Regulating Self-Renewal and Osteogenic Differentiation of Mesenchymal Stromal Cells and Pre-Osteoblasts, Clinical Oral Investigations. (2020) 24, no. 11, 3923–3937, https://doi.org/10.1007/s00784-020-03259-8, 32236725.
Stein E., Koehn J., Sutter W., Wendtlandt G., Wanschitz F., Thurnher D., Baghestanian M., and Turhani D., Initial Effects of Low-Level Laser Therapy on Growth and Differentiation of Human Osteoblast-Like Cells, Wiener Klinische Wochenschrift. (2008) 120, no. 3-4, 112–127, PMID: 18322773https://doi.org/10.1007/s00508-008-0932-6, 2-s2.0-40549119163.
Nammour S., El Mobadder M., Brugnera A. J., Namour M., Houeis S., Heysselaer D., Vanheusden A., and Namour A., Photobiomodulation Therapy vs. Corticosteroid for the Management of Erosive/Ulcerative and Painful Oral Lichen Planus. Assessment of Success Rate During One-Year Follow-Up: A Retrospective Study, Healthcare (Basel). (2021) 9, no. 9, https://doi.org/10.3390/healthcare9091137, 34574912.
Kesler G., Shvero D. K., Tov Y. S., and Romanos G., Platelet Derived Growth Factor Secretion and Bone Healing After Er:YAG Laser Bone Irradiation, Journal of Oral Implantology. (2011) 37, no. sp1, 195–204, https://doi.org/10.1563/AAID-JOI-D-09-00120.1, 2-s2.0-79958835927, 20594059.
Park J. B., Ahn S. J., Kang Y. G., Kim E. C., Heo J. S., and Kang K. L., Effects of Increased Low-Level Diode Laser Irradiation Time on Extraction Socket Healing in Rats, Lasers in Medical Science. (2015) 30, no. 2, 719–726, https://doi.org/10.1007/s10103-013-1402-6, 2-s2.0-84881069394, 23929563.
Mergoni G., Vescovi P., Sala R., Merigo E., Passerini P., Maestri R., Corradi D., Govoni P., Nammour S., and Bianchi M. G., The Effect of Laser Therapy on the Expression of Osteocalcin and Osteopontin After Tooth Extraction in Rats Treated With Zoledronate and Dexamethasone, Supportive Care in Cancer. (2016) 24, no. 2, 807–813, https://doi.org/10.1007/s00520-015-2847-x, 2-s2.0-84952876127, 26190360.
Namour M., El Mobadder M., Magnin D., Peremans A., Verspecht T., Teughels W., Lamard L., Nammour S., and Rompen E., Q-Switch Nd:YAG Laser-Assisted Decontamination of Implant Surface, Dentistry Journal. (2019) 7, no. 4, https://doi.org/10.3390/dj7040099, 31581536.
Aoki A., Mizutani K., Schwarz F., Sculean A., Yukna R. A., Takasaki A. A., Romanos G. E., Taniguchi Y., Sasaki K. M., Zeredo J. L., Koshy G., Coluzzi D. J., White J. M., Abiko Y., Ishikawa I., and Izumi Y., Periodontal and Peri-Implant Wound Healing Following Laser Therapy, Periodontology 2000. (2015) 68, no. 1, 217–269, https://doi.org/10.1111/prd.12080, 2-s2.0-84927125257, 25867988.
Dalvi S., Benedicenti S., and Hanna R., Effectiveness of Photobiomodulation as an Adjunct to Nonsurgical Periodontal Therapy in the Management of Periodontitis- a Systematic Review of In Vivo Human Studies, Photochemistry and Photobiology. (2021) 97, no. 2, 223–242, https://doi.org/10.1111/php.13348, 33098680.
Cho Y. D., Kim K. H., Lee Y. M., Ku Y., and Seol Y. J., Periodontal Wound Healing and Tissue Regeneration: A Narrative Review, Pharmaceuticals (Basel). (2021) 14, no. 5, https://doi.org/10.3390/ph14050456, 34065862.
Shirakata Y., Imafuji T., Nakamura T., Shinohara Y., Iwata M., Setoguchi F., Noguchi K., and Sculean A., Cross-Linked Hyaluronic Acid Gel With or Without a Collagen Matrix in the Treatment of Class III Furcation Defects: A Histologic and Histomorphometric Study in Dogs, Journal of Clinical Periodontology. (2022) 49, no. 10, 1079–1089, https://doi.org/10.1111/jcpe.13694, 35817414.
Eliezer M., Sculean A., Miron R. J., Nemcovsky C., Weinberg E., Weinreb M., Zoabi H., Bosshardt D. D., Fujioka-Kobayashi M., and Moses O., Hyaluronic Acid Slows Down Collagen Membrane Degradation in Uncontrolled Diabetic Rats, Journal of Periodontal Research. (2019) 54, no. 6, 644–652, https://doi.org/10.1111/jre.12665, 2-s2.0-85067385889, 31190426.
Silva E. C., Omonte S. V., Martins A. G., de Castro H. H., Gomes H. E., Zenóbio É. G., de Oliveira P. A., Horta M. C., and Souza P. E., Hyaluronic Acid on Collagen Membranes: An Experimental Study in Rats, Archives of Oral Biology. (2017) 73, 214–222, https://doi.org/10.1016/j.archoralbio.2016.10.016, 2-s2.0-84992223670, 27776288.
Zhai P., Peng X., Li B., Liu Y., Sun H., and Li X., The Application of Hyaluronic Acid in Bone Regeneration, International Journal of Biological Macromolecules. (2020) 151, 1224–1239, https://doi.org/10.1016/j.ijbiomac.2019.10.169.
García-Gareta E., Coathup M. J., and Blunn G. W., Osteoinduction of Bone Grafting Materials for Bone Repair and Regeneration, Bone. (2015) 81, 112–121, https://doi.org/10.1016/j.bone.2015.07.007, 2-s2.0-84937002671.
Karageorgiou V. and Kaplan D., Porosity of 3D Biomaterial Scaffolds and Osteogenesis, Biomaterials. (2005) 26, no. 27, 5474–5491, https://doi.org/10.1016/j.biomaterials.2005.02.002, 2-s2.0-17844400927.
Seliktar D., Designing Cell-Compatible Hydrogels for Biomedical Applications, Science. (2012) 336, no. 6085, 1124–1128, PMID: 22654050https://doi.org/10.1126/science.1214804, 2-s2.0-84861714640.
de Brito B. B., Mendes Brazão M. A., de Campos M. L., Casati M. Z., Sallum E. A., and Sallum A. W., Association of Hyaluronic Acid With a Collagen Scaffold May Improve Bone Healing in Critical-Size Bone Defects, Clinical Oral Implants Research. (2012) 23, no. 8, 938–942, https://doi.org/10.1111/j.1600-0501.2011.02234.x, 2-s2.0-84863879779, 21689163.
Arpağ OF, Damlar I., Altan A., Tatli U., and Günay A., To What Extent Does Hyaluronic Acid Affect Healing of Xenografts? A Histomorphometric Study in a Rabbit Model, Journal of Applied Oral Science. (2018) 26, e20170004, https://doi.org/10.1590/1678-7757-2017-0004, 2-s2.0-85040987978, 29364337.
Lee J. B., Chu S., Ben Amara H., Song H. Y., Son M. J., Lee J., Kim H. Y., Koo K. T., and Rhyu I. C., Effects of Hyaluronic Acid and Deproteinized Bovine Bone Mineral With 10% Collagen for Ridge Preservation in Compromised Extraction Sockets, Journal of Periodontology. (2021) 92, no. 11, 1564–1575, https://doi.org/10.1002/JPER.20-0832, 33484160.
Daigo Y., Daigo E., Hasegawa A., Fukuoka H., Ishikawa M., and Takahashi K., Utility of High-Intensity Laser Therapy Combined with Photobiomodulation Therapy for Socket Preservation After Tooth Extraction, Photobiomodulation, Photomedicine, and Laser Surgery. (2020) 38, no. 2, 75–83, https://doi.org/10.1089/photob.2019.4652, 31846389.
Zou X., Li H., Chen L., Baatrup A., Bünger C., and Lind M., Stimulation of Porcine Bone Marrow Stromal Cells by Hyaluronan, Dexamethasone and rhBMP-2, Biomaterials. (2004) 25, no. 23, 5375–5385, https://doi.org/10.1016/j.biomaterials.2003.12.041, 2-s2.0-2342579570, 15130722.
Scarano A., Qorri E., Gehrke S. A., Nicolai G., and Tari S. R., Cross-Linked Hyaluronic Acid Enriched With Amino Acids Used for Bone Filler Defect: A Histological and Histomorphometry Study in Rabbit Tibiae, Journal of Stomatology Oral and Maxillofacial Surgery. (2025) 126, no. 5, 102435, https://doi.org/10.1016/j.jormas.2025.102435, 40602748.
Itoh S., Matubara M., Kawauchi T., Nakamura H., Yukitake S., Ichinose S., and Shinomiya K., Enhancement of Bone Ingrowth in a Titanium Fiber Mesh Implant by rhBMP-2 and Hyaluronic Acid, Journal of Materials Science. Materials in Medicine. (2001) 12, no. 7, 575–581, https://doi.org/10.1023/a:1011277207574, 2-s2.0-0034923473, 15348249.
Hasan M. and Al-Ghaban N. M., The Effects of Hyaluronic Acid on Bone-Implant Interface in Rabbits (Immunohistochemical Study for TNF-α), International Journal of Advance Biological Research. (2017) 7, no. 4, 733–738.
Shirakata Y., Nakamura T., Setoguchi F., Imafuji T., Shinohara Y., Matsumura S., Iwata M., Noguchi K., Ramanauskaite E., and Sculean A., Histological Evaluation of Nonsurgical Periodontal Treatment With and Without the Use of Sodium Hypochlorite / Amino Acids and Cross-Linked Hyaluronic Acid Gels in Dogs, Clinical Oral Investigations. (2024) 28, no. 5, https://doi.org/10.1007/s00784-024-05674-7, 38676852.
Vanden B. L., Treatment of Infrabony Periodontal Defects With Esterified Hyaluronic Acid: Clinical Report of 19 Consecutive Lesions, International Journal of Periodontics & Restorative Dentistry. (2009) 29, no. 3, 315–323, PMID: 19537471.
Briguglio F., Briguglio E., Briguglio R., Cafiero C., and Isola G., Treatment of Infrabony Periodontal Defects Using a Resorbable Biopolymer of Hyaluronic Acid: A Randomized Clinical Trial, Quintessence International. (2013) 44, no. 3, 231–240, https://doi.org/10.3290/j.qi.a29054, 2-s2.0-84995770413, 23444204.
Shirakata Y., Imafuji T., Nakamura T., Shinohara Y., Iwata M., Setoguchi F., Noguchi K., and Sculean A., Cross-linked hyaluronic acid gel with or without a collagen matrix in the treatment of class III furcation defects: A histologic and histomorphometric study in dogs, Journal of Clinical Periodontology. (2022) 49, no. 10, 1079–1089, https://doi.org/10.1111/jcpe.13694, 35817414.
Pilloni A., Schmidlin P. R., Sahrmann P., Sculean A., and Rojas M. A., 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) 23, no. 3, 1133–1141, https://doi.org/10.1007/s00784-018-2537-4, 2-s2.0-85049230924.
Eliezer M., Imber J. C., Sculean A., Pandis N., and Teich S., Hyaluronic Acid as Adjunctive to Non-Surgical and Surgical Periodontal Therapy: A Systematic Review and Meta-Analysis, Clinical Oral Investigations. (2019) 23, no. 9, 3423–3435, https://doi.org/10.1007/s00784-019-03012-w, 2-s2.0-85069683204, 31338632.
Kauffmann F., Fickl S., Sculean A., Fischer K. R., and Friedmann A., Alveolar Ridge Alterations After Lateral Guided Bone Regeneration With and Without Hyaluronic Acid: A Prospective Randomized Trial With Morphometric and Histomorphometric Evaluation, Quintessence International. (2023) 54, no. 9, 712–722, https://doi.org/10.3290/j.qi.b4171703, 37345441.
Gholami L., Asefi S., Hooshyarfard A., Sculean A., Romanos G. E., Aoki A., and Fekrazad R., Photobiomodulation in Periodontology and Implant Dentistry: Part 1, Photomedicine, and Laser Surgery. (2019) 37, no. 12, 739–765, https://doi.org/10.1089/photob.2019.4710, 31750783.
Gholami L., Asefi S., Hooshyarfard A., Sculean A., Romanos G. E., Aoki A., and Fekrazad R., Photobiomodulation in Periodontology and Implant Dentistry: Part 2, Photomedicine, and Laser Surgery. (2019) 37, 766–783, https://doi.org/10.1089/photob.2019.4731.
Sourvanos D., Poon J., Lander B., Sarmiento H., Carroll J., Zhu T. C., and Fiorellini J. P., Improving Titanium Implant Stability With Photobiomodulation: A Review and Meta-Analysis of Irradiation Parameters, Photomedicine and Laser Surgery. (2023) 41, no. 3, 93–103, https://doi.org/10.1089/photob.2022.0161, 36856530.
Camolesi G. C. V., Somoza-Martín J. M., Reboiras-López M. D., Camacho-Alonso F., Blanco-Carrión A., and Pérez-Sayáns M., Photobiomodulation in Dental Implant Stability and Post-Surgical Healing and Inflammation. A Randomised Double-Blind Study, Clinical Oral Implants Research. (2023) 34, no. 2, 137–147, https://doi.org/10.1111/clr.14026, 36541106.
Poli P. P., Jesus L. K., Dayube U. R. C., Hadad H., Loureiro C., Chiba F. Y., Furtado T. S. M., Silva M. P., Okamoto R., Maiorana C., Carvalho P. S. P., and Souza F. Á., An Evaluation of the Effects of Photobiomodulation Therapy on the Peri-Implant Bone Healing of Implants With Different Surfaces: An In Vivo Study, Materials (Basel). (2022) 15, no. 13, https://doi.org/10.3390/ma15134371, 35806496.
GamdF.da, Mfxb C., Souza MaiorJ. D.de, Silva PereiraJ.da, Pinto L. A., Matias M., and Frigo L., Laser-Photobiomodulation on Titanium Implant Bone Healing in Rat Model: Comparison Between 660- and 808-nm Wavelength, Lasers in Medical Science. (2022) 37, no. 4, 2179–2184, https://doi.org/10.1007/s10103-021-03481-0, 35028766.
Soares L. G., Magalhães E. B., Magalhães C. A., Ferreira C. F., Marques A. M., and Pinheiro A. L., New Bone Formation Around Implants Inserted on Autologous and Xenografts Irradiated or Not With IR Laser Light: A Histomorphometric Study in Rabbits, Brazilian Dental Journal. (2013) 24, no. 3, 218–223, https://doi.org/10.1590/0103-6440201302186, 2-s2.0-84881510732, 23969909.
Kashefimehr A., Rahbar M., Faramarzi M., Babaloo A., Sadighi M., and Goshaderoo A., Effect of Light Emitting Diode Photobiomodulation on the Stability of Dental Implants in Bone Grafted Cases: A Split-Mouth Randomized Clinical Trial, Maedica (Bucur). (2021) 16, no. 2, 223–229, https://doi.org/10.26574/maedica.2021.16.2.223, 34621344.
Matys J., Świder K., Grzech-Leśniak K., Dominiak M., and Romeo U., Photobiomodulation by a 635nm Diode Laser on Peri-Implant Bone: Primary and Secondary Stability and Bone Density Analysis-a Randomized Clinical Trial, BioMed Research International. (2019) 2019, no. 2019, 2785302, https://doi.org/10.1155/2019/2785302, 2-s2.0-85065626325, 31143771.
Suchánek J., Ivančaková R. K., Mottl R., Browne K. Z., Pilneyová K. C., Pilbauerová N., Schmidt J., and Suchánková K. T., Hyaluronic Acid-Based Medical Device for Treatment of Alveolar Osteitis-Clinical Study, International Journal of Environmental Research and Public Health. (2019) 16, no. 19, https://doi.org/10.3390/ijerph16193698, 2-s2.0-85072912138, 31581430.