Impact of Hyaluronic Acid and Bone Graft on Peri-Implant Tissue

This randomized controlled clinical trial aims to evaluate the effect of hyaluronic acid (HA) and particulate bone graft on the peri-implant tissue phenotype in patients receiving dental implants. Healthy adult participants requiring dental implant placement will be randomly allocated into one of three equal groups (12 implants per group): Group 1 will receive dental implants combined with hyaluronic acid gel (Gengigel); Group 2 will receive dental implants combined with both hyaluronic acid and particulate bone graft; and the control group will receive dental implants alone. Clinical and radiographic assessments will be performed using a customized measurement stent to ensure standardized evaluations at baseline, immediately postoperatively, and at 8 and 16 weeks of follow-up. The primary and secondary outcomes include alterations in ridge width, keratinized tissue width/thickness, radiographic soft tissue height, and marginal bone height. The study aims to determine whether the adjunctive use of hyaluronic acid and bone grafts enhances the quality of the peri-implant soft and hard tissue phenotype.

Inclusion Criteria: * Adults ≥ 18 years old. * Partially edentulous patients requiring dental implant placement. * Good oral hygiene (Calibrated Gingival Bleeding Index (GBI) \< 10%, O'Leary ---Plaque Index (PI) \< 10%). * Sufficient bone volume for implant placement. Exclusion Criteria: * Systemic conditions affecting bone healing (e.g., uncontrolled diabetes). * Smoking \> 10 cigarettes/day. * Medications affecting bone metabolism (e.g., bisphosphonates). * Active periodontal disease. * Pregnant or lactating women.