The Role of Hyaluronic Acid in Veterinary Periodontal Therapy

I’d like to share some thoughts on a product that has shown promising clinical relevance in veterinary dentistry: hyaluronic acid (HA) gel, specifically in the context of periodontal disease management. One formulation, PerioVive, I’ve incorporated into dental procedures in my practice. I think this product is especially appropriate for generalist dentistry because of its ease of use. See below for additional detail.

In veterinary medicine today, periodontal disease remains one of the most common health conditions in companion animals, affecting approximately 80% of dogs and 70% of cats by three years of age. The effects are not only detrimental to the oral health of a patient, but can also lead to significant complications, such as systemic inflammation and organ damage.

Despite the prevalence and consequences of periodontal disease, treatment continues to rely heavily on surgical interventions like extractions and debridement. These procedures require anesthesia, owner compliance, and often follow-up care, which presents logistical and financial challenges. At-home routines, such as teeth brushing, are additionally an important element to dental maintenance; however, this too is frequently neglected due to challenges in the task itself for owners. Therefore, there is a demand for innovations that can maximize the effects of the small window of opportunity to perform dental treatment. 

Historically, treatment strategies have focused on bacterial reduction through medication and surgery (debridement, extractions). However, current understanding recognizes inflammation as a central component in the pathogenesis and progression of periodontal disease. This shift opens new avenues for therapeutic approaches.

Hyaluronic acid (HA), a naturally occurring glycosaminoglycan, has demonstrated benefits in supporting tissue healing and modulating inflammation. In veterinary applications, PerioVive is a cross-linked HA gel delivered through a pre-filled applicator, applied directly to the gingival or surgical sites.

Mechanistically, HA has demonstrated the following properties:

• Modulation of IL-1β expression via CD44 interaction: By dampening this key inflammatory cytokine, HA helps reduce connective tissue destruction.
•  Adhesive and hygroscopic action: HA binds effectively to mucosal surfaces, retaining moisture and enhancing healing.
• Promotion of angiogenesis: HA stimulates endothelial proliferation, facilitating blood vessel growth and tissue regeneration.
• Reduction in biofilm formation: Its physical structure and biochemical properties contribute to decreased microbial colonization.

Recognizing the potential of these various properties in the treatment of periodontal disease, several studies have been carried out to examine the application of HA. Amongst these studies, significant findings include:

•  In intrabony and Class II furcation defects in dogs, adjunctive HA application resulted in over twice the regenerated bone and tissue area compared to debridement alone. 
• Following extractions in chronically diseased canine sites, HA contributed to enhanced bone formation.
•  In milder cases, such as gingival recession, HA use with surgical flaps led to greater tissue fill and reduced probing depths, compared to surgery alone.

Given these findings, the inclusion of HA as an adjunct in periodontal treatment protocols offers a minimally invasive, biologically active option that may enhance healing and reduce inflammation. In our practice, we’ve found it integrates easily into procedures such as scaling and root planing, extractions, cyst removal, and gingival surgery. While more studies are always valuable, current evidence suggests that hyaluronic acid has a role to play in elevating the standard of care in veterinary dentistry.

Citations

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