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

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.