Hyaluronic Acid Boosts Early Stability in Immediate Implants

Clinical question: does adding hyaluronic acid (HA) to natural bovine bone grafting material improve outcomes when grafting fresh extraction sockets around immediate implants?

Methodology: randomized clinical trial, 16 immediate implants placed in medically healthy patients with non-restorable single-rooted maxillary anterior or premolar teeth. Group 1 (control): implants alone in fresh extraction sockets. Group 2 (study): implants plus grafting with natural bovine bone combined with HA. Implant stability quotient (ISQ) was measured at surgery and at 4 months; bone density and buccal bone width were measured via cone-beam CT at baseline and 6 months.

Findings: at 4 months, the HA group showed significantly higher ISQ than the control group (72.25 vs 64.88, p<0.001). At 6 months, bone density was significantly higher in the HA group (1163.38 vs 1034.13 HU, p=0.016). Buccal bone width loss was numerically smaller in the HA group (3.88%) than in the control group (15.99%, p<0.001 within groups), though the authors note no statistically significant between-group difference was detected at either individual assessment point.

Clinical relevance: in this small RCT, adding HA to bovine bone grafting at immediate implant placement was associated with higher early implant stability and higher peri-implant bone density, alongside a smaller reduction in buccal bone width — a potentially useful adjunct for immediate implant protocols in esthetically demanding sites, though the between-group buccal-width comparison should be read cautiously given the sample size.