This systematic review aims to evaluate the efficacy of hyaluronic acid (HA) in promoting bone regeneration in patients with maxillofacial alveolar bone defects. The review focuses on clinical outcomes, including bone volume and density, while exploring HA’s underlying mechanisms in bone healing. A systematic literature search was conducted across multiple databases, including PubMed, Web of Science, Google Scholar, and the Cochrane Library, to identify clinical studies evaluating the role of HA in maxillofacial bone regeneration. Studies involving human subjects with maxillofacial alveolar bone defects treated with HA, alone or in combination with bone grafts, were included. We appraised the risk of bias and the level of evidence for all included studies using standardized tools. The systematic review included 4 studies with a total of 96 patients. The majority of studies reported significant improvements in bone volume and density following the local drug application of HA, with enhanced healing time compared to traditional bone grafts or other synthetic substitutes. The unique viscoelastic property and high water retention, HA was found to promote angiogenesis, reduce inflammation, and act as a scaffold, facilitating cellular migration and new bone formation. However, variability in assessment methods and HA formulations used made it challenging to standardize results across all studies. Hyaluronic acid shows promise as a biomaterial for enhancing bone regeneration in maxillofacial alveolar bone defects. However, further well-designed, large-scale clinical trials are necessary to establish standardized protocols and determine optimal HA formulations for predictable clinical success.
