Effects of Hyaluronic Acid Gel on Initial Wound Healing Following Tooth Extraction and Crown Lengthening Procedures: A Retrospective Analysis

Suhailah AlShaali,1,2 Momen Atieh,1 Abeer Hakam,1 Nabeel HM Alsabeeha,2 Maanas Shah1 1Department of Periodontology, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai Healthcare City, Dubai, United Arab Emirates; 2Department of Dental Services, Emirates Health Services, Dubai, United Arab EmiratesCorrespondence: Maanas Shah, Email [email protected]: There is limited evidence highlighting the implications of adjunctive topical application of wound healing agents on clinical and patient-related outcomes in surgical procedures. The aim of the retrospective analysis was to evaluate the effects of 0.8% hyaluronic acid (HA) gel on wound healing following tooth extraction and crown lengthening procedures using the Inflammatory Proliferative and Remodeling (IPR) scale in a postgraduate clinical setting.Methods: A retrospective assessment of medical record database related to clinical and patient-related outcomes of patients who received tooth extraction or crown lengthening procedures was conducted. Wound healing was assessed using the IPR scale providing scores for patient-reported postoperative pain, bleeding, granulation tissue, hematoma, tissue color compared to unaffected site, complete/incomplete flap closure, suppuration, and edema. The test group included participants who received an adjuvant application of 1mL of 0.8% HA gel versus control group participants receiving the same procedures without HA gel application.Results: Overall, no statistically significant differences were observed between the total IPR wound healing scores for test (5.54 ± 1.02) versus control (5.19 ± 1.21, P=0.30) groups. Bleeding and hematoma were less frequent in participants receiving 0.8% HA gel, though the differences were not statistically significant (bleeding: P=0.09, hematoma: P=0.12). Of the 45 participants analysed, 79.2% in the test group achieved successful inflammatory phase scores (5– 8), compared to 76.2% in the control group (P = 0.81). More sites with a successful inflammatory phase (score 5– 8) were observed in systemically healthy, male, non-smokers, and those with posterior mandibular surgeries, though without statistical significance.Conclusion: Although 0.8% HA gel did not significantly improve early wound healing, well-designed clinical trials are necessary to evaluate its safety and potential benefits in routine periodontal surgeries. The IPR wound healing index demonstrated high reliability with excellent inter- and intra-examiner agreement in assessing the initial healing process after periodontal surgery.Keywords: hyaluronic acid gel, wound healing, extractions, crown lengthening, periodontics