Effect of Probiotic Limosilactobacillus reuteri and Hyaluronic Acid Gel Combination Therapy on Neutrophil Response, Neovascularization, and Reepithelialization in the Wound-Healing Process Following Tooth Extraction: An In Vivo Study

This study aimed to analyze the effects of supportive therapy using a combination of <i>Limosilactobacillus reuteri (L. reuteri)</i> and hyaluronic acid (HA) gel on the wound-healing process during inflammatory, proliferative, and remodeling/maturation phases following tooth extraction.Forty-five white Wistar rats (<i>Rattus norvegicus</i>) were divided into five treatment groups after the left mandibular central incisor was extracted. The experimental groups were treated with HA gel, probiotic <i>L. reuteri</i> gel, a combination of HA gel and <i>L. reuteri</i> gel, and povidone-iodine (PVP-I). The negative control group was treated with sterile tampons. Tissue samples were collected on days 3, 7, and 14 post-tooth extractions and analyzed histologically using hematoxylin-eosin (HE) staining to evaluate neutrophil numbers, neovascularization, and epithelial thickness.Data analysis was performed using IBM SPSS version 29. Inter-rater reliability was tested using the intraclass correlation coefficient (ICC), followed by normality and homogeneity tests. For normally distributed data, parametric hypothesis testing was conducted using one-way ANOVA at a 95% confidence level (<i>p</i> < 0.05). The post hoc least significant difference test was used to observe significant differences between the groups.Significant differences in neutrophil numbers, neovascularization, and re-epithelialization were found between the negative control and combination group (<i>p</i> < 0.05) on days 3, 7, and 14.HA and <i>L. reuteri</i> combination therapy is effective in accelerating wound healing after tooth extraction.