Effect of Topical Hyaluronic Acid on Wound Healing and Pain Following Electrocautery Frenectomy: A Randomized Controlled Trial

INTRODUCTION: Aberrant labial frenal attachments can lead to plaque accumulation, gingival inflammation, periodontal deterioration, and aesthetic issues. Electrocautery frenectomy provides effective hemostasis; however, it may result in delayed wound healing due to thermal tissue damage. Hyaluronic acid (HA) has demonstrated anti-inflammatory and pro-healing properties in the management of oral soft tissues. This study aimed to assess wound healing and postoperative pain following electrocautery frenectomy with and without the topical application of HA gel. METHODS: This randomized controlled clinical trial included 24 systemically healthy participants (aged 18-60 years) with type III or type IV maxillary labial frenal attachments. Participants were randomly assigned to two groups: Group 1 (test group) underwent electrocautery frenectomy followed by the topical application of 0.2% HA gel (Gengigel®, Ricerfarma S.r.l., Milano, Italy) for three days postoperatively, while Group 2 (control group) underwent electrocautery frenectomy alone. Wound healing was evaluated using the Landry et al. healing index at days 7, 14, 21, and 28 postoperatively. Postoperative pain was assessed using a visual analog scale (VAS) on days 1, 3, and 7. Intergroup comparisons were conducted using independent t-tests. RESULTS: The test group exhibited significantly superior wound healing scores compared to the control group at all postoperative time points (p<0.05). The mean VAS pain scores were significantly lower in the HA group on postoperative days 1, 3, and 7 (p<0.0001). CONCLUSION: The topical application of HA gel following electrocautery frenectomy significantly enhances wound healing and reduces postoperative pain. HA can be considered a beneficial adjunct for improving postoperative outcomes after frenectomy procedures.