Clinical Evaluation of the Impact of 0.2% Chlorhexidine and 1% Hyaluronic Acid Gel on Pain and Post-Extraction Tooth Socket Healing

Background: Pain and delayed socket healing still represent common problems in the field of dental tooth extraction. Antiseptic/ regenerative agents used topically have been suggested to lead better clinical outcomes. Objective: The present study aimed to evaluate the clinical effect of 0.2% chlorhexidine mixed with 1% hyaluronic acid gel on pain control and socket healing following mandibular molar extraction. Methods: A randomized controlled trial was performed among 50 medically healthy patients scheduled for unilateral extraction of mandibular molar. Patients were randomly assigned to a test group (n=20) twice daily application of 0.2% chlorhexidine with 1% hyaluronic acid gel (Perio-kin) for 7 days, or a control group (n=30) receiving no topical intervention. Outcomes included pain scores (VAS) at day 1 and day 7; wound healing measured by Landry's Healing Index at day 7; buccolingual socket width decrease between day 1 and day 7. Results: The test group showed a significantly greater healing index (4.35 ± 0.55 vs. 3.80 ± 0.60, p = 0.02) and socket width reduction (2.30 ± 0.40 mm vs. 0.90 ± 0.25 mm, p < 0.001). Repeated measures ANOVA showed a significant main effect of group on pain scores (p value = 0.019). At day 7, the analgesic effect was most prominent (p value = 0.003, Cohen's d = –0.612). Conclusion: Topical application of 0.2% chlorhexidine with 1% hyaluronic acid gel significantly affects on socket healing, and decreases postoperative pain after mandibular molar extraction, with its earlier analgesic effect at the end of 72 hours post-surgery.