Efficacy of hyaluronic acid gel and photobiomodulation therapy on wound healing after surgical gingivectomy: a randomized controlled clinical trial

Basma Khalil Yakout; Fatma Ramzy Kamel; Maha Abd El-Aziz Abou Khadr; Lamia Ahmed Hassan Heikal; Gillan Ibrahim El-Kimary

doi:10.1186/s12903-023-03519-5

Efficacy of hyaluronic acid gel and photobiomodulation therapy on wound healing after surgical gingivectomy: a randomized controlled clinical trial

BMC Oral Health. 2023 Oct 27;23(1):805. doi: 10.1186/s12903-023-03519-5.

Authors

Basma Khalil Yakout¹, Fatma Ramzy Kamel², Maha Abd El-Aziz Abou Khadr², Lamia Ahmed Hassan Heikal³, Gillan Ibrahim El-Kimary²

Affiliations

¹ Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt. basma.yakout.dent@alexu.edu.eg.
² Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champolion St. Azarita, Alexandria, 21521, Egypt.
³ Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.

Abstract

Background: Surgical gingivectomy can be considered the gold standard treatment for gingival enlargement. The healing of wound site after gingivectomy occurs slowly by secondary intention. To accelerate the wound healing process, several studies have been conducted evaluating the effect of various treatment modalities. Photobiomodulation therapy (PBMT) was proposed to provide minimally invasive and painless treatment as well as to decrease discomfort of the patient following the surgical process. Another factor that is expected to improve the healing after surgery is topical application of chemotherapeutic agents such as Hyaluronic acid (HA). This study aims to assess the effect of topically applied HA gel after PBMT on the healing of wound site after surgical gingivectomy.

Methods: This randomized controlled clinical trial included twenty-six surgical gingivectomy wound sites, equally divided into two groups, Group-I (test group): the surgical sites after gingivectomy were irradiated with a diode laser (980 nm, 0.2 W) then covered by 2% HA gel loaded in a special custom-made soft transparent tissue guard appliance for each patient. Group II (control group): the surgical sites were irradiated with a diode laser (980 nm, 0.2 W) only. Wound healing was assessed subjectively by Landry healing index on the 3rd, 7th, 14th and 21st days after surgery, and pain perception was assessed by the patients using visual analog scale (VAS) throughout the 21 days of the follow up period. Comparisons between the two study groups were performed using Mann-Whitney U test, while comparisons between different time points were performed using Friedman test. Significance was inferred at p value < 0.05.

Results: By the end of the follow-up period, surgical sites of the test group showed excellent healing compared to the control group. There were no significant differences in VAS scores between both groups (p > 0.05).

Conclusions: Application of 2% HA gel as an adjunctive to PBMT was found to have significant clinical effects and higher power of repair among test group when compared to that achieved by PBMT alone in control group.

Trial registration: This study was retrospectively registered on ClinicalTrials.gov and first posted on 28th of March 2023 with an identifier number: NCT05787912.

Keywords: Hyaluronic acid gel; LLLT; Photobiomodulation therapy; Surgical gingivectomy; Wound healing.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Gingival Hyperplasia*
Gingivectomy
Humans
Hyaluronic Acid / pharmacology
Hyaluronic Acid / therapeutic use
Low-Level Light Therapy*
Wound Healing

Substances

Hyaluronic Acid

Associated data

ClinicalTrials.gov/NCT05787912