Effect of Hyaluronic Acid Mucoadhesives on Palatal Wound Healing and Postoperative Discomfort in Free Gingival Graft Surgery: A Clinical Trial

Abstract

Objectives: This study aimed to assess the effect of hyaluronic acid (HA) mucoadhesives with two different concentrations on palatal epithelial wound healing and postoperative discomfort following free gingival graft (FGG) surgery. Materials and Methods: In this triple-blind, randomized, controlled clinical trial, 39 patients undergoing FGG surgery were randomly allocated to three groups (N=13). Following palatal graft harvesting, the two experimental groups received mucoadhesives containing 0.8% and 0.2% HA, while the control group received mucoadhesives without HA. In all groups, the donor site was protected with periodontal dressing. Epithelization, color match, contour, and distortion were assessed at 3, 7, 14, 21, and 42 days, postoperatively using the Landry's healing index and modified Manchester Scar Proforma (mMSP) index. Pain level and response to thermal stimuli were evaluated after 3, 7, 14, and 21 days using a visual analog scale (VAS). Data were analyzed by the Chi-square, Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon signed-rank tests (alpha=0.05). Results: Significant differences were observed in the mMSP index scores among the groups at 3, 7, 14, and 42 days, favoring HA groups (P<0.05). The Landry's healing index score was significantly higher in 0.8% HA group on day 21 (P=0.023), compared to the control group. No significant differences were found in pain score or thermal stimulus responses among the groups (P>0.05). Conclusion: Mucoadhesives containing HA were found to enhance palatal wound healing, leading to improved outcomes in terms of epithelization, color match, contour, and distortion reduction.