Abstract
Background:Hyaluronic acid (HA) has the potential to promote wound healing. Pain and swelling with trismus are common sequalae post wisdom teeth removal. This study aims to investigate the effectiveness of intra-socket HA solution to reduce these uncomfortable post-operative events.Materials and methods:30 patients underwent bilateral extractions of mandibular wisdom teeth for this study. Intra-socket application of 0.7 ml 20 mg/2 ml HA solution (Hyalgun) with Gel foam as a scaffold in study site versus Gel foam only on control site was conducted via a split mouth study design. Data collection of five facial reference points for swelling and maximum mouth opening was recorded during the pre-operative period and post-operative 2nd and 7th day. The VAS pain score at post-op 1st, 2nd and 3rd day and the number of analgesics for the 7-day post-operative duration were evaluated.Results:The HA group demonstrated statistically significant less swelling, trismus and analgesia consumption on the 2 and 7 days after surgery. VAS scores on day 1, 2 and 3 after surgery (P = 0.05) were significantly less in the HA group compared to the control group.Conclusion:The application of intra-socket HA has a positive effect for reducing postoperative pain and swelling with trismus after the lower third molar intervention (LTMI).
Highlights
Postoperative pain measurements were recorded by using pain score in the immediate postoperative period, the first, second and third post-operative days, whilst there are no pain measurements taken from post-operative day 4–7
The results showed that leukocyte plateletrich fibrin (L-PRF) in combination with Hyaluronic acid (HA), has the potential to reduce swelling after lower third molar intervention (LTMI)
In this study there were no postoperative complications after 60 LTMI. This current study found beneficial effects by the use of HA solution to reduce pain, swelling and trismus after impacted LTMI, there were several limitations: – We had a small sample size. – the study showed that the application of HA
Summary
Mandibular third molar removal is one of the most widely done treatments in the oral cavity. These inflammatory responses after wisdom teeth surgery may badly affect a patients’ quality of life [1–3]. Post-operative complications like dry socket, nerve damage, bone fracture, delayed healing and damage of the second molar can happen quite frequently following the surgical removal of mandibular third molars [4,5]. The lower third molar surgery usually entails the elevation of a full thickness gingival flap and guttering of bone surrounding the tooth, this causes a significant post-operative downtime which has been documented to reduce the patients’ quality of life [2,6]. In 1997 Berge [7] published a study in Norway where 57% of patients who had underwent wisdom teeth removal could not turn up for work for an average of 1.07 days
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