Effect of intrasocket application of hyaluronic acid on pain, swelling, and trismus after surgical extraction of impacted mandibular third molar - A randomized control trial.

Authors

Deepshikha Bhave, Mouneshkumar Chapi Devendrappa, Kumar N Mishra, Vinay K Gupta, Vidit Jain

Published in

National journal of maxillofacial surgery. Volume 17. Issue 2. Pages 280-289. Epub Jun 03, 2026.

Abstract

Mandibular third molar removal is one of the most widely performed treatments in the oral cavity. Nevertheless, surgeons often encounter undesirable postoperative sequelae. These inflammatory responses after wisdom teeth surgery may badly affect a patients' quality of life. Though traditional measures such as non-steroidal anti-inflammatory drugs and corticosteroids proposed for control of postoperative complications work well, their potential side effects have led to a search for an easily applicable way to reduce postoperative pain and swelling. Hyaluron or Hyaluronic acid (HA) is a biomaterial that has been introduced as an alternative approach to enhance wound healing. Hyaluronic acid is a major carbohydrate with multifaceted roles. It plays a critical role in wound healing by inducing early granulation tissue formation, inhibiting destructive inflammation, and promoting angiogenesis. It is available in gel or liquid form to be applied topically in oral cavity. This study aims to evaluate the efficacy of hyaluronic acid in reducing pain, swelling, and trismus after surgical extraction of the lower third molar.
Forty patients underwent surgical extraction of impacted lower third molar for this study A.0.7 mL 2%hyaluronic acid gel (Hyalgun®) along with abgel as scaffold was placed in the extraction socket in study group and abgel alone was placed in control group. Data collection was performed to assess the pain using the visual analog scale on 1^st, 3^rd, and 7^th postoperative days, swelling using the tape measure method, and trismus by measuring interincisal distance preoperatively, on 1^st, 3^rd, and 7^th postoperative days.
The hyaluronic acid gel group demonstrated statistically significantly less swelling and trismus. Pain assessed on the visual analog scale (VAS) was significantly less (P < 0.05) on 1^st, 3^rd, and 7^th day. Swelling showed a significant decrease (P < 0.05) and trismus scores were highly significant (P < 0.001).
The application of HA gel following third molar extraction effectively alleviates postoperative pain, swelling, and trismus, enhancing patient comfort and recovery. HA gel, with its anti-inflammatory and analgesic properties, offers promise as an adjunct in postoperative management.

PMID:
42422773
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.

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