The Effect of Cross-Linked Hyaluronic Acid in Surgical Extraction of Impacted Mandibular Third Molars

Objectives: The aim of the study was to evaluate the effectiveness of cross-linked Hyaluronic Acid (HA) gel on facial swelling, pain, and truisms after extraction of impacted mandibular third molars. Method and Materials: This randomized, double-blinded, split mouth clinical trial included 14 patients. For each patient, a combination of cross-linked HA with Gelfoam scaffold were randomly applied to one extraction site, while Gelfoam alone was applied to the other extraction site. Measurements of three facial reference points, pain and maximum mouth opening were recorded preoperatively, as well as on the 2nd, 4th and 7th days after the surgery. Results: The scores for facial swelling, pain and trismus were the highest on the 2nd postoperative day and decreased gradually on the 4th to the 7th days in both groups. Cross-linked HA group demonstrated statistically significant reduction in swelling, pain, and trismus on the 7th postoperative day when compared to its control group (p<0.05). Conclusion: The application of cross-linked HA after extraction of impacted mandibular third molars has a positive impact on postoperative swelling, pain and trismus after the extraction of impacted lower third molars.