Comparative Evaluation of Clinical Efficacy of Hyaluronic Acid Spray versus Normal Saline Spray on Swelling, Pain, and Trimus after Surgical Extraction of Impacted Mandibular Third Molar - A Randomized Controlled Split Mouth Study

Aim and objective The aim of this study was compare the efficacies of two oral sprays in reducing swelling, pain, and trismus after the extraction of impacted mandibular third molars. Materials and method This prospective double-blind, randomized, crossover clinical trial included 30 patients with bilateral symmetrically impacted mandibular third molars of similar surgical difficulty. Hyaluronic acid or Normal saline spray was applied (two pumps) to the extraction area, three times daily for 7 days. Swelling was evaluated using a tape measure method, pain with a visual analogue scale (VAS), and trismus by measuring the maximum inter-incisal opening. Assessments were made on the day of surgery and on days 2 and 7 after surgery. Result Statistically significant differences were detected for the swelling and trismus values between the two treatment groups on the second postoperative day (P = 0.000 and P = 0.024, respectively). However, there was no statistically significant difference in VAS scores between the two groups. The administration of hyaluronic acid spray was more effective than Normal saline spray in reducing swelling and trismus. Conclusion Although no evidence of a reduction in pain levels was detected, hyaluronic acid appears to offer a beneficial effect in the management of swelling and trismus during the immediate postoperative period following impacted third molar surgery.