Gingival enlargement may impair oral hygiene, esthetics, and periodontal health, and gingivectomy is commonly performed when non-surgical treatment is insufficient. Because gingivectomy wounds heal by secondary intention, postoperative wound healing and pain control are clinically important. Low-level laser therapy and hyaluronic acid are adjunctive approaches that may support tissue healing through different biological mechanisms. This randomized controlled clinical trial compared the effects of topical 0.04% high-molecular-weight hyaluronic acid spray and low-level laser therapy on early wound healing and postoperative pain following gingivectomy. Sixty-four systemically healthy patients requiring gingivectomy were randomly assigned to receive either hyaluronic acid spray applied twice daily for 7 days or 940-nm diode laser therapy applied on postoperative days 0, 3, 5, and 7. Wound healing was assessed using standardized clinical photographs and digital planimetric analysis at baseline and on postoperative days 3, 7, and 14. Postoperative pain was evaluated using a visual analogue scale, and periodontal parameters were recorded at baseline and 6 weeks. The study aimed to compare these two adjunctive postoperative wound-management approaches after gingivectomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
64
A 940-nm diode laser was applied to the gingivectomy wound area on postoperative days 0, 3, 5, and 7. The laser parameters were set as follows: 3 W power output, 1.07 W/cm² power density, 2.8 cm² probe spot size, continuous wave mode, 1-mm application distance, and non-contact stationary application. The laser was applied for 120 seconds per session.
Participants received a 0.04% high-molecular-weight hyaluronic acid spray after gingivectomy. They were instructed to apply the spray to the surgical wound area twice daily for the first 7 postoperative days.
Akdeniz University
Antalya, Konyaaltı, Turkey (Türkiye)
Wound Healing Percentage
Wound healing was assessed by measuring the surgical wound surface area using standardized clinical photographs and digital planimetric analysis with ImageJ software. At baseline and on postoperative days 3, 7, and 14, the gingivectomy wound area was stained with an erythrosin-based plaque-disclosing agent to identify non-epithelialized or insufficiently keratinized areas. The healing percentage was calculated by comparing the wound area at each postoperative time point with the baseline wound area using the following formula: Healing (%) = \[(Baseline wound area - Wound area at time point) / Baseline wound area\] × 100.
Time frame: Baseline, postoperative day 3, day 7, and day 14
Postoperative Pain Score (VAS)
Postoperative pain was assessed using a 10-cm Visual Analogue Scale (VAS). Participants were asked to mark their perceived pain intensity on a horizontal line ranging from 0, indicating no pain, to 10, indicating the worst imaginable pain.
Time frame: Postoperative day 1, day 3, day 7, and day 14
Gingival Index
The GI was measured at six sites per tooth, according to Löe \& Silness: 0- Normal gingiva; 1. Mild inflammation with slight color change, mild alteration of gingival surface structure and no bleeding on probing; 2. Moderate inflammation with edema, redness, swelling and bleeding on probing; 3. Severe inflammation with marked edema and redness, ulceration and tendency to bleed spontaneously.
Time frame: Baseline and 6 weeks postoperatively
Full Mouth Bleeding Score
FMBS: Bleeding on probing was assessed dichotomously as present or absent at six sites per tooth. The Full Mouth Bleeding Score was calculated as the percentage of bleeding-positive sites relative to the total number of examined sites.
Time frame: Baseline and 6 weeks postoperatively
Probing Pocket Depth
Probing pocket depth was measured in millimeters from the gingival margin to the base of the sulcus or pocket at six sites per tooth using a Williams periodontal probe.
Time frame: Baseline and 6 weeks postoperatively
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