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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low Level Laser Therapy | Active Comparator | Participants in this group received low-level laser therapy after gingivectomy. A 940-nm diode laser was applied to the surgical wound area on postoperative days 0, 3, 5, and 7. The laser parameters were 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 for 120 seconds per session. |
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| Hyaluronic Acid Spray | Active Comparator | Participants in this group received topical 0.04% high-molecular-weight hyaluronic acid spray after gingivectomy. Patients were instructed to apply the spray to the surgical wound area twice daily for the first 7 postoperative days. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low Level Laser Therapy | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| 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. | Baseline, postoperative day 3, day 7, and day 14 |
| Measure | Description | Time Frame |
|---|---|---|
| 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. | Postoperative day 1, day 3, day 7, and day 14 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nezahat Arzu Kayar, PhD, DDS | Akdeniz University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Akdeniz University | Antalya | Konyaaltı | 07070 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32435906 | Background | Uslu MO, Akgul S. Evaluation of the effects of photobiomodulation therapy and ozone applications after gingivectomy and gingivoplasty on postoperative pain and patients' oral health-related quality of life. Lasers Med Sci. 2020 Sep;35(7):1637-1647. doi: 10.1007/s10103-020-03037-8. Epub 2020 May 20. | |
| 31993275 | Background |
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| ID | Term |
|---|---|
| D005885 | Gingival Hyperplasia |
| ID | Term |
|---|---|
| D019214 | Gingival Overgrowth |
| D005882 | Gingival Diseases |
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
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| ID | Term |
|---|---|
| D028022 | Low-Level Light Therapy |
| ID | Term |
|---|---|
| D053685 | Laser Therapy |
| D013812 | Therapeutics |
| D010789 | Phototherapy |
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| Hyaluronic Acid Spray | Other | 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. |
|
| Gingival Index |
The GI was measured at six sites per tooth, according to Löe & Silness: 0- Normal gingiva;
|
| 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. | 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. | Baseline and 6 weeks postoperatively |
| Reddy SP, Koduganti RR, Panthula VR, Surya Prasanna J, Gireddy H, Dasari R, Ambati M, Chandra G B. Efficacy of Low-level Laser Therapy, Hyaluronic Acid Gel, and Herbal Gel as Adjunctive Tools in Gingivectomy Wound Healing: A Randomized Comparative Clinical and Histological Study. Cureus. 2019 Dec 21;11(12):e6438. doi: 10.7759/cureus.6438. |
| 18269665 | Background | Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G. Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study. J Clin Periodontol. 2008 Mar;35(3):250-4. doi: 10.1111/j.1600-051X.2007.01194.x. |
| 37891549 | Background | Yakout BK, Kamel FR, Khadr MAEA, Heikal LAH, El-Kimary GI. Efficacy of hyaluronic acid gel and photobiomodulation therapy on wound healing after surgical gingivectomy: a randomized controlled clinical trial. BMC Oral Health. 2023 Oct 27;23(1):805. doi: 10.1186/s12903-023-03519-5. |
| D009057 |
| Stomatognathic Diseases |