Hyaluronic acid versus amniotic membrane in wound healing and bone regeneration in extraction sockets - A randomized controlled trial

Abstract

Background

Surgical removal of the impacted third molar is a routinely employed procedure in oral surgery, often associated with various complications which affect wound healing. Hyaluronic acid (HA) and freeze-dried (lyophilized) amniotic membrane (AM) have demonstrated the potential to promote wound healing and bone regeneration. These could aid in the healing of the extraction socket post-disimpaction.

Objectives

To assess the extent of wound healing and bone regeneration in extraction sockets of surgically removed mandibular third molars following intra-socket application of 0.2 % HA gel and 2.5 × 2.5 cm of AM.

Material and methods

45 patients were clinically and radiographically evaluated based on the inclusion and exclusion criteria and were randomized by lottery method into three groups – Group 1, control, Group 2, AM, and Group 3, HA. The pain scores were evaluated using the visual analog scale. The extent of facial swelling, trismus and bone regeneration were assessed at three different time intervals.

Results

A significant difference (p<0.05) in the pain score was observed between the control group and the study groups. The extent of facial swelling and trismus observed was of significance within the groups (p<0.05). Group 2 exhibited significantly improved levels of trabecular bone formation at the third post-operative month (p<0.05).

Conclusion

HA and AM could be potentially useful in improving the post-operative sequelae following surgical removal of mandibular third molars in terms of pain, wound healing, and overall bone regeneration.