Comparative evaluation of hyaluronic acid spray and low-level laser therapy on wound healing following gingivectomy: a randomized controlled clinical trial

Gingivectomy wounds heal by secondary intention, prolonging recovery and postoperative discomfort; this randomized controlled trial compared low-level laser therapy and hyaluronic acid spray for early wound healing and postoperative pain after gingivectomy. Systemically healthy patients requiring gingivectomy were randomly allocated to receive either LLLT (940 nm diode laser, 3 W, 128.4 J/cm2, applied on days 0, 3, 5, and 7) or 0.04% high-molecular-weight HA spray (applied twice daily for 7 days). Wound epithelialization was quantified through Mira-2-Ton plaque-disclosing staining combined with digital planimetric analysis (ImageJ) at baseline and on postoperative days 3, 7, and 14. Secondary outcomes included gingival index (GI), full-mouth bleeding score (FMBS), probing pocket depth (PPD), and visual analogue scale (VAS) pain scores. A total of 64 participants were enrolled and randomized (n = 32 per group). Both groups exhibited significant wound area reduction over time (p < 0.001). However, the HA spray group demonstrated significantly higher wound epithelialization percentages (percentage reduction from baseline in the non-epithelialized, disclosing-solution-stained wound surface area) than the LLLT group on days 3 (p < 0.001; Cohen's d = 1.39), 7 (p < 0.001; d = 1.12), and 14 (p = 0.044; d = 0.73). The HA spray group also reported significantly lower VAS pain scores on days 1 and 3 (p < 0.05). Periodontal parameters improved significantly from baseline to week 6 in both groups (all p < 0.001), with no significant between-group differences at week 6 for GI (p = 0.999), FMBS (p = 0.843), or PPD (p = 0.718). HA spray yielded significantly accelerated re-epithelialization and superior early pain reduction compared to LLLT following gingivectomy, suggesting it may serve as a practical, patient-friendly adjunctive alternative to laser biostimulation in postoperative wound management. Trial registration: ClinicalTrials.gov Number: NCT07034625.