Effect of Hyaluronic Acid on Palatal Wound Healing—A Randomized Crossover Clinical Trial

AIM: To assess the effect of a hyaluronic acid (HyA) containing gel on patient-related outcomes (PRO) and wound healing after palatal punch-biopsy representing a free gingival graft. MATERIAL AND METHODS: A punch-biopsy (6 mm diameter, 2 mm thickness) was harvested from one side of the palate at Day 0 and from the contralateral side at Day 21. Sites were randomly allocated to either 0.3% HyA containing gel (test) or sterile saline solution (control), professionally applied after harvesting and then self-applied three times/day for 7 days. Up to 21 days PRO-related questionnaires were answered and intraoral scans and photographs recorded to assess wound re-epithelialization, tissue refill, and color match. RESULTS: Eighteen of 25 recruited participants were analyzed. Pain perception, difficulties with eating/drinking, and taste alterations significantly decreased over time and were hardly experienced after Day 7 in both groups (p > 0.05). Participants reported significantly more often a positive experience after applying HyA compared to placebo, that is, in 8 versus 1 out of 18 cases. The residual wound area was significantly smaller in the test compared to control group at Day 7, and cases with a thicker palatal tissue showed tendency for faster re-epithelialization. CONCLUSION: Despite the potential limitations of the present study (i.e., possibility of a carryover effect, questionable blinding of the participants), repeated local application of a 0.3% HyA containing gel appears to only accelerate re-epithelialization in an open palatal wound and provide a positive experience after application, but it did not improve any PRO in such small-sized wounds compared to sterile saline application. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05099718.