Topical Hyaluronic Acid Gel as an Adjunct to Surgical Gingival Depigmentation: A Pilot Clinical Study on Early Wound Healing and Postoperative Pain

Abstract

Gingival depigmentation is a common cosmetic periodontal procedure that heals by secondary intention, making postoperative pain and early wound healing important clinical concerns. Hyaluronic acid (HA), a naturally occurring extracellular matrix component with anti-inflammatory, angiogenic, and wound-healing properties, may be useful as an adjunct to periodontal surgery. This study assessed topical HA gel after surgical gingival depigmentation. Fifty patients with gingival hyperpigmentation were allocated equally to an HA group (n=25) and a non-HA control group (n=25). Standardised healing indices and a visual analogue scale were used to assess early healing and postoperative pain. By day 7, clinically assessed pigmentation reduction from baseline DOPI was 97.2% in the HA group versus 76.8% in controls (p<0.001), and complete pigmentation resolution (DOPI=0) occurred in 92% versus 48%, respectively. Mean epithelialisation time was reduced by 2.5 days (30% faster; p<0.001). Pain on days 3 and 7, erythema, and oedema were lower with HA; patient satisfaction was higher, and no adverse events were reported in the HA group. These findings support topical HA as a promising adjunct following gingival depigmentation, while larger controlled studies with standardised protocols and longer follow-up are warranted.