Thursday, August 7, 2025
This study evaluates the effects of polyvinylpyrrolidone sodium hyaluronate gel (Gelclair®) on palatal wound healing, pain, and bleeding following free gingival graft surgery (FGG). Thirty-two patients underwent FGG and were randomly assigned to two groups: the test group received Gelclair® and chlorhexidine mouthwash, while the control group received only chlorhexidine. Patients were assessed at first, third, seventh, fourteenth, and twenty-eighth postoperative days using the Visual Analog Scale (VAS), Wound Healing Index (WHI), hydrogen peroxide (H₂O₂) bubbling scores, and bleeding situations. Friedman and Wilcoxon signed-rank tests were used for repeated measures and between-group comparisons. H₂O₂ test values decreased over time in both groups, with significant differences observed in H₂O₂ test values on days 7, 14, and 28 compared to the control group. WHI values increased similarly, showing significant improvements in both groups. VAS pain, chewing, and burning scores were also significantly lower in the test group on days 1, 3, 7, and 14 compared to the control group. Control groups reported higher bleeding rates on day 1 compared to the test group (p < 0.001). The study suggests that Gelclair® promotes wound healing and reduces discomfort and bleeding in the palatal donor area after FGG. NCT06610331; Retrospectively registered on 23/09/2024. Free gingival grafts (FGGs) are often used in periodontal plastic surgery to address gingival and peri-implant soft tissue defects and restore keratinized gingiva [1]. FGGs are considered the gold standard for treating gingival recession [2], augmenting peri-implant soft tissue, and preserving the alveolar ridge [3, 4]. Due to its anatomical advantages and optimal tissue thickness, the palatal keratinized mucosa is recommended as the ideal donor site for FGG [5]. After FGG surgery, the palatal donor site undergoes secondary wound healing [6]. One of the major postoperative challenges for patients is the morbidity associated with the palatal donor site [7]. Pain is the most common postoperative complication, with some patients recalling this discomfort even a decade after the procedure [8]. Other potential palatal complications include prolonged bleeding, necrosis, infection, and delayed wound healing, often due to injury to the greater palatine artery during surgery [7]. Numerous clinical studies have focused on improving palatal wound healing and reducing patient discomfort [9, 10, 11, 12]. Hyaluronic acid (HA) is a connective tissue component found in the periodontal ligament and gingival tissues, exhibiting bacteriostatic, anti-inflammatory, and antioxidant properties [13]. With its remarkable moisturizing, retention, and viscoelastic capacities, HA contributes to essential structural, rheological, physiological, and biological functions. Due to its anti-immunogenic and non-toxic characteristics that support periodontal wound healing, it is widely used in reconstructive periodontal soft tissue surgery [14]. An in vitro study demonstrated that the film form of HA enhances adhesion upon contact with water, facilitating its penetration into tissues and supporting the prolonged functional effect of HA within the tissue [15]. Supporting this finding, an in vivo animal study showed that the HA film structure promoted palatal wound healing both clinically and histologically in experimentally induced palatal wounds in rats [16]. Gelclair® is a film form bioadhesive oral gel commonly used to treat painful oral lesions. This viscous gel contains polyvinylpyrrolidone (PVP), sodium hyaluronate, and glycyrrhetinic acid. The chemical structure of PVP allows it to adhere to mucosal surfaces and form a protective film. Sodium hyaluronate which is a type of HA salt; improves tissue lubrication and hydration due to its high water-holding capacity and viscoelastic properties. Glycyrrhetinic acid supports wound healing through its anti-inflammatory effects. Together, these three components in Gelclair® provide hydration and lubrication to damaged tissues in the oral cavity and protect nerve endings from physical stimuli [17].
Reference: The effect of Polyvinylpyrrolidone-Sodium hyaluronate gel on palatal wound healing: a randomized controlled clinical trialLabels: BMC Oral Health
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