{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:59:25Z","timestamp":1787169565562,"version":"build-2736575974"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Mandibular third molar removal is one of the most widely performed treatments in the oral cavity. Nevertheless, surgeons often encounter undesirable postoperative sequelae. These inflammatory responses after wisdom teeth surgery may badly affect a patients\u2019 quality of life. Though traditional measures such as non-steroidal anti-inflammatory drugs and corticosteroids proposed for control of postoperative complications work well, their potential side effects have led to a search for an easily applicable way to reduce postoperative pain and swelling. Hyaluron or Hyaluronic acid (HA) is a biomaterial that has been introduced as an alternative approach to enhance wound healing. Hyaluronic acid is a major carbohydrate with multifaceted roles. It plays a critical role in wound healing by inducing early granulation tissue formation, inhibiting destructive inflammation, and promoting angiogenesis. It is available in gel or liquid form to be applied topically in oral cavity. This study aims to evaluate the efficacy of hyaluronic acid in reducing pain, swelling, and trismus after surgical extraction of the lower third molar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      Forty patients underwent surgical extraction of impacted lower third molar for this study A.0.7 mL 2%hyaluronic acid gel (Hyalgun\u00ae) along with abgel as scaffold was placed in the extraction socket in study group and abgel alone was placed in control group. Data collection was performed to assess the pain using the visual analog scale on 1\n                      <jats:sup>st<\/jats:sup>\n                      , 3\n                      <jats:sup>rd<\/jats:sup>\n                      , and 7\n                      <jats:sup>th<\/jats:sup>\n                      postoperative days, swelling using the tape measure method, and trismus by measuring interincisal distance preoperatively, on 1\n                      <jats:sup>st<\/jats:sup>\n                      , 3\n                      <jats:sup>rd<\/jats:sup>\n                      , and 7\n                      <jats:sup>th<\/jats:sup>\n                      postoperative days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The hyaluronic acid gel group demonstrated statistically significantly less swelling and trismus. Pain assessed on the visual analog scale (VAS) was significantly less (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) on 1\n                      <jats:sup>st<\/jats:sup>\n                      , 3\n                      <jats:sup>rd<\/jats:sup>\n                      , and 7\n                      <jats:sup>th<\/jats:sup>\n                      day. Swelling showed a significant decrease (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) and trismus scores were highly significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The application of HA gel following third molar extraction effectively alleviates postoperative pain, swelling, and trismus, enhancing patient comfort and recovery. HA gel, with its anti-inflammatory and analgesic properties, offers promise as an adjunct in postoperative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/njms.njms_137_24","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:01:04Z","timestamp":1780491664000},"page":"280-289","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effect of intrasocket application of hyaluronic acid on pain, swelling, and trismus after surgical extraction of impacted mandibular third molar \u2013 A randomized control trial"],"prefix":"10.4103","volume":"17","author":[{"given":"Deepshikha","family":"Bhave","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, School of Dental Sciences, KVVDU, Karad, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouneshkumar Chapi","family":"Devendrappa","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, School of Dental Sciences, KVVDU, Karad, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumar N.","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, School of Dental Sciences, KVVDU, Karad, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, School of Dental Sciences, KVVDU, Karad, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidit","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, School of Dental Sciences, KVVDU, Karad, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"R1-20260604","doi-asserted-by":"crossref","first-page":"229","DOI":"10.4103\/2141-9248.160177","article-title":"Impacted mandibular third molars: Review of literature and a proposal of a combined clinical and radiological classification","volume":"5","author":"Santosh","year":"2015","journal-title":"Ann Med Health Sci Res"},{"key":"R2-20260604","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1016\/j.ijom.2014.05.003","article-title":"Efficacy of hyaluronic acid spray on swelling, pain, and trismus after surgical extraction of impacted mandibular third molars","volume":"43","author":"Koray","year":"2014","journal-title":"Int J Oral Maxillofac Surg"},{"key":"R3-20260604","doi-asserted-by":"crossref","first-page":"483","DOI":"10.17219\/dmp\/133664","article-title":"Effect of the local application of bupivacaine in early pain control following impacted mandibular third molar surgery: A randomized controlled study","volume":"58","author":"Shabat","year":"2021","journal-title":"Dent Med Probl"},{"key":"R4-20260604","doi-asserted-by":"crossref","first-page":"163","DOI":"10.5114\/jos.2022.119158","article-title":"The effectiveness of limited flap design in surgical removal of fully impacted lower third molars: A comparative clinical study","volume":"75","author":"Jamil","year":"2022","journal-title":"J Stoma"},{"key":"R5-20260604","doi-asserted-by":"crossref","first-page":"2454","DOI":"10.4103\/jfmpc.jfmpc_188_20","article-title":"Postoperative pain, edema and trismus following third molar surgery \u2013A comparitive study between submucosal and intravenous dexamethasone","volume":"9","author":"Sreesha","year":"2020","journal-title":"J Family Med Prim Care"},{"key":"R6-20260604","first-page":"530","article-title":"Management of inflammatory complications in third molar surgery: A review of the literature","volume":"11","author":"Osunde","year":"2011","journal-title":"Afr Health Sci"},{"key":"R7-20260604","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.joca.2010.09.014","article-title":"Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis--meta-analysis","volume":"19","author":"Bannuru","year":"2011","journal-title":"Osteoarthritis Cartilage"},{"key":"R8-20260604","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/j.1742-481X.2012.01057.x","article-title":"The role of hyaluronan in wound healing","volume":"11","author":"Frenkel","year":"2014","journal-title":"Int Wound J"},{"key":"R9-20260604","first-page":"1","article-title":"The effect of cross-linked hyaluronic acid in surgical extraction of impacted mandibular third molars","volume":"4","author":"Bayoumi","year":"2018","journal-title":"Int J Dent Oral Health"},{"key":"R10-20260604","doi-asserted-by":"crossref","first-page":"184","DOI":"10.4103\/0972-124X.99260","article-title":"Effect of hyaluronan on periodontitis: A clinical and histological study","volume":"16","author":"Gontiya","year":"2012","journal-title":"J Indian Soc Periodontol"},{"key":"R11-20260604","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.4103\/1119-3077.224131","article-title":"The efficacy of hyaluronic acid in postextraction sockets of impacted third molars: A pilot study","volume":"20","author":"Yilmaz","year":"2017","journal-title":"Niger J Clin Pract"},{"key":"R12-20260604","first-page":"152","article-title":"Comparative evaluation of clinical efficacy of hyaluronic acid spray versus normal saline spray on swelling, pain, and trimus after surgical extraction of impacted mandibular third molar\u2013a randomized controlled split mouth study","volume":"7","author":"Merchant","year":"2018","journal-title":"Int J Sci Res"},{"key":"R13-20260604","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1038\/sj.bdj.4809930","article-title":"Changes in life quality following third molar surgery--the immediate postoperative period","volume":"194","author":"McGrath","year":"2003","journal-title":"Br Dent J"},{"key":"R14-20260604","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1054\/ijom.2002.0263","article-title":"Contemporary views on dry socket (alveolar osteitis): A clinical appraisal of standardization, aetiopathogenesis and management: A critical review","volume":"31","author":"Blum","year":"2002","journal-title":"Int J Oral Maxillofac Surg"},{"key":"R15-20260604","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1016\/j.joms.2005.11.107","article-title":"The effect of a single dose prednisolone with and without diclofenac on pain, trismus, and swelling after removal of mandibular third molars","volume":"64","author":"Buyukkurt","year":"2006","journal-title":"J Oral Maxillofac Surg"},{"key":"R16-20260604","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1054\/bjom.2000.0535","article-title":"Pell-Gregory classification is unreliable as a predictor of difficulty in extracting impacted lower third molars","volume":"38","author":"Garc\u00eda","year":"2000","journal-title":"Br J Oral Maxillofac Surg"},{"key":"R17-20260604","doi-asserted-by":"crossref","first-page":"10296","DOI":"10.3390\/ijms241210296","article-title":"Hyaluronic acid: A powerful biomolecule with wide-ranging applications \u2013A comprehensive review","volume":"24","author":"Iaconisi","year":"2023","journal-title":"Int J Mol Sci"},{"key":"R18-20260604","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3389\/fimmu.2014.00101","article-title":"Hyaluronan, a crucial regulator of inflammation","volume":"5","author":"Petrey","year":"2014","journal-title":"Front Immunol"},{"key":"R19-20260604","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1111\/j.1468-3083.2007.02564.x","article-title":"The efficacy of topical 0.2% hyaluronic acid gel on recurrent oral ulcers: Comparison between recurrent aphthous ulcers and the oral ulcers of Beh\u00e7et's disease","volume":"22","author":"Lee","year":"2008","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R20-20260604","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.joms.2006.06.281","article-title":"Relationships between surgical difficulty and postoperative pain in lower third molar extractions","volume":"65","author":"Lago-M\u00e9ndez","year":"2007","journal-title":"J Oral Maxillofac Surg"},{"key":"R21-20260604","doi-asserted-by":"crossref","first-page":"e65","DOI":"10.4317\/medoral.18039","article-title":"Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables","volume":"18","author":"de Santana-Santos","year":"2013","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"R22-20260604","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jcms.2018.11.023","article-title":"Effects of leukocyte- and platelet-rich fibrin alone and combined with hyaluronic acid on early soft tissue healing after surgical extraction of impacted mandibular third molars: A prospective clinical study","volume":"47","author":"Afat","year":"2019","journal-title":"J Craniomaxillofac Surg"}],"container-title":["National Journal of Maxillofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/njms.njms_137_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:10:33Z","timestamp":1787166633000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/njms.njms_137_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/njms.njms_137_24","relation":{},"ISSN":["0975-5950","2229-3418"],"issn-type":[{"value":"0975-5950","type":"print"},{"value":"2229-3418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2024-09-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}