Effect of a Polynucleotide-Hyaluronic Acid Gel on Mandibular Third-Molar Extraction Discomfort

Postoperative pain, swelling, and transient trismus commonly follow impacted mandibular third-molar surgery. Hyaluronic acid (HA) can modulate early inflammation and support soft-tissue repair, while polynucleotides (PN) may further enhance fibroblast activity. This study evaluated whether an intrasocket PN-HA gel improves early postoperative outcomes versus standard care.

Single-center, retrospective split-mouth study in adults undergoing bilateral removal of partially impacted mandibular third molars. One socket received PN-HA gel (Regenfast © , 5 mL) before suturing (TG), the contralateral socket received no adjunct (CG). Outcomes: pain (VAS 0-10) at 12 hours and daily for 7 days; maximum interincisal distance on 2, 5, and 7 postoperative days (POD); facial swelling from standardized 3D facial scans at baseline, POD2, POD5, and POD7. Parametric analyses used paired tests and one-way ANOVA with Tukey post hoc; Pearson correlations assessed relations among pain, swelling, and mouth opening.

Eighteen patients completed follow-up without complications. Operative time was comparable between allocations. Pain peaked at approximately 12 hours and was lower on test sides during the early window, with differences diminishing by POD5-7. Swelling increases were smaller on test sides at POD2 and POD5 and converged by POD7. MID recovered faster on test sides at POD2 and POD5, approaching baseline in both groups by POD7. Correlations reflected expected dynamics: higher pain was associated with greater swelling and reduced mouth opening, most pronounced around the inflammatory peak.

Intrasocket PN-HA gel reduced early pain and swelling and hastened mouth-opening recovery (greatest at 48-72 h, converging by 1 week), indicating clinical utility for reducing short-term morbidity after third-molar surgery.