Blue®m gel vs hyaluronic acid gel in wound healing and pain control following functional crown lengthening: a randomized controlled trial

Periodontal wound dressings have advanced from passive protectants to bioactive agents. This study compared the efficacy of Blue®m gel and a hyaluronic acid (HA) gel in promoting wound healing and controlling postoperative pain after functional crown lengthening surgery. A prospective, randomized, patient and outcome assessor-blinded study was conducted on 40 systemically healthy patients (aged 20-60 years) requiring crown lengthening of posterior teeth. Participants were divided into two groups: Blue®m gel (Group A) and custom-formulated HA gel (Group B). Both gels were applied to the surgical site immediately after suturing and then three times daily for 1 week. Wound healing was assessed at 1, 2, and 3 weeks using the Early Wound Healing Index (EHS, including CSR for closure, CSH for hemostasis and CSI for inflammation) and the Landry Wound Healing Index. Postoperative pain was evaluated via a Numeric Pain Rating Scale (NPRS) on Days 1, 2, and 3. Outcome comparisons between groups were performed with Chi-square tests for categorical healing indices and Mann-Whitney test for ordinal data. Both interventions yielded excellent clinical outcomes with comparable healing patterns. By Week 1, 100% of sites in both groups had complete incision closure (merged margins). Approximately 20% of patients in each group showed slight fibrin presence and mild redness at Week 1, which resolved entirely by Week 2. Consequently, EHS scores were high in both groups (most cases scoring 9-10 at Week 1 and 10 by Week 2) with no significant intergroup difference (p > 0.05). The Landry index reflected progressive improvement from predominantly red tissue at Week 1 to fully pink, healthy tissue by Week 3 in both groups (p > 0.05). Postoperative pain was mild and diminished rapidly: On Day 1, pain scores ranged from 0 to 4 in Group A and 1 to 2 in Group B, dropping significantly by Day 3 with no difference between the two groups (p > 0.05). No adverse effects were observed with either gel. Blue®m gel and HA gel demonstrated favorable clinical outcomes in soft tissue wound healing and early postoperative pain control, with no statistically significant differences observed between groups. Both agents can be safely recommended as effective periodontal dressings in this context, with the choice between them potentially guided by practical considerations such as cost and availability.