Early Wound Healing After Chlorhexidine Rinsing in Third Molar Surgery: A Randomized Clinical Trial

Aim: Optimal wound healing is a primary objective in oral surgical procedures. This study evaluated the effects of chlorhexidine + anti-discoloration system (CHX + ADS) with or without hyaluronic acid (HA) mouth rinse compared to placebo (PLCB) in promoting wound healing following third molar surgery. Methods: Healthy subjects with indication to third molar extraction were included in this single center, randomized, placebo-controlled clinical trial. Following surgery, the patients were randomly assigned to three treatment groups, namely CHX + ADS + HA, CHX + ADS, or PLCB. Wound healing was assessed at 3, 7 and 14 days postoperatively using the Early Healing Index (EHI) ranging between Score 1 (complete wound healing in the absence of fibrin line) and 5 (incomplete wound healing with necrotic tissue). Results: Fifty-four patients (18 per group) were included in the analysis. At 3 and 7 days, EHI scores were lower in both CHX + ADS- groups compared to PLCB (p < 0.01 for CHX + ADS + HA, p < 0.05 for CHX + ADS). Improved healing at Days 3 and 7 was observed in the CHX + ADS + HA compared to CHX + ADS (p < 0.05). At 14 days, no differences were noted among groups. Conclusion: CHX + ADS-based mouth rinses promoted early wound healing compared to placebo. The adjunct of HA improved wound closure, especially in the first postoperative week. Trial Registration: ClinicalTrials.gov: NCT05414253.