Effect of aloe vera hydrogel on the scarring and healing of free gingival graft: Randomized controlled trial


  • Walaa Alawad Periodontology department, Faculty of dentistry, Damascus University, Damascus, Syria
  • Majed Othman Periodontology department, Faculty of dentistry, Damascus University, Damascus, Syria
  • Jameela Hsaian Pharmaceutics and pharmaceutical technology department, faculty of pharmacy, Damascus university, Syria.
  • Laith Alsabek clinical science institute, the National University of Ireland - Galway, Ireland http://orcid.org/0000-0003-0837-4405




free gingival graft, aloe vera, hydrogel, scarring


Objective: Several studies have used aloe vera hydrogel to enhance various tissues regeneration to reduce scar formation in wounds. This study aimed to prepare a hydrogel specified for the oral cavity and observe scar formation and healing of free gingival graft after its application compared with the natural healing and scaring of the graft without any material.

Design: This study is a randomized controlled clinical trial that included 22 patients with a width of attached gingiva less than 2 mm. after preparing the aloe vera hydrogel and completing the laboratory stage, the hydrogel was randomly applied for 11 patients after the free gingival graft procedure while the other 11 patients did not use any material after the same surgery. Landry’s scale was used to assess the healing index, scarring was evaluated using Mucosal Scarring Index.

Results: The healing index was higher in the intervention group with a statistical difference P<0.05 than the control group after three weeks. Moreover, Scar formation in the intervention group was less in the intervention group with a significant difference P<0.05 after 1,2,3,6 months.

Conclusion: Within the limitations of our study, the aloe vera hydrogel can be considered as a good topical treatment after oral surgery due to its ability to reduce scar formation and speeding up the healing in the receiving area in free gingival graft procedures.  



The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: Critical elements in design and execution. Zuhr O, Bäumer D, Hürzeler M. J Clin Periodontol. 2014;41 Suppl s:S123-S142. doi:10.1111/jcpe.12185

Soft tissue substitutes in non-root coverage procedures : a systematic review and meta-analysis. Bertl K, Melchard M, Pandis N, Müller-kern M, Stavropoulos A.Clin Oral Investig. 2017. doi:10.1007/s00784-016-2044-4

Review A. of Early Healing Events Periodontal Repair : A Review Significance. :158-165.

Assessment of healing after periodontal flap surgery with and without periodontal pack. Murthykumar K, Rajasekar A, Kaarthikeyan G. Int J Pharm Res. 2020;12(August):125-130. doi:10.31838/ijpr/2020.SP1.020

Herbs in Dentistry. Buggapati L. 2016;5(6):7-12.

Oral local drug delivery and new perspectives in oral drug formulation. Paderni C, Compilato D, Giannola LI, Campisi G. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(3):e25-e34. doi:10.1016/j.oooo.2012.02.016

Hydrogels in pharmaceutical formulations. Peppas NA, Bures P, Leobandung W, Ichikawa H.2000;50.

’History OF Aloe Vera’-(A Magical Plant). Mehta I. IOSR J Humanit Soc Sci (IOSR-JHSS. 2017;22(8):21-24. doi:10.9790/0837-2208162124

Composition and applications of Aloe vera leaf gel. Hamman JH. Molecules. 2008;13(8):1599-1616. doi:10.3390/molecules13081599

Aloe Vera: A Valuable Ingredient for the Food, Pharmaceutical and Cosmetic Industries - A Review. Eshun K, He Q. Crit Rev Food Sci Nutr. 2004;44(2):91-96. doi:10.1080/10408690490424694

Thin hydrogel films for optical biosensor applications. Mateescu A, Wang Y, Dostalek J, Jonas U. Membranes (Basel). 2012;2(1):49-69. doi:10.3390/membranes2010040

The Mucosal Scarring Index: reliability of a new composite index for assessing scarring following oral surgery. Wessels R, De Roose S, De Bruyckere T, et al. Clin Oral Investig. 2019;23(3):1209-1215. doi:10.1007/s00784-018-2535-6

Effectiveness of benzydamine HC1 in the treatment of periodontal post-surgical patients. Landry RG. 1985.

Post-operative complications after periodontal surgery. Professor SA, Tanwar Post Graduate Student E, Graduate Student P, Tanwar E, Bhat D. ~ 152 ~ Int J Appl Dent Sci. 2018;4(4):152-156.

Oral local drug delivery: An overview. Mathew AK. Pharm Pharmacol Res. 2015;3(1):1-6.

The use of mucoadhesive polymers in ocular drug delivery. Ludwig A. Adv Drug Deliv Rev. 2005;57(11):1595-1639. doi:10.1016/j.addr.2005.07.005

Alginate/Aloe vera hydrogel films for biomedical applications. Pereira R, Mendes A, Bártolo P. Procedia CIRP. 2013;5:210-215. doi:10.1016/j.procir.2013.01.042

Development of novel alginate based hydrogel films for wound healing applications. Pereira R, Carvalho A, Vaz DC, Gil MH, Mendes A, Bártolo P. Int J Biol Macromol. 2013;52(1):221-230. doi:10.1016/j.ijbiomac.2012.09.031

Influence of Aloe vera on the glycosaminoglycans in the matrix of healing dermal wounds in rats. Chithra P, Sajithlal GB, Chandrakasan G. J Ethnopharmacol. 1998;59(3):179-186. doi:10.1016/S0378-8741(97)00112-8

The efficacy of aloe vera used for burn wound healing: A systematic review. Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, Kongkaew C. Burns. 2007;33(6):713-718. doi:10.1016/j.burns.2006.10.384

Clinical efficacy of new aloe vera- and myrrh-based oral mucoadhesive gels in the management of minor recurrent aphthous stomatitis: A randomized, double-blind, vehicle-controlled study. Mansour G, Ouda S, Shaker A, Abdallah HM. J Oral Pathol Med. 2014;43(6):405-409. doi:10.1111/jop.12130

Adjunctive Local Delivery of Aloe Vera Gel in Patients With Type 2 Diabetes and Chronic Periodontitis: A Randomized, Controlled Clinical Trial. Pradeep AR, Garg V, Raju A, Singh P. J Periodontol. 2016;87(3):268-274. doi:10.1902/jop.2015.150161

Pharmacological attribute of Aloe vera: Revalidation through experimental and clinical studies. Gupta V, Malhotra S. AYU (An Int Q J Res Ayurveda). 2012;33(2):193. doi:10.4103/0974-8520.105237

Antiinflammatory activity of extracts from Aloe vera gel. Vázquez B, Avila G, Segura D, Escalante B. J Ethnopharmacol. 1996;55(1):69-75. doi:10.1016/S0378-8741(96)01476-6

Effects of Scutellariae radix and Aloe vera gel extracts on immunoglobulin E and cytokine levels in atopic dermatitis NC/Nga mice. Kim J, Lee I seok, Park S, Choue R. J Ethnopharmacol. 2010;132(2):529-532. doi:10.1016/j.jep.2010.08.049






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