## 1 Introduction  
Extraction of third molars is one of the most performed procedures in maxillofacial surgery [1]. Impaction of third molars can be caused by various factors, including genetic and environmental conditions [2]. Classification systems, like the Pell and Gregory method, help clinicians assess the extraction difficulty for impacted mandibular third molars by evaluating their position relative to the mandibular ramus and second molars [3]. The extraction of impacted third molars is primarily indicated for symptomatic cases. These include conditions such as pain, recurrent infection (e.g., pericoronitis), pathologies like cysts or tumors, and root resorption of adjacent teeth. Symptomatic impacted third molars can also complicate orthodontic or prosthetic treatments and, in some cases, lead to systemic complications if left untreated [4]. For patients with elevated infection risk due to systemic conditions, removal to prevent future extraction complications, with antibiotic prophylaxis, may be advised [5]. The most common complications of extracting an impacted third molar are postoperative pain, edema, and trismus. Postoperative pain typically peaks within the first 6-12 h as a response to surgical trauma, which is commonly managed through NSAIDs, sometimes with opioid analgesics if necessary [6; 7]. The other most common complication is postoperative edema, reaching its peak within 48-72 h due to inflammatory fluid accumulation, which can be effectively controlled with cold compresses and corticosteroids [8]. Trismus, a limitation in jaw movement resulting from trauma to the masticatory muscles, can be treated through heat application, targeted exercises, and muscle relaxants [9]. Hyaluronic acid (HA) is a glycosaminoglycan integral to the extracellular matrix (ECM) found throughout connective, epithelial, and neural tissues. Structurally, HA comprises repeated disaccharide units of D-glucuron acid and D-N-acetylglucosamine [10]. It is distinct from other ECM molecules as it is nonsulfated and exhibits highly effective water retention capabilities, binding water up to 1000-10,000 times its weight [11]. Its concentration increases during embryonic development and inflammatory responses, where it aids tissue hydration, facilitates cell migration, and promotes cell proliferation [12]. This viscous matrix also provides a barrier against pathogens and modulates ion flow, critical for cellular signaling [13]. Hyaluronic acid (HA) has diverse applications across medical fields. In ophthalmology, it is used to maintain intraocular pressure during surgery. In dermatology, HA is a dermal filler that reduces the signs of aging. Orthopedics employs intra-articular HA injections to alleviate osteoarthritis symptoms and improve joint functionality, while in rheumatology, it helps reduce joint inflammation in rheumatoid arthritis [14]. In dentistry, HA is applied in treatments of TMJ disorders, aids in oral ulcer healing, supports postsurgical tissue regeneration, and enhances bone repair when used with grafts [15]. The effects of hyaluronic acid on the body depend a lot on its molecular weight. Low-molecular-weight HA can spark inflammation by activating specific immune pathways, like those involving TLR-4 and NF-kB, which turn on genes that promote inflammation. On the other hand, high-molecular-weight HA (HMW-HA, >1000 kDa) tends to do the opposite; it calms inflammation by interacting with CD44 receptors and blocking NF-kB activity, helping to keep the inflammatory response in check [16]. Naturally occurring HA in the body is generally found in its high-molecular-weight form, which has anti-inflammatory and tissue healing properties. Hyaluronic acid has been shown to reduce cell proliferation and inflammatory responses in treating periodontal diseases [17; 18]. In contrast, low-molecular-weight HA enhances angiogenesis and promotes collagen production. It also plays a role in tissue repair by protecting the granulation tissue from oxidative damage.