THE RELATIONSHIP BETWEEN HIGH-DENSITY LIPOPROTEIN LEVELS AND EARLY WOUND HEALING AFTER MANDIBULAR THIRD MOLAR ODONTECTOMY IN SMOKERS

Background: Smoking is associated with impaired postoperative healing and alterations in lipid metabolism, including reduced high-density lipoprotein (HDL) levels. HDL has anti-inflammatory, antioxidant, endothelial, and tissue-repair functions, but its relationship with early intraoral wound healing after mandibular third molar odontectomy remains insufficiently explored. 
Objective: To determine the relationship between HDL levels and wound healing after mandibular third molar odontectomy and to compare HDL levels and wound-healing scores between smokers and non-smokers. 
Methods: This analytical observational study used a cross-sectional approach and purposive sampling. Ten male patients aged 19–36 years undergoing mandibular third molar odontectomy at the Dental Hospital of Universitas Airlangga were included, comprising five smokers and five non-smokers. Serum HDL was measured using a TMS Premium 24i analyzer. Early wound healing was assessed at postoperative day 2 (H+2) and day 8 (H+8) using the Early Wound Healing Score (EHS). Between-group comparisons and Pearson correlation analyses were performed using a significance level of p<0.05. 
Results: Mean HDL was 37.6±3.05 mg/dL in smokers and 45.4±2.61 mg/dL in non-smokers (p=0.002). Mean wound-healing scores were lower in smokers at H+2 (4.8±0.84 vs 7.8±0.84; p<0.001), while the difference at H+8 was not statistically significant (6.2±1.92 vs 8.0±2.00; p=0.185). HDL was positively correlated with wound-healing score at H+2 (r=0.686; p=0.029), but not at H+8 (r=0.561; p=0.091). 
Conclusion: Lower HDL levels and poorer early wound-healing scores were observed in smokers. HDL showed a significant positive association with wound-healing quality at H+2, although the small sample and limited inter-rater reliability warrant cautious interpretation.