Comparison of Chlorhexidine and Hypochlorous Acid Mouthwash After Impacted Third Molar Surgery

March 8, 2026 updated by: Serap Keskin Tunc, Yuzuncu Yil University

Postoperative Effects of Hypochlorous Acid Versus Chlorhexidine Mouthwash Following Impacted Third Molar Extraction: A Randomized Split-Mouth Study

Impacted mandibular third molar extraction is one of the most common procedures in oral and maxillofacial surgery and is frequently associated with postoperative complications such as pain, edema, and trismus, which may negatively affect patients' quality of life. Various pharmacological and topical agents have been used to reduce these postoperative complications. Chlorhexidine gluconate mouthwash is widely considered the gold standard antiseptic agent due to its broad antimicrobial activity; however, its use may be associated with adverse effects such as tooth staining and taste alteration. Hypochlorous acid is an alternative antiseptic agent with antimicrobial and anti-inflammatory properties and good tissue compatibility.

The aim of this randomized clinical study was to compare the effectiveness of hypochlorous acid mouthwash and chlorhexidine gluconate mouthwash in reducing postoperative complications following impacted mandibular third molar surgery. A total of 43 healthy patients with bilateral impacted mandibular third molars were included in the study. Postoperative outcomes including pain (VAS), edema, trismus, and wound healing were evaluated at specific follow-up intervals. The results were analyzed to determine whether hypochlorous acid could be considered a potential alternative to chlorhexidine in postoperative oral care.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

42

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Van, Turkey (Türkiye), 65580
        • Van Yüzüncü Yıl Üniversitesi Diş Hekimliği Fakültesi

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Age between 18 and 40 years
  • Presence of bilateral impacted mandibular third molars with similar surgical difficulty
  • Good general health with no systemic disease
  • Ability to comply with postoperative instructions and follow-up visits

Exclusion Criteria:

  • Presence of systemic disease
  • Pregnancy or breastfeeding
  • Active infection at the surgical site
  • History of allergy to study medications
  • Use of antibiotics or anti-inflammatory drugs within two weeks before surgery
  • Temporomandibular joint disorders causing limited mouth opening

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: chlorhexidine gluconate
Patients used chlorhexidine gluconate mouthwash starting 24 hours after surgery, three times daily.
Drug: Hypochlorous Acid
Hypochlorous acid mouthwash is an antimicrobial oral rinse with broad-spectrum activity against bacteria, viruses, and fungi. It is used as a postoperative antiseptic agent to reduce microbial load, inflammation, and the risk of infection following oral surgical procedures.
Drug: Chlorhexidine Gluconate Mouthwash
Patients used chlorhexidine gluconate mouthwash starting 24 hours after surgery, three times daily.
Active Comparator: Hypochlorous Acid Mouthwash
Patients used hypochlorous acid mouthwash starting 24 hours after surgery, three times daily.
Drug: Hypochlorous Acid
Hypochlorous acid mouthwash is an antimicrobial oral rinse with broad-spectrum activity against bacteria, viruses, and fungi. It is used as a postoperative antiseptic agent to reduce microbial load, inflammation, and the risk of infection following oral surgical procedures.
Drug: Chlorhexidine Gluconate Mouthwash
Patients used chlorhexidine gluconate mouthwash starting 24 hours after surgery, three times daily.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Trismus
Time Frame: preop, 2th and 7th days
In all patients participating in the study, the maximum interincisal distance for trismus was measured and recorded by the same physician before the operation and on the 2nd and 7th days after the operation.
preop, 2th and 7th days
Edema
Time Frame: preop, 2th and 7th days
For edema, some anatomical points on the face were taken as reference points and the distance between these points was measured with a tape measure and recorded. The angulus point was determined as the center point and the distances between angulus-tragus, angulus-lateral corner of the eye, angulus-nasal base, angulus-labial commissure and angulus-pogonion point were measured.
preop, 2th and 7th days
Visual Analog Scale (VAS)
Time Frame: 3, 6, 12 and 24 hours and the 2nd, 3rd, 4th, 5th, 6th and 7th days
n the pain assessment, the patients were given a VAS form at 3, 6, 12 and 24 hours and on the 2nd, 3rd, 4th, 5th, 6th and 7th days and the pain felt by the patient was marked on this scale. This form consists of numbers between 0 and 10. 0 represents 'no pain at all' and 10 represents 'worst possible pain'.
3, 6, 12 and 24 hours and the 2nd, 3rd, 4th, 5th, 6th and 7th days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Yuzuncu Yil University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2021

Primary Completion (Actual)

July 1, 2022

Study Completion (Actual)

August 1, 2022

Study Registration Dates

First Submitted

March 8, 2026

First Submitted That Met QC Criteria

March 8, 2026

First Posted (Actual)

March 12, 2026

Study Record Updates

Last Update Posted (Actual)

March 12, 2026

Last Update Submitted That Met QC Criteria

March 8, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • YYU-20/20.09.2021

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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