A randomized clinical trial compared the effect of intra-alveolar 0.2 % Chlorohexidine bio-adhesive gel versus 0.12% Chlorohexidine rinse in reducing alveolar osteitis following molar teeth extractions

Nedal-Abdullah Abu-Mostafa, Abdullah Alqahtani, Mohammed Abu-Hasna, Ahmed Alhokail, Ammar Aladsani, Nedal-Abdullah Abu-Mostafa, Abdullah Alqahtani, Mohammed Abu-Hasna, Ahmed Alhokail, Ammar Aladsani

Abstract

Objectives: To evaluate socket healing, incidence of acute alveolar ostieitis (AO) and associated pain following single molar tooth extraction in patients who receive intra-alveolar 0.2% chlorhexidine (CHX) gel, and those who rinsed with 0.12 % CHX rinse.

Study design: A prospective randomized clinical trial was conducted on two parallel groups of patients. Group 1 (141 patients): Rinsed with 0.12 % CHX rinse from the second postoperative day, two times daily for a week. Group2 (160 patients): Who had direct intra-alveolar application of 0.2% CHX gel and day 3 post-operatively. The socket was evaluated 3 and 7 day postoperatively for the presence of AO by checking probing tenderness in the socket, empty socket, food debris, halitosis and pain assessment by VAS.

Results: Forty-eight AO cases were diagnosed out of 301 extractions (15.9%). In Group 1, 25 cases were found (17.7%) while 23 cases were found in Group 2 (14.4%). The difference was not statistically significant (p=0.428). Presence of empty socket and food debris in Group 1 were higher than in Group 2 but the difference was not statistically significant (p= 0.390 & p = 0.415). Occurrence of halitosis in Group 2 was more than Group 1, but the difference was not significant (p= 0.440). Statistical significance was found between AO in extraction done by root separation (29%) and those routinely extracted (12.3 %) (p=0.001).

Conclusion: Postoperative evaluation of molar extraction sockets that received direct intra-alveolar application of 0.2% CHX gel showed insignificant less occurrence of AO when compared with 0.12 % CHX rinse.

Conflict of interest statement

Conflict of interest statement: The authors have declared that no conflict of interest exist.

References

    1. Blum IR. Contemporary views on dry socket (alveolar osteitis): A clinical appraisal of standardization, aetiopathogenesis and management: A critical review. Int J Oral Maxillofac Surg. 2002;31:309–17.
    1. Bonine FL. Effect of chlorhexidine rinse on the incidence of dry socket in impacted mandibular third molar extraction sites. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:154–7.
    1. Torres-Lagares D, Infante-Cossio P, Gutierrez-Perez JL, Romero-Ruiz MM, Garcia-Calderon M, Serrera-Figallo MA. Intra-alveolar chlorhexidine gel for the prevention of dry socket in mandibular third molar surgery. A pilot study. Med Oral Patol Oral Cir Bucal. 2006;11:E179–84.
    1. Hita P, Torres D, Flores R, Magallanes N, Basallote M, Gutierrez JL. Effectiveness of chlorhexidine gel versus chlorhexidine rinse in reducing alveolar osteitis in mandibular third molar surgery. J Oral Maxillofac Surg. 2008;66:441–5.
    1. Babar A, Ibrahim MW, Baig NJ, Shah I, Amin E. Efficacy of intra-alveolar chlorhexidine gel in reducing frequency of alveolar osteitis in mandibular third molar surgery. J Coll Physicians Surg Pak. 2012;22:91–4.
    1. Jaafar N, Nor GM. The prevalence of post-extraction complications in an outpatient dental clinic in Kuala Lumpur Malaysia--a retrospective survey. Singapore Dent J. 2000;23:24–8.
    1. Bloomer CR. Alveolar osteitis prevention by immediate placement of medicated packing. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2000;90:282–4.
    1. Larsen PE. The effect of a chlorhexidine rinse on the incidence of alveolar osteitis following the surgical removal of impacted mandibular third molars. J Oral Maxillofac Surg. 1991;49:932–7.
    1. Birn H. Etiology and pathogenesis of fibrinolytic alveolitis (dry socket) Int J Oral Maxillofac Surg. 1973;2:211–263.
    1. Alexander RE. Dental extraction wound management: a case against medicating postextraction sockets. J Oral Maxillofac Surg. 2000;58:538–51.
    1. Larsen PE. Alveolar osteitis after surgical removal of impacted mandibular third molars. Identification of the patient at risk. Oral Surg Oral Med Oral Pathol. 1992;73:393–7.
    1. Peñarrocha M, Sanchis JM, Sáez U, Gay C, Bagán JV. Oral hygiene and postoperative pain after mandibular third molar surgery. OralSurgOral Med OralPatholOralRadiolEndod. 2001;92:260–4.
    1. Caso A, Hung LK, Beirne OR. Prevention of alveolar osteitis with chlorhexidine: a meta-analytic review. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2005;99:155–9.
    1. Swanson AE. A double-blind study on the effectiveness of tetracycline in reducing the incidence of fibrinolytic alveolitis. J Oral Maxillofac Surg. 1989;47:165–7.
    1. Ritzau M, Hillerup S, Branebjerg PE, Ersbøl BK. Does metronidazole prevent alveolitis sicca dolorosa?. A double-blind, placebo-controlled clinical study. Int J Oral Maxillofac Surg. 1992;21:299–302.
    1. Delilbasi C, Saracoglu U, Keskin A. Effects of 0.2% chlorhexidine gluconate and amoxicillin plus clavulanic acid on the prevention of alveolar osteitis following mandibular third molar extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:301–4.
    1. Jenkins S, Addy M, Wade W. The mechanism of action of chlorhexidine. A study of plaque growth on enamel inserts in vivo. J Clin Periodontol. 1988;15:415–24.
    1. Ragno JR, Szkutnik AJ. Evaluation of 0.12% chlorhexidine rinse on the prevention of alveolar osteitis. Oral Surg Oral Med Oral Pathol. 1991;72:524–6.
    1. Hermesch CB, Hilton TJ, Biesbrock AR, Baker RA, Cain-Hamlin J, McClanahan SF. Perioperative use of 0.12% chlorhexidine gluconate for the prevention of alveolar osteitis: efficacy and risk factor analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:381–7.
    1. Sridhar V, Wali GG, Shyla HN. Evaluation of the perioperative use of 0.2% chlorhexidine gluconate for the prevention of alveolar osteitis after the extraction of impacted mandibular third molars: A clinical study. J Maxillofac Oral Surg. 2011;10:101–111.
    1. Helms JA, Della-Fera MA, Mott AE, Frank ME. Effects of chlorhexidine on human taste perception. Arch Oral Biol. 1995;40:913–20.
    1. Fotos PG, Koorbusch GF, Sarasin DS, Kist RJ. Evaluation of intra-alveolar chlorhexidine dressings after removal of impacted mandibular third molars. Oral Surg Oral Med Oral Pathol. 1992;73:383–8.
    1. Torres-Lagares D, Gutierrez-Perez JL, Infante-Cossio P, Garcia-Calderon M, Romero-Ruiz MM, Serrera-Figallo MA. Randomized, double-blind study on effectiveness of intra-alveolar chlorhexidine gel in reducing the incidence of alveolar osteitis in mandibular third molar surgery. Int J Oral Maxillofac Surg. 2006;35:348–51.
    1. Daly B, Sharif MO, Newton T, Jones K, Worthington HV. Local interventions for the management of alveolar osteitis (dry socket) Cochrane Database Syst Rev. 2012;12:CD006968.
    1. Haraji A, Rakhshan V, Khamverdi N, Alishahi HK. Effects of intra-alveolar placement of 0.2% chlorhexidine bioadhesive gel on dry socket incidence and postsurgicalpain: a double-blindsplit mouthrandomizedcontrolledclinicaltrial. J OrofacPain. 2013;27:256–62.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa