Effects of Irrigation Solutions at Different Temperatures Used in Mandibular Third Molar Surgery
A Comparison of the Effects of Irrigation Solutions at Different Temperatures Used in Oral Surgery on Postoperative Complications and Oral Health-Related Quality of Life
The present study aims to compare the effects of saline, chlorhexidine, and hydrogen peroxide irrigation solutions at different temperatures on postoperative complications, including pain, swelling, and mouth opening, as well as oral health-related quality of life, in patients undergoing surgical extraction of impacted mandibular third molars. The irrigation solutions will be applied immediately following surgical tooth extraction at temperatures of either 4°C or 25°C.
An a prior power analysis based on repeated-measures analysis of variance (Repeated Measures ANOVA, within-between interaction) was performed. An effect size of f = 0.25, a Type I error rate (α = 0.05), and a statistical power of 1 - β = 0.95 were assumed.
Based on the power analysis, a minimum of 11 participants per group was determined to be sufficient. Considering potential loss to follow-up and missing data, the sample size was increased by approximately 15%, and it was decided to enroll 13 participants in each group. Accordingly, the planned study will be conducted with a total of 78 participants allocated to six groups, and all participants will be evaluated at four different time points.
調査の概要
状態
詳細な説明
The removal of mandibular third molars is among the most common procedures carried out in oral surgery. After extraction, patients often experience postoperative complications such as pain, swelling, and limited mouth opening. If these complications become more severe, they can negatively impact the patient's oral health-related quality of life.
In mandibular third molar surgery, following elevation of the soft tissue flap to gain access to the tooth, bone removal is performed using high-speed rotary instruments with continuous irrigation using physiological solutions . Following bone removal and exposure of the tooth, the extraction is performed. Subsequently, irrigation of the extraction socket with physiological saline or antiseptic solutions has been recommended. After socket irrigation and evaluation of the bony structures, the surgical site is sutured and postoperative instructions are provided to the patients.Although the aforementioned studies have demonstrated that socket irrigation may produce favorable postoperative outcomes, to the best of our knowledge, no study has evaluated the effectiveness of irrigation solutions used at different temperatures for socket irrigation.Therefore, the present study aims to compare the effects of saline, chlorhexidine, and hydrogen peroxide irrigation solutions at different temperatures on postoperative complications, including pain, swelling, and mouth opening, as well as oral health-related quality of life, in patients undergoing surgical extraction of impacted mandibular third molars. The irrigation solutions will be applied immediately following surgical tooth extraction at temperatures of either 4°C or 25°C.
The present study aims:
- To evaluate the effectiveness of 0.2% chlorhexidine gluconate and 1.5% hydrogen peroxide irrigation solutions at temperatures of 4°C or 25°C, compared with saline irrigation at the corresponding temperatures, on postoperative complications, including pain, mouth opening, and swelling, following mandibular third molar surgery.
- To evaluate the effectiveness of 0.2% chlorhexidine gluconate and 1.5% hydrogen peroxide irrigation solutions at temperatures of 4°C or 25°C, compared with saline irrigation at the corresponding temperatures, on oral health-related quality of life following mandibular third molar surgery.
Accordingly, the planned study will be conducted with a total of 78 participants allocated to six groups, and all participants will be evaluated at four different time points.
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Sara Samur Ergüven, DDS, PhD. Associate Professor
- 電話番号:+90 5334165005
- メール:sara.samur@sbu.edu.tr
研究場所
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Ankara、トルコ(Türkiye)、06610
- University of Health Sciences, Keciören, Ankara
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Presence of a unilateral or bilateral impacted mandibular third molar classified as Class II, Position B according to the Pell and Gregory classification), indicating that there is insufficient space in the jaw for eruption of the tooth and that the cervical line of the impacted tooth is at the level of the cervical line of the adjacent second molar.
- Systemically healthy individuals classified as ASA Physical Status I.
- Age between 18 and 35 years.
- Willingness to participate in the study.
Exclusion Criteria:
- Individuals outside the specified age range.
- Pregnant individuals.
- Individuals who are currently breastfeeding.
- Presence of clinical signs of infection in the region of the impacted third molar, including acute pericoronitis.
- Presence of any systemic disease that may affect wound healing, including metabolic, immunological, or endocrine disorders.
- Presence of a cystic or tumoral lesion associated with the impacted third molar.
- History of allergy, hypersensitivity, or intolerance to chlorhexidine gluconate or hydrogen peroxide solutions to be used in the study.
- Unwillingness to participate in the study.
- Poor oral hygiene at a level that may adversely affect wound healing.
- Cold intolerance or the presence or history of cold-related diseases, including Raynaud's disease, cold urticaria, or cryoglobulinemia.
- Use of systemic antibiotics, corticosteroids, or nonsteroidal anti-inflammatory drugs (NSAIDs) within the previous two weeks.
- Cases in which no bone removal is required during surgery.
- Patients who meet the inclusion criteria but are unwilling to participate in the study.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:4°C sterile saline solution
Patients whose extraction sockets will be irrigated with 4°C sterile saline solution following mandibular third molar surgery. |
Patients whose extraction sockets will be irrigated with 4°C sterile saline solution following mandibular third molar surgery. |
|
実験的:25°C sterile saline solution
Patients whose extraction sockets will be irrigated with 25°C sterile saline solution |
Patients whose extraction sockets will be irrigated with 25°C sterile saline solution following mandibular third molar surgery. |
|
実験的:4°C 0.2% chlorhexidine solution
Patients whose extraction sockets will be irrigated with 4°C 0.2% chlorhexidine solution following mandibular third molar surgery. |
Patients whose extraction sockets will be irrigated with 4°C 0.2% chlorhexidine solution following mandibular third molar surgery. |
|
実験的:25°C 0.2% chlorhexidine solution
Patients whose extraction sockets will be irrigated with 25°C 0.2% chlorhexidine solution following mandibular third molar surgery. |
Patients whose extraction sockets will be irrigated with 25°C 0.2% chlorhexidine solution following mandibular third molar surgery. |
|
実験的:4°C 1.5% hydrogen peroxide solution
Patients whose extraction sockets will be irrigated with 4°C 1.5% hydrogen peroxide solution following mandibular third molar surgery. |
Patients whose extraction sockets will be irrigated with 4°C 1.5% hydrogen peroxide solution following mandibular third molar surgery. |
|
実験的:25°C 1.5% hydrogen peroxide solution
Patients whose extraction sockets will be irrigated with 25°C 1.5% hydrogen peroxide solution following mandibular third molar surgery. |
Patients whose extraction sockets will be irrigated with 25°C 1.5% hydrogen peroxide solution following mandibular third molar surgery. |
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Postoperative Edema (Swelling)
時間枠:Preoperatively and on postoperative days 2, 4, and 7
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Edema will be measured along five predetermined anatomical reference lines using a flexible millimeter ruler. Measurements will be recorded in millimeters. |
Preoperatively and on postoperative days 2, 4, and 7
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Postoperative Pain
時間枠:Preoperative and postoperative days 2, 4, and 7 using a 10-cm VAS.
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Postoperative pain will be assessed by Visual Analog Scale (VAS). The amount of analgesic required by each patient during the postoperative period will be recorded daily on the patient follow-up form. |
Preoperative and postoperative days 2, 4, and 7 using a 10-cm VAS.
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Trismus (Restriction of Mouth Opening)
時間枠:Preoperative day and postoperative days 2, 4, and 7
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Maximum mouth opening will be measured in millimeters using a digital caliper. |
Preoperative day and postoperative days 2, 4, and 7
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Oral Health Related Quality of Life (QoL)
時間枠:Preoperatively and on postoperative days 2, 4, and 7.
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The Oral Health Impact Profile-14 (OHIP-14), a validated and reliable instrument, will be used to evaluate changes in patients' daily comfort and oral health-related quality of life. |
Preoperatively and on postoperative days 2, 4, and 7.
|
協力者と研究者
出版物と役立つリンク
一般刊行物
- Sifuentes-Cervantes JS, Carrillo-Morales F, Castro-Nunez J, Cunningham LL, Van Sickels JE. Third molar surgery: Past, present, and the future. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Nov;132(5):523-531. doi: 10.1016/j.oooo.2021.03.004. Epub 2021 Mar 14.
- Canakci FG, Er N, Duygu G, Tanan Karaca G. Does Saline Irrigation at Different Temperatures Affect Pain, Edema, and Trismus After Impacted Third Molar Surgery: A Clinical Trial. J Oral Maxillofac Surg. 2023 Jan;81(1):88-94. doi: 10.1016/j.joms.2022.08.015. Epub 2022 Aug 29.
- Shahraki M, Khazaei AH, Hakimi S, Hasheminasab M, Haradasht SA. Effect of chlorhexidine, povidone-iodine, and hydrogen peroxide irrigation on pain and swelling after mandibular third molar surgery: randomized controlled trial. Int J Oral Maxillofac Surg. 2025 Jul;54(7):677-683. doi: 10.1016/j.ijom.2025.01.021. Epub 2025 Feb 14.
- Brauer HU. Unusual complications associated with third molar surgery: a systematic review. Quintessence Int. 2009 Jul-Aug;40(7):565-72.
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 2026-300
- Academician (その他の識別子:University of Health Sciences, Türkiye)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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