The Efficacy of 1% Chlorhexidine Gel on the Reduction of Dry Socket Occurence Following Surgical Third Molar Extraction— Pilot Study

Abstract

Aim & Objectives: The aim of this prospective pilot-study was to assess the efficacy of intra alveolar application of 1% chlorhexidine gel (CHX) on the reduction of dry socket (DS) occurrence following surgical extraction of mandibular third molars. Materials and Methods: A randomized split-mouth-design study included twenty-five patients with bilaterally impacted lower third molars (partial or full bone) requiring full thickness mucoperiastal flap reflection for extraction. Following surgical extraction of third lower molar, 2 ml of gel containing 1% chlorhexidine digluconate (Chlorhexamed ® Gel 1%) were placed in the experimental side, and saline solution was used for irrigation in the control side of extraction sockets, both followed by suturing of extraction site. The surgeries and follow up examinations were performed by the same surgeon. The follow up visits were performed at 48 hours and on day seven, post surgery where presence or absence of dry socket using the Blum criteria for diagnosis was evaluated and pain intensity by Visual Analogue Scale (VAS) 0 -100 was observed. Results: In this pilot study, dry socket was present in 4.0 and 28.0% of cases in the experimental and control groups, respectively (P = 0.048). Fisher's test revealed a statistically significant reduction of dry socket occurrence following the use of 1% CHX gel versus saline solution. Conclusion: The application of CHX gel 1% may significantly reduce the incidence of DS following third molar extraction. Prophylactic use of CHX gel 1% may be suggested in all patients, especially in the patients at risk of development of DS. KeywordsDry Socket; Chlorhexidine 1%; Third Molar Surgery J. Ahmedi et al. 153

Effect of chlorhexidine gel on the prevention of alveolar osteitis and post‐operative pain following transalveolar extraction of impacted mandibular third molars: A randomized study

“…Our findings contrast with a previous study that reported a significant difference between chlorhexidine gel and warm saline rinse in preventing AO after surgical extraction of IMTM 17 . Similarly, our results differ from studies that evaluated the efficacy of chlorhexidine gel compared with placebos and other preventive formulations 16,22 .…”

“…Previous studies have shown the effectiveness of chlorhexidine gel in preventing AO after transalveolar extraction of mandibular third molars 15–18 . However, these studies did not account for important confounding factors such as extraction difficulty and bone operating time.…”

“…14 Previous studies have shown the effectiveness of chlorhexidine gel in preventing AO after transalveolar extraction of mandibular third molars. [15][16][17][18] However, these studies did not account for important confounding factors such as extraction difficulty and bone operating time. Moreover, only one study has compared chlorhexidine gel to WSMR, 17 which is the main prophylactic therapy used in low resource settings after transalveolar extraction.…”

Preventing Alveolar Osteitis After Molar Extraction Using Chlorhexidine Rinse and Gel: A Meta-Analysis of Randomized Controlled Trials

“…Subsequently, 23 records were excluded, including four RCTs that tested CHX mixed with other materials; one RCT that was not restricted to molar extraction; 16 RCTs that tested CHX dosage, administration time, or treatment period; and one RCT that used a duplicate sample. Of the remaining 23 trials, 20 were identified from the academic databases and three ( Ahmedi et al, 2014 ; Shaban et al, 2014 ; Younus et al, 2014 ) were identified through Google Scholar. The data from these 23 trials were used in analysis, and their characteristics are presented in Table 1 .…”

“…Thirteen of the included trials compared the incidence of AO between CHX gel and a control. Of these, 11 used 0.2% CHX gel, one used 0.12% CHX gel ( Requena-Calla & Funes-Rumiche, 2016 ), and one used 1% CHX gel ( Ahmedi et al, 2014 ). These trials were analyzed in three subgroups, with the results summarized in Figure 3 .…”