The Efficiency of Three Irrigating Solutions after Surgical Removal of Impacted Mandibular Third Molars: A Cross-sectional Study

Jadhao, Varsha A; Rao, Amit; Hande, Pratik; Mahajani, Monica; Raktade, Prashant; Gedam, Ravidra; Acharya, Vishwas Diwakar; Tekale, Pawankumar Dnyandeo

doi:10.5005/jp-journals-10024-2396

Cited by 13 publications

(12 citation statements)

References 13 publications

(13 reference statements)

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“…A comparative study 31 assessed the use of saline vs. 0.12% chlorhexidine rinse and found no significant difference in AO incidence between the two interventions. Jadhao 32 compared saline, chlorhexidine and povodine iodine irrigation and noted a significant reduction in AO incidence with chlorhexidine rinsing.…”

Section: Resultsmentioning

confidence: 99%

Aetiology, Prevention and Management of Alveolar Osteitis—A Scoping Review

Ghosh

Aggarwal

Moore

2021

J of Oral Rehabilitation

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Background Alveolar osteitis (AO) is a poorly understood, common, painful complication following exodontia. It is sometimes managed by inappropriate prescription of antibiotics which contributes to the global threat of antimicrobial resistance. Use of intra‐alveolar chlorhexidine also presents a serious risk of anaphylaxis to the patient. Objective This scoping review aims to investigate the aetiology, prevention and management of AO and highlight the extent of inappropriate prescribing and intra‐alveolar chlorhexidine use. Design A scoping review was undertaken using the PRISMA guidelines. Medline, Ovid and Pubmed were searched between 2010 and 2020, from which 63 studies were selected for review that related to the aetiology, prevention or management of AO. Data were analysed for frequency of studies reporting information on risk factors for aetiology, prevention strategies and management including inappropriate management using antibiotic prescribing and intra‐alveolar chlorhexidine. Results Impaired immune response, surgical technique and age were identified as significant factors in the development of AO, while there is conflicting evidence regarding the effects of smoking and gender. With regard to prevention, the use of prophylactic antibiotics is not supported within the literature. Saline irrigation and eugenol pastes used preventively have been shown to be cheap and effective alternatives to chlorhexidine with no adverse effects. Hyaluronic acid and low‐level laser therapies showed a significant reduction in pain and soft‐tissue inflammation in the management of AO compared to Alveogyl. Conclusions Further understanding of the pathophysiology of AO is needed, in addition to large high‐quality RCTs or long‐term observational studies into the aetiology, prevention, and management of AO to produce up‐to‐date evidence‐based clinical guidelines. Clinicians should also be mindful of their contribution to growing antimicrobial resistance and avoid inappropriate prescribing of antibiotics. Saline should replace chlorhexidine as the intra‐alveolar irrigant of choice.

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Section: Resultsmentioning

confidence: 99%

Aetiology, Prevention and Management of Alveolar Osteitis—A Scoping Review

Ghosh

Aggarwal

Moore

2021

J of Oral Rehabilitation

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“…A meta-analysis studying the contribution of PRF (Platelet-rich Fibrin) in the sockets confirmed significant improvement regarding pain, edema and onset of osteitis [ 24 ]. A study demonstrated greater efficacy of irrigating the site with chlorhexidine versus saline solution and iodinated povidone on reducing postoperative pain, edema and trismus [ 25 ]. Reyes-Gilabert et al [ 26 ] identified a statistically significant association between pre- and postoperative anxiety and also between postoperative anxiety and pain in oral surgery.…”

Section: Discussionmentioning

confidence: 99%

Sutureless socket technique after removal of third molars: a multicentric, open, randomized controlled trial

Takadoum

Douilly²,

Boutray³

et al. 2022

BMC Oral Health

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Background Although wisdom-tooth extraction is a routine intervention, the postoperative period remains marked by local inflammation classically manifesting as pain, edema and trismus. Furthermore, there is no consensus on the best operative techniques, particularly for the mucosal closure stage on impacted mandibular wisdom teeth. Methods This parallel, randomized, non-blinded study compared pain following removal of impacted third molars, with and without sutures. Patients were electronically allocated 1:1 to extraction with versus without sutures. Patients ≥ 14 years’ old scheduled for extraction of four impacted wisdom teeth under general anesthesia at three French hospitals were eligible for inclusion. Exclusion criteria included taking antiplatelet agents or anticoagulants, coagulation disorders or immunosuppression, and planned orofacial surgical procedures or emergency pain/infection. The primary objective was pain evaluated by Visual Analogue Scale on Day 3. Secondary outcomes were edema, trismus, healing, complications, painkiller consumption and quality of life on Day 3 and 31. Results Between June 2016 and November 2018, 100 patients were randomized. Finally, 44 patients in the Suture group and 50 patients in the Without Suture group were analyzed. Mean age was 16.5 years and 66.6% of patients were female. After adjustment on center, age and smoking, no statistical difference was seen between groups for pain on Day 3 (p = 0.904). No differences were seen for swelling, trismus, consumption of painkillers, healing, complications or quality of life. Smokers had a 3.65 times higher complications rate (p = 0.0244). Conclusions Sutureless removal of third molars is thus a reliable technique without negative consequence on outcomes, and allows shorter operating time. Smoking is a risk factor for postoperative complications. Trial registration www.clinicaltrials.gov (NCT02583997), registered 22/10/2015

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“…Postoperative sequelae, such as pain, trismus, swelling, and chewing problems, commonly arise after tissue injury. Numerous researchers have studied the effects of various preoperative, intraoperative, and postoperative intervention strategies to avoid or decrease the degree of discomfort due to inflammation induced by tissue injury during the surgical removal of mandibular third molars [ 26 – 34 ]. Here, we demonstrated that the application of an iodine-containing tampon reduced the amount of perceived postoperative discomfort, and thus improved the OHRQoL.…”

Section: Discussionmentioning

confidence: 99%

Alveolar iodine tampon packing after impacted third molar surgery improves oral health–related quality of life and postoperative sequela: a randomized study

Lindeboom

Tuk

Möllenkamp

et al. 2020

Oral Maxillofac Surg

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Objective The aim of this study was to evaluate the effect of an iodine tampon on postoperative discomfort after surgical removal of a mandibular third molar. Material and methods Patients were randomly assigned to two groups: one group received an alveolar iodine-containing tampon in the extraction socket (N = 44), and the other group used a disposable syringe (Monoject®) to rinse the wound (N = 43). Postoperative discomfort was assessed with the Oral Health Impact Profile-14 (OHIP-14) questionnaire, Pain Intensity Numerical Rating Scale (PI-NRS), and questions about self-care and discomfort. Results This study included 87 patients (52 women and 35 men) with an average age of 26.47 years (SD, 6.36). The mean OHIP-14 sum scores were significantly lower in the iodine tampon group compared with the Monoject® syringe group. Mean PI-NRS scores significantly differed between the iodine tampon group (3.33; SE, 0.27) and Monoject® syringe group (4.46; SE, 0.27) (F (1, 85) = 8.16, p < 0.01), with no interaction effect between time and PI-NRS (F (6, 510) = 1.26, p = 0.28). Patients in the iodine tampon group reported less postoperative discomfort. Conclusions Insertion of an iodine-containing tampon in the postoperative socket reduced the pain and impact on oral healthrelated quality of life during the first postoperative week and positively influenced postoperative sequelae.

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The Efficiency of Three Irrigating Solutions after Surgical Removal of Impacted Mandibular Third Molars: A Cross-sectional Study

Cited by 13 publications

References 13 publications

Aetiology, Prevention and Management of Alveolar Osteitis—A Scoping Review

Aetiology, Prevention and Management of Alveolar Osteitis—A Scoping Review

Sutureless socket technique after removal of third molars: a multicentric, open, randomized controlled trial

Alveolar iodine tampon packing after impacted third molar surgery improves oral health–related quality of life and postoperative sequela: a randomized study

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