Effectiveness of 1% versus 0.2% chlorhexidine gels in reducing alveolar osteitis from mandibular third molar surgery: a randomized, double-blind clinical trial

Abstract

Purpose: Alveolar osteitis (AO) is the most common postoperative complication of dental extractions. The purpose of this study was to compare the effectiveness of 1% versus 0.2% chlorhexidine (CHX) gel in reducing postoperative AO after surgical extraction of mandibular third molars, and assess the impact of treatment on the Oral HealthRelated Quality of Life (OHRQoL).

Material and methods: This clinical study was a randomized, double-blind clinical trial. Eighty eight patients underwent surgical extraction of one retained mandibular third molar with the intra-alveolar application of 0.2% CHX gel. Afterwards, they were assigned to one of two groups: 1% CHX gel (n=42) or 0.2% CHX gel (n=46). The patients applied the gel twice a day to the wound for one week. All patients were evaluated for AO.

Results: In the 0.2% CHX gel group, 13% of AO incidence was found, while in the 1% CHX gel group, AO incidence was 7%, a difference that was not statistically significant. Variables such as sensation of pain and inflammation at baseline and during one week, as well as OHRQoL of the patients at 24 hours and 7 days post-extraction, gave no statistically significant differences.

Conclusions: There are no significant differences in AO after surgical extraction of mandibular third molars, when comparing applying 1% CHX gel twice a day for 7 days with 0.2% CHX gel.

Figure 1

Pain and inflammation, from pre-extraction (day 0) to day 7. Continuous lines refer to group CHX 1%, and discontinuous lines to group CHX 0.2%. Inflammation for days 3 to 6 are extrapolations (not collected). Comparisons between the two groups are non-significant (p>0.05, Mann-Whitney test) for all variables and for all times. All measurements within each line are significantly higher than basal measurements (p<0.05, Wilcoxon’s test).

Figure 2

Maximum bucal aperture at pre-extraction (day 0), days 1, 2 and 7. Continuous lines refer to group CHX 1%, and discontinuous lines to group CHX 0.2%. Comparisons between the two groups are non-significant (p>0.05, Mann-Whitney test) for all variables and for all times. All measurements within each line are significantly lower than basal measurements (p<0.05, Wilcoxon’s test).

Figure 3

Different facial measurements from mandibular angle, from pre-extraction (day 1) to day 7. Continuous lines refer to group CHX 1%, and discontinuous lines to group CHX 0.2%. Comparisons between both groups are non-significant (p>0.05, Mann-Whitney test) for all variables and for all times. All measurements within each line are significantly higher than basal measurements (p<0.05, Wilcoxon’s test), except for MAB at day 7 (p=0.085).