Abstract
BackgroundTo evaluate the effects of intraalveolar placement of gel containing 0.2% chlorhexidine and 10gm of metronidazole on the incidence of alveolar osteitis.Material and MethodsA total of 300 impacted third molars were extracted in 150 patients enrolled in this trial. In each subject a socket was randomly selected and packed to the crest of alveolar ridge with the gel. The contralateral socket was packed with placebo dressing. The occurrence of dry socket was assessed during 3rd and 5th postoperative days .The data was analysed using a meta analytical program. Study Design Double blind, prospective, placebo controlled trial.ResultsThe combination of metronidazole + chlorhexidine gel significantly reduced dry socket incidence from 22.6% to 6.6% (P ≤ 0.001) [McNemar and chi-square tests].ConclusionsThe decrease in incidence of adverse reactions and complications related to local application of metronidazole and chlorhexidine gel explains its clinical use, specifically in mandibular molar extractions where the chances of dry sockets are high. Key words:Chlorhexidine, dry socket, intra-alveolar, metronidazole, placebo.
Highlights
Removal of impacted third molar is the most consistently performed procedure in oral and maxillofacial surgery
Brin suggested that increased fibrinolysis lead to disintegration of clot which is responsible for alveolar osteitis
Since microorganisms are involved in the etiology of alveolar osteitis, the effective treatment approach is application of antibiotics and antiseptics
Summary
Removal of impacted third molar is the most consistently performed procedure in oral and maxillofacial surgery. On the contrary chlorhexidine is a biguanide antiseptic used as a mouthwash or bioadhesive gel It is active against a wide variety of aerobic/ anaerobic oral pathogens. As there hasn’t been much information about the use and effects of these two drugs in combination especially as local application, this present study aims to assess the effects of intraalveolar application of chlorhexidine and metronidazole gel on the incidence of alveolar osteitis which is first time reported of its kind of studies. To evaluate the effects of intraalveolar placement of gel containing 0.2% chlorhexidine and 10gm of metronidazole on the incidence of alveolar osteitis. Conclusions: The decrease in incidence of adverse reactions and complications related to local application of metronidazole and chlorhexidine gel explains its clinical use, in mandibular molar extractions where the chances of dry sockets are high
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