A randomized clinical trial compared the effect of intra-alveolar 0.2 % Chlorohexidine bio-adhesive gel versus 0.12% Chlorohexidine rinse in reducing alveolar osteitis following molar teeth extractions

Objectives: To evaluate socket healing, incidence of acute alveolar ostieitis (AO) and associated pain following single molar tooth extraction in patients who receive intra-alveolar 0.2% chlorhexidine (CHX) gel, and those who rinsed with 0.12 % CHX rinse. Study Design: A prospective randomized clinical trial was conducted on two parallel groups of patients. Group1 (141 patients): Rinsed with 0.12 % CHX rinse from the second postoperative day, two times daily for a week. Group2 (160 patients): Who had direct intra-alveolar application of 0.2% CHX gel and day 3 post-operatively. The socket was evaluated 3 and 7 day post operatively for the presence of AO by checking probing tenderness in the socket, empty socket, food debris, halitosis and pain assessment by VAS. Results: Forty-eight AO cases were diagnosed out of 301 extractions (15.9%). In Group1, 25 cases were found (17.7%) while 23 cases were found in Group2 (14.4%). The difference was not statistically significant (p=0.428). Presence of empty socket and food debris in Group1 were higher than in Group2 but the difference was not statistically significant (p= 0.390 & p = 0.415). Occurrence of halitosis in Group2 was more than Group1, but the difference was not significant (p= 0.440). Statistical significance was found between AO in extraction done by root separation (29%) and those routinely extracted (12.3 %) (p=0.001). Conclusions: Postoperative evaluation of molar extraction sockets that received direct intra-alveolar application of 0.2% CHX gel showed insignificant less occurrence of AO when compared with 0.12 % CHX rinse. Key words:Chlorhexidine rinse, bio adhesive gel, alveolarosteitis, dry socket, molar teeth extraction, post-extraction socket.