Effects of lavage techniques with third molar surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Site Infection Prevention
• Wound Healing

Background:

• Postoperative complications such as localized osteitis and infection are common after mandibular third-molar extraction.
• Current irrigation techniques aim to reduce these complications but vary in efficiency and ease of use.

Purpose of the Study:

• To compare the efficacy of mechanical pulsating lavage versus conventional hand syringe irrigation in preventing localized osteitis and infection following mandibular third-molar surgery.
• To evaluate the impact of irrigation method on surgical site cleanliness and procedure time.

Main Methods:

• A comparative study involving 206 patients undergoing mandibular third-molar surgery.
• Surgical sites were irrigated with 350 ml of isotonic normal saline solution using either a mechanical pulsating lavage instrument or a conventional hand syringe.
• Outcomes including localized osteitis, infection, and wound healing at 3 and 5 days were assessed.

Main Results:

• Mechanical lavage resulted in 0% localized osteitis and 0.97% infection, compared to 0.97% localized osteitis and 1.96% infection with conventional irrigation.
• Mechanical lavage was significantly faster (30 seconds vs. 4-5 minutes) and more effective in removing loose tissue and bony spicules.
• No significant differences in 3- and 5-day healing were observed between the groups.

Conclusions:

• High-volume irrigation with isotonic normal saline, particularly using mechanical pulsating lavage, effectively reduces the incidence of localized osteitis and infection after mandibular third-molar surgery.
• Mechanical lavage offers advantages in speed and debridement efficiency over conventional methods.
• This technique provides a viable antibiotic-free approach to managing surgical sites.