Does Chlorhexidine Prevent Alveolar Osteitis After Third Molar Extractions? Systematic Review and Meta-Analysis

Area of Science:

• Oral Surgery
• Pharmacology
• Evidence-Based Dentistry

Background:

• Alveolar osteitis (AO) is a common complication following dental extractions.
• Chlorhexidine is a widely studied antiseptic for AO prevention.
• Its efficacy in third molar extraction cases requires systematic evaluation.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of chlorhexidine in preventing AO post-third molar extraction.
• To assess chlorhexidine's effectiveness across different formulations, concentrations, and regimens.

Main Methods:

• Searched databases and references up to December 2015 for randomized controlled trials (RCTs).
• Included RCTs using chlorhexidine for AO prevention.
• Analyzed data using a fixed-effects model, calculating risk ratios and 95% confidence intervals.

Main Results:

• Included 18 RCTs with 2,824 third molar extractions.
• Overall relative risk for AO was 0.53 (95% CI, 0.45-0.62), indicating significant prevention.
• No significant difference in efficacy between chlorhexidine rinse and gel; no increased adverse reactions.

Conclusions:

• Chlorhexidine is efficacious and effective in preventing AO after third molar extractions, regardless of formulation.
• Chlorhexidine gel demonstrated slightly greater efficacy compared to the rinse formulation.
• The use of chlorhexidine is recommended for AO prevention in this patient group.