Preventing Alveolar Osteitis After Molar Extraction Using Chlorhexidine Rinse and Gel: A Meta-Analysis of Randomized Controlled Trials

Chia-Hui WANG; Shu-Hui YANG; Hsiu-Ju JEN; Jui-Chen TSAI; Hsi-Kuei LIN; El-Wui LOH

doi:10.1097/jnr.0000000000000401

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Preventing Alveolar Osteitis After Molar Extraction Using Chlorhexidine Rinse and Gel: A Meta-Analysis of Randomized Controlled Trials

Chia-Hui WANG ； Shu-Hui YANG ； Hsiu-Ju JEN ； Jui-Chen TSAI ； Hsi-Kuei LIN ； El-Wui LOH

The Journal of Nursing Research ； 29 卷 1 期 (2021 / 02 / 01) ， P1 - 11

英文 DOI： 10.1097/jnr.0000000000000401

chlorhexidine ； rinse ； gel ； alveolar osteitis

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摘要 │ 参考文献 (49) │ 国际计量

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Background: Alveolar osteitis (AO) may occur after molar extraction. Chlorhexidine (CHX) rinse and CHX gel are widely used to prevent AO. Although previous meta-analyses support the effectiveness of both CHX rinse and CHX gel in preventing AO, important issues regarding these two formulations have not been addressed adequately in the literature. Purpose: A systematic review and meta-analysis of randomized controlled trials was conducted to determine the effectiveness of CHX rinse and CHX gel in preventing AO. Methods: PubMed, EMBASE, SCOPUS, and Cochrane databases were searched for randomized controlled trials published before June 2018. The risk ratio (RR) was used to estimate the pooled effect of AO incidence using a random-effect model. Results: The RRs of AO in patients treated with 0.12%CHX rinse (RR = 0.54, 95% CI [0.41, 0.72]) and 0.2%CHX rinse (RR = 0.84, 95% CI [0.52, 1.35]) were significantly lower than in those treated with the control. Moreover, a significantly lower RR was identified in patients treated with 0.2% CHX gel (RR = 0.47, 95% CI [0.34, 0.64]) than in those treated with the control. When CHX products of different concentrations were grouped together, patients treated with CHX rinse showed an RR of AO of 0.61 (95% CI [0.48, 0.78]) and those treated with CHX gel showed an RR of AO of 0.44 (95% CI [0.43, 0.65]). On the other hand, a meta-analysis of three trials that compared CHX rinse and CHX gel directly showed a significantly lower RR of AO in patients treated with CHX rinse than in those treated with CHX gel (RR = 0.56, 95%CI [0.34, 0.96]). Conclusions/Implications for Practice: The results support the effectiveness of both CHX rinse and gel in reducing the risk of AO after molar extraction. Each formulation provides unique benefits in terms of ease of application and cost. On the basis of the results of this study, the authors recommend that CHX gel be used immediately after molar extraction because of the convenience and cost-effectiveness of this treatment and that CHX rinse be used by the patient after discharge at home in combination with appropriate health education and case management.

参考文献 ( 49 ) 〈TOP〉

Abu Younis, M. H.,Abu Hantash, R. O.(2011).Dry socket: Frequency, clinical picture, and risk factors in a Palestinian dental teaching center.Open Dentistry Journal,5,7-12.
Abu-Mostafa, N. A.,Alqahtani, A.,Abu-Hasna, M,Alhokail, A.,Aladsani, A.(2015).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.Medicina Oral Patología Oral y Cirugía Bucal,20(1),e82-e87.
Ahmedi, J.,Ahmedi, E.,Agani, Z.,Hamiti, V.,Reçica, B.,Tmava-Dragusha, A.(2014).The efficacy of 1% chlorhexidine gel on the reduction of dry socket occurrence following surgical thirdmolar extraction-pilot study.Open Journal of Stomatology,4(3),152-160.
Babar, A.,Ibrahim, M. W.,Baig, N. J.,Shah, I.,Amin, E.(2012).Efficacy of intra-alveolar chlorhexidine gel in reducing frequency of alveolar osteitis in mandibular third molar surgery.Journal of the College of Physicians and Surgeons-Pakistan,22(2),91-94.
Balagopal, S.,Arjunkumar, R.(2013).Chlorhexidine: The gold standard antiplaque agent.Journal of Pharmaceutical Sciences and Research,5(12),270-274.

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