Prevention of Alveolar Osteitis in Surgical Removal of Lower Third Molar

The purpose of this study was to evaluate and compare the efficacy of chlorhexidine (CHX) and amoxicillin plus clavulanic acid combination with control and Chlorhexidine CHX rinse alone for prevention of alveolar ostitis following the extraction of mandibular third molar. This clinical double blind randomized control trial was carried out in the Department of Oral and Maxillofacial Surgery at Liaquat University Hospital, Hyderabad for a period of two years from February 2008 to December 2009. A total of 214 patients were included in the study using nonprobability purposive sampling technique. Informed consent was taken for participation in studyand all treatment options, risks, benefits and complications were discussed before any intervention. The study was approved by university ethical review committee. All the patients were randomly divided into three groups by using random number table. After written informed consent extraction of 3rd mandibular molar was performed. Group1 rinsed with 15 ml of 0.2% Chlorhexidine solution for 30 seconds twice daily for seven days. Group 2 patients in addition to 0.2% Chlorhexidine solution were prescribed Augmentin (amoxicillin trihydrate 500 mg plus, clavulanic acid (125 mg)) twice daily for 7 days. The patients of Group 3 used normal saline solution (0.09 % NaCl). Patients were scheduled on third and seventh day postoperatively for postoperative follow-up and were evaluated for the presence or absence of alveolar osteitis. The diagnosis of alveolar osteitis was made on the basis of collaborative clinical and subjective findings. The results of this study showed significant reduction in the incidence of alveolar osteitis in patients who received 0.2% CHX rinse in combination with oral amoxicillin and clavulanic acid.