Does Intra-alveolar application of chlorhexadine gel in combination with PRF has advantage over PRF application in reducing Alveolar Osteitis following Mandibular Third Molar Surgery? A Double-Blind Randomized Clinical Trial

Publication date: Available online 16 December 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Majid Eshghpour, Nasrin Danaeifar, Hamed Kermani, Amir Hossein Nejat
PurposeTo evaluate the effectiveness of chlorhexidine (CHX) gel and platelet-rich fibrin (PRF) in comparison to the PRF in preventing development of alveolar osteitis (AO).Materials and MethodsIn a double blind trial, patients in need of surgical management of bilateral impacted mandibular third molars were randomly divided into two groups; one group receiving PRF in one of the extraction sockets with the other socket as control and the other group receiving 0.2% CHX gel plus PRF in one socket with the other socket serving as a control. Study and control side was unknown to both the surgeon and the patient. The predictor variables were PRF and PRF plus CHX application with categorization of PRF or non-PRF and PRF/CHX or non-PRF/CHX, respectively. The outcome variable was AO development during the first week after the surgery. Age, gender, surgical difficulty score, surgeon experience, number of anesthesia cartridges injected, and irrigation volume were other variables. Data were analyzed in SPSS software using t-test and Chi-square, with the confidence interval set at 95%.ResultsA total of 482 surgeries performed on 241 patients with a mean age of 24 years. The overall frequency of AO in all surgeries, PRF, and PRF/CHX group was 15.14, 17.37, and 13%, respectively. The frequency of AO in PRF and PRF/CHX sockets was significantly lower than the non-PRF (relative risk 0.46) and non PRF/CHX (relative risk 0.18) sockets, respectively (P < 0.05). Moreover, the risk of developing AO in PRF/CHX sockets was significantly lower than PRF sockets with the relative risk of 0.37 (P < 0.05).ConclusionAccording to the current findings, the application of CHX gel with PRF increases the efficiency of PRF in reducing the risk of AO development following surgical removal of impacted mandibular third molars.



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