Cb. Hermesch et al., PERIOPERATIVE USE OF 0.12-PERCENT CHLORHEXIDINE GLUCONATE FOR THE PREVENTION OF ALVEOLAR OSTEITIS - EFFICACY AND RISK FACTOR-ANALYSIS, Oral surgery, oral medicine, oral pathology, oral radiology and endodontics, 85(4), 1998, pp. 381-387
Citations number
42
Categorie Soggetti
Pathology,Surgery,"Dentistry,Oral Surgery & Medicine
Objectives. The purposes of this study were to evaluate the use of 0.1
2% chlorhexidine gluconate as a prophylactic therapy for the preventio
n of alveolar osteitis and to further examine subject-based risk facto
rs associated with alveolar osteitis. Design. The trial was a randomiz
ed, double-blind, placebo-controlled, parallel-group study conducted a
mong 279 subjects, each of whom required oral surgery for the removal
of a minimum of one impacted mandibular third molar. Subjects were ins
tructed to rinse twice daily with 15 ml of chlorhexidine or placebo mo
uthrinse for 30 seconds for 1 week before and 1 week after the surgica
l extractions. This regimen included a supervised presurgical rinse. A
lveolar osteitis diagnosis was based on the subjective finding-of incr
easing postoperative pain at the surgical site that was not relieved w
ith mild analgesics, supported by clinical evidence of one or more of
the following: loss of blood clot, necrosis of blood clot, and exposed
alveolar bone. Results. In comparison with use of the placebo mouthri
nse, prophylactic use of the chlorhexidine mouthrinse resulted in stat
istically significant (p < 0.05) reductions in the incidence of alveol
ar osteitis. With chlorhexidine therapy, the subject-and extraction-ba
sed incidences of alveolar osteitis in the evaluable subset(271 subjec
ts) were reduced, relative to placebo, by 38% and 44%, respectively. T
he corresponding odds ratios that describe the increased odds of exper
iencing alveolar osteitis in the placebo group were 1.87 and 2.05 for
subject-and extraction-based analyses, respectively. In comparison wit
h nonuse of oral contraceptives, the use of oral contraceptives in fem
ale subjects was related to a statistically significant increase in th
e incidence of alveolar osteitis (odds ratio = 1.92, p = 0.035). Relat
ive to male subjects, the observed incidence of alveolar osteitis for
female subjects not using oral contraceptives was not statistically si
gnificant (odds ratio = 1.18, p = 0.64). Smoking did not increase the
incidence of alveolar osteitis relative to not smoking (odds ratio = 1
.20, p = 0.33). Conclusions. These data confirm that the prophylactic
use of 0.12% chlorhexidine gluconate mouthrinse results in a significa
nt reduction in the incidence of alveolar osteitis after the extractio
n of impacted mandibular third molars. In addition, oral contraceptive
use in females was confirmed to be a risk factor for the development
of alveolar osteitis.