Assessment of the Efficacy of 0.12% Chlorhexidine Gluconate Mouth Rinse in Preventing Alveolar Osteitis Following Mandibular Molar Extraction

评估0.12%葡萄糖酸氯己定漱口水预防下颌磨牙拔除后牙槽骨炎的疗效

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Abstract

BACKGROUND: Alveolar osteitis (AO) is a common, painful post-extraction complication, particularly following mandibular molar removal. Clinicians widely recommend 0.12% chlorhexidine (CHX) mouth rinse to prevent AO, but studies on its use in non-surgical extractions with early wound healing assessment are still limited. AIM: The study aims to assess the efficacy of 0.12% CHX gluconate mouth rinse in preventing AO and enhancing early soft tissue healing after non-surgical mandibular molar extraction. MATERIALS AND METHODS: A prospective, randomized controlled trial enrolled 60 adult patients, equally allocated to a study group (0.12% CHX rinse, twice daily for seven days starting 24 hours postoperative) and a control group (standard care, no rinse). AO was diagnosed on days three and seven. Early wound healing was evaluated on day seven via the Early Wound Healing Score (EWHS), assessing clinical signs of re-epithelialization (CSR), clinical signs of hemostasis (CSH), and clinical signs of inflammation (CSI). Statistical analysis used Fisher's exact test for AO incidence and the Mann-Whitney U test for EWHS (p<0.05, significant). RESULTS: The CHX group recorded zero AO cases (100% success) compared with four cases (13.33%) in controls (p=0.041). Mean EWHS was higher in the study group (7.33 ± 2.12 vs. 6.73 ± 2.36; p=0.198, not significant). About 53.3% of cases in the CHX group achieved excellent healing compared with 36.7% in the control group, with zero poor-healing cases compared with 13.3% in the control group. CSR scores were significantly higher (4.13 vs. 3.60), indicating enhanced epithelialization, while CSH and CSI scores were comparable between groups. CONCLUSION: Postoperative use of 0.12% CHX mouth rinse is highly effective in preventing AO and demonstrates a clinically meaningful improvement in early epithelial wound healing. Its simplicity, low cost, and high patient compliance make it an ideal prophylactic strategy for routine clinical implementation.

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