Chlorhexidine in the prevention of dry socket: Effectiveness of different dosage forms and regimens
Por:
Minguez-Serra MP, Salort-Llorca C and Silvestre-Donat FJ
Publicada:
1 sep 2009
Ahead of Print:
1 sep 2009
Resumen:
Dry socket (DS) is a potential postoperative complication of dental
extractions. It is clinically diagnosed by the presence of a denuded
socket secondary to premature loss of the blood clot, and manifests as
slight discomfort for the patient, followed by sudden worsening with
intense or lancing pain.
Since the underlying etiology is not clear, the best treatment is
prevention. Chlorhexidine (CHX) is an antiseptic that acts upon the
bacteria of the oral cavity, and is widely used in dental practice.
Objectives: A metaanalysis is made of the different CHX treatment
regimens used for the prevention of DS, with the proposal of a
management protocol designed to maximize the efficacy of such treatment.
Material and Methods: Literature searches were made in the PubMed
Medline, Cochrane and ISI Web of Knowledge databases, crossing the
terms: alveolar osteitis, dry socket and chlorhexidine. The search was
limited to randomized or nonrandomized clinical trials.
Results: Twelve clinical trials using CHX in rinse or gel form at doses
of 0.12% or 0.2% with different administration regimens for the
prevention of DS were identified.
Conclusion: After reviewing the existing medical literature, it can be
concluded that 0.2% CHX gel, applied every 12 hours for 7 days after
extraction is the best available option for the prevention of DS.
However, this is also the most expensive option, and since CHX is not
subsidized by the Spanish public healthcare system, it occasionally may
be more advisable to use the 0.12% rinse with the same dosing regimen.
Filiaciones:
:
Stomatology Unit, Doctor Peset University Hospital, Valencia, Spain
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