Rubio-Palau Josep, Garcia-Linares Jordi, Hueto-Madrid Juan-Antonio, González-Lagunas Javier, Raspall-Martin Guillermo, Mareque-Bueno Javier
Hospital Clínic de Barcelona, C/ Villarroel 170. Escala 4, planta 2, 08036, Barcelona. Spain,
Med Oral Patol Oral Cir Bucal. 2015 Jan 1;20(1):e117-22. doi: 10.4317/medoral.20009.
Alveolar osteitis (AO) is a common complication after third molar surgery. One of the most studied agents in its prevention is chlorhexidine (CHX), which has proved to be effective.
The aim of this randomized double-blind clinical trial was to evaluate the efficacy of 0.2% bioadhesive chlorhexidine gel placed intra-alveolar in the prevention of AO after the extraction of mandibular third molars and to analyze the impact of risk factors such as smoking and oral contraceptives in the development of AO.
The study was a randomized, double-blind, clinical trial performed in the Ambulatory Surgery Unit of Hospital Vall d'Hebron and was approved by the Ethics Committee. A total of 160 patients randomly received 0.2% bioadhesive gel (80 patients) or bioadhesive placebo (80 patients).
0.2% bioadhesive chlorhexidine gel applied in the alveolus after third molar extraction reduced the incidence of dry socket by 22% compared to placebo with differences that were not statistically significant. Smoking and the use of oral contraceptives were not related to higher incidence of dry socket. Female patients and the difficulty of the surgery were associated with a higher incidence of AO with statistically significant differences. 0.2% bioadhesive chlorhexidine gel did not produce any of the side effects related to chlorhexidine rinses.
A 22% reduction of the incidence of alveolar osteitis with the application of 0.2% bioadhesive chlorhexidine gel compared to placebo with differences that were not statistically significant was found in this clinical trial. The lack of adverse reactions and complications related to chlorhexidine gel supports its clinical use specially in simple extractions and adds some advantages compared to the rinses in terms of duration of the treatment and reduction of staining and taste disturbance.
牙槽骨炎（AO）是第三磨牙手术后常见的并发症。在其预防方面研究最多的药物之一是氯己定（CHX），已证明其有效。
本随机双盲临床试验旨在评估牙槽内放置0.2%生物黏附性氯己定凝胶预防下颌第三磨牙拔除后AO的疗效，并分析吸烟和口服避孕药等危险因素对AO发生的影响。
该研究是在巴塞罗那瓦尔德希伯伦医院门诊手术部进行的一项随机、双盲临床试验，已获伦理委员会批准。共有160例患者随机接受0.2%生物黏附性凝胶（80例患者）或生物黏附性安慰剂（80例患者）。
与安慰剂相比，第三磨牙拔除后在牙槽内应用0.2%生物黏附性氯己定凝胶使干槽症的发生率降低了22%，但差异无统计学意义。吸烟和口服避孕药与干槽症较高的发生率无关。女性患者和手术难度与AO较高的发生率相关，差异有统计学意义。0.2%生物黏附性氯己定凝胶未产生与氯己定冲洗相关的任何副作用。
本临床试验发现，与安慰剂相比，应用0.2%生物黏附性氯己定凝胶使牙槽骨炎的发生率降低了22%，但差异无统计学意义。氯己定凝胶缺乏不良反应和并发症支持其临床应用，特别是在简单拔牙中，并且与冲洗相比，在治疗持续时间、减少染色和味觉干扰方面具有一些优势。
