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Clinical oral investigations
Jan, 2017;21 (1): 71-83.

Postoperative socket irrigation with drinking tap water reduces the risk of inflammatory complications following surgical removal of third molars: a multicenter randomized trial.

H Ghaeminia, Th J M Hoppenreijs, T Xi, J P Fennis, T J Maal, S J Bergé, G J Meijer
Author Information
  1. H Ghaeminia: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands. hossein.ghaeminia@radboudumc.nl.
  2. Th J M Hoppenreijs: Department of Oral and Maxillofacial Surgery, Rijnstate Hospital Arnhem, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands.
  3. T Xi: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
  4. J P Fennis: Department of Oral and Maxillofacial Surgery, Rijnstate Hospital Arnhem, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands.
  5. T J Maal: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
  6. S J Bergé: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
  7. G J Meijer: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
PMID: 26922634 DOI: 10.1007/s00784-016-1751-1

Abstract

OBJECTIVES: The primary aim of the present study was to evaluate the effectiveness of postoperative irrigation of the socket with drinking tap water on inflammatory complications following lower third molar removal.
MATERIAL AND METHODS: A multicenter randomized controlled trial was carried out from June 2013 to June 2014. In one arm of the study, patients were instructed to irrigate the tooth socket and surgical site with a Monoject® Curved 412 Tip Syringe (Tyco/healthcare-Kendall, Mansfield, MA, USA) with tap water. In a second arm of the study, the standard postoperative instructions did not include irrigation instructions. The incidences of alveolar osteitis and wound infection were recorded for each group and analyzed by the Fisher's exact test.
RESULTS: A total of 280 patients with 333 mandibular third molars were analyzed. According to the intention-to-treat (ITT) analysis, inflammatory complications occurred in 18 cases in the Monoject® group (11.4 %) compared to 34 cases (19.1 %) in the control group (p = 0.04). These complications were associated with significant worse outcomes regarding quality of life, pain, and trismus and caused significantly more missed days of work or study. Female gender, age >26, bone removal, deep impacted third molars, less experienced surgeons, and a high amount of debris at the surgical site were also identified as risk factors for developing inflammatory complications following lower third molar removal.
CONCLUSION: Irrigation of the surgical site with drinking tap water using a curved syringe following removal of third molars is effective in reducing the risk of inflammatory complications.
CLINICAL RELEVANCE: Water is a very accessible, cost-effective irrigant without side effects and the results from this study have proven that it can be used to reduce the risk of inflammatory complications and associated morbidity following lower third molar removal.

Keywords

Drinking water Irrigation Oral health impact profile Pain Prevention Quality of life Risk factors Trismus

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MeSH Term

Adolescent
Adult
Drinking Water
Dry Socket
Female
Humans
Male
Mandible
Molar, Third
Pain Measurement
Postoperative Complications
Risk Factors
Surgical Wound Infection
Syringes
Therapeutic Irrigation
Tooth Socket
Tooth, Impacted
Treatment Outcome

Chemicals

Drinking Water
Journal Article Multicenter Study Randomized Controlled Trial

Word Cloud

Created with Highcharts 10.0.0complicationsthirdinflammatoryremovalstudywaterfollowingtapsurgicalriskirrigationsocketdrinkinglowermolarsitegroupmolarspostoperativemulticenterrandomizedtrialJunearmpatientsMonoject®instructionsanalyzedcasesassociatedlifefactorsIrrigationOBJECTIVES:primaryaimpresentevaluateeffectivenessMATERIALANDMETHODS:controlledcarried20132014oneinstructedirrigatetoothCurved412TipSyringeTyco/healthcare-KendallMansfieldMAUSAsecondstandardincludeincidencesalveolarosteitiswoundinfectionrecordedFisher'sexacttestRESULTS:total280333mandibularAccordingintention-to-treatITTanalysisoccurred18114 %compared34191 %controlp = 004significantworseoutcomesregardingqualitypaintrismuscausedsignificantlymisseddaysworkFemalegenderage>26bonedeepimpactedlessexperiencedsurgeonshighamountdebrisalsoidentifieddevelopingCONCLUSION:usingcurvedsyringeeffectivereducingCLINICALRELEVANCE:Wateraccessiblecost-effectiveirrigantwithoutsideeffectsresultsprovencanusedreducemorbidityPostoperativereducesmolars:DrinkingOralhealthimpactprofilePainPreventionQualityRiskTrismus

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