Comparative Efficacy of Amoxicillin, Metronidazole, and Chlorhexidine in Preventing Alveolar Osteitis

Summary

This study will compare the effectiveness of amoxicillin, metronidazole, and chlorhexidine in preventing alveolar osteitis (dry socket) following lower third molar extraction. Participants will be randomly assigned to one of three groups: amoxicillin, metronidazole, or chlorhexidine. Participants will be assessed on Days 3 and 7 after extraction for the presence or absence of alveolar osteitis and postoperative pain. The study will determine whether there is a difference in the incidence of alveolar osteitis among the three treatment groups.

Timeline

Start

2026-09-25

Primary completion

2027-02-25

Completion

2027-04-20

Publications

• Background Arteagoitia MI, Barbier L, Santamaria J, Santamaria G, Ramos E. Efficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention of infection and dry socket after third molar extraction. A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2016 Jul 1;21(4):e494-504. doi: 10.4317/medoral.21139.
• Background Bergdahl M, Hedstrom L. Metronidazole for the prevention of dry socket after removal of partially impacted mandibular third molar: a randomised controlled trial. Br J Oral Maxillofac Surg. 2004 Dec;42(6):555-8. doi: 10.1016/j.bjoms.2004.06.015.
• Background Wright C, Mistry V, Smyth J, Saik WN, Innes N, Lamont T. The use of chlorhexidine in the prevention of alveolar osteitis after third molar extractions. Evid Based Dent. 2018 Mar 23;19(1):18-19. doi: 10.1038/sj.ebd.6401289.
• Background Babar A, Ibrahim MW, Baig NJ, Shah I, Amin E. Efficacy of intra-alveolar chlorhexidine gel in reducing frequency of alveolar osteitis in mandibular third molar surgery. J Coll Physicians Surg Pak. 2012 Feb;22(2):91-4.
• Background Freudenthal N, Sternudd M, Jansson L, Wannfors K. A double-blind randomized study evaluating the effect of intra-alveolar chlorhexidine gel on alveolar osteitis after removal of mandibular third molars. J Oral Maxillofac Surg. 2015 Apr;73(4):600-5. doi: 10.1016/j.joms.2014.08.035. Epub 2014 Sep 16.
• Background Teshome A. The efficacy of chlorhexidine gel in the prevention of alveolar osteitis after mandibular third molar extraction: a systematic review and meta-analysis. BMC Oral Health. 2017 May 19;17(1):82. doi: 10.1186/s12903-017-0376-3.
• Background Ramos E, Santamaria J, Santamaria G, Barbier L, Arteagoitia I. Do systemic antibiotics prevent dry socket and infection after third molar extraction? A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Oct;122(4):403-25. doi: 10.1016/j.oooo.2016.04.016. Epub 2016 May 11.

Drugs

Indications