Chlorhexidine Versus Normal Saline Socket Irrigation for Prevention of Dry Socket After Lower Wisdom Tooth Extraction

NCT07814430 | Active Not Recruiting DMC

• 1 other identifier: 228/ERC/CMH/LMC
• Study Type: interventional
• Target: 174
• Locations: 1 country
• Sites: 1

Brief Summary

Dry socket, also called alveolar osteitis, is a painful complication that can occur after tooth extraction, particularly following removal of impacted lower wisdom teeth. It occurs when the blood clot that normally forms in the extraction socket is lost or breaks down, resulting in pain and delayed healing. This study will compare two solutions used to irrigate the extraction socket immediately after removal of an impacted lower wisdom tooth: normal saline and chlorhexidine. The study will determine whether immediate socket irrigation with chlorhexidine reduces the frequency of dry socket compared with normal saline. A total of 174 eligible patients undergoing surgical extraction of impacted lower wisdom teeth will be randomly assigned to receive either normal saline or chlorhexidine for immediate post-extraction socket irrigation. Participants will not be informed which irrigation solution they receive. The extraction will be performed by a single surgeon, and postoperative assessment will be performed by a co-researcher. Participants will be assessed for signs and symptoms of dry socket on postoperative days 2, 3, and 5. The occurrence of dry socket will be determined using predefined clinical criteria, including pain, trismus, halitosis, gingival inflammation, exposed or bare bone, radiating pain, and ipsilateral lymphadenopathy. The study will compare the frequency of dry socket between the chlorhexidine and normal saline groups. The findings may help determine whether chlorhexidine is more effective than normal saline for reducing the occurrence of dry socket after surgical extraction of impacted lower wisdom teeth.

Conditions

Alveolar Osteitis; Impacted Lower Third Molar

Keywords

Alveolar osteitis; Dry socket; Chlorhexidine; Normal saline; Socket irrigation

Outcome Measures

Primary Outcomes (1)

• Frequency of Alveolar Osteitis (Dry Socket)

  The frequency of alveolar osteitis (dry socket) will be assessed in participants following surgical extraction of an impacted lower third molar. Alveolar osteitis will be diagnosed when at least three predefined clinical criteria are present, including mild to severe postoperative pain, trismus, halitosis, inflamed or hyperaemic gingiva, exposed or bare bone with an empty socket, radiating pain to the ear or temporal region, and ipsilateral lymphadenopathy. The number and percentage of participants developing alveolar osteitis will be compared between the chlorhexidine and normal saline groups.

  Postoperative days 2, 3, and 5

Secondary Outcomes (2)

• Postoperative Pain Intensity

  Postoperative days 2, 3, and 5

• Postoperative Trismus

  Postoperative days 2, 3, and 5

Study Arms (2)

Chlorhexidine Socket Irrigation

EXPERIMENTAL

Participants allocated to the experimental group will undergo surgical extraction of an impacted lower third molar under local anaesthesia. Immediately after extraction, the extraction socket will be irrigated with chlorhexidine according to the study protocol, followed by socket closure with silk suture. Participants will receive the same postoperative instructions and medications as the comparator group. Postoperative assessment for alveolar osteitis will be performed on days 2, 3, and 5.

Procedure: Chlorhexidine Socket Irrigation

Normal Saline Socket Irrigation

ACTIVE COMPARATOR

Participants allocated to the comparator group will undergo surgical extraction of an impacted lower third molar under local anaesthesia. Immediately after extraction, the extraction socket will be irrigated with normal saline according to the study protocol, followed by socket closure with silk suture. Participants will receive the same postoperative instructions and medications as the experimental group. Postoperative assessment for alveolar osteitis will be performed on days 2, 3, and 5.

Procedure: Normal Saline Socket Irrigation

Interventions

Chlorhexidine Socket Irrigation PROCEDURE

Immediate post-extraction irrigation of the surgical extraction socket with chlorhexidine following removal of an impacted lower third molar. The allocated chlorhexidine solution will be applied immediately after extraction and before socket closure with silk suture. The extraction will be performed under local anaesthesia by a single surgeon. The concentration and volume of chlorhexidine will be administered according to the study protocol.

Chlorhexidine Socket Irrigation

Normal Saline Socket Irrigation PROCEDURE

Immediate post-extraction irrigation of the surgical extraction socket with normal saline following removal of an impacted lower third molar. The allocated normal saline solution will be applied immediately after extraction and before socket closure with silk suture. The extraction will be performed under local anaesthesia by a single surgeon. The volume of normal saline will be administered according to the study protocol.

Normal Saline Socket Irrigation

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged 18 to 50 years.
• Patients requiring surgical extraction of an impacted lower third molar (lower wisdom tooth).
• Impacted lower third molars classified as having slight to moderate difficulty according to Pederson's scale.
• Patients classified as American Society of Anesthesiologists (ASA) physical status I or II.
• Patients of either biological sex.
• Patients who provide written informed consent to participate in the study.

You may not qualify if:

• Systolic blood pressure ≥160 mmHg.
• Diastolic blood pressure ≥100 mmHg.
• Current smokers.
• Alcohol use.
• Patients with muscular diseases.
• Patients currently taking antibiotics or anti-inflammatory medications.
• Patients with physical or mental disabilities that would prevent participation in the study or completion of follow-up assessments.
• Patients requiring extraction without bony osteotomy.
• Deep or very difficult impactions according to Pederson's scale.

Sponsors & Collaborators

• CMH Lahore Medical College and Institute of Dentistry: lead

Study Sites (1)

CMH Lahore

Lahore, Pakistan

Location

MeSH Terms

Conditions

Dry Socket

Condition Hierarchy (Ancestors)

Mouth Diseases; Stomatognathic Diseases

Study Officials

• Asad A Chatha, BDS, FCPS

  CMH Lahore Medical College and Institute of Dentistry

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants will be unaware of their assigned socket irrigation solution. The outcome assessor will also be blinded to group allocation during postoperative assessment.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will be randomly assigned in a 1:1 ratio to one of two parallel intervention groups and followed prospectively for development of alveolar osteitis after extraction.

Study Record Dates

• First Submitted: September 5, 2026
• First Posted: September 11, 2026
• Study Start: February 14, 2026
• Primary Completion: October 4, 2026
• Study Completion (Estimated): October 28, 2026
• Last Updated: September 14, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)