This review of antibiotic prophylactic treatments in relation to the risk of developing dry socket (DS) and site-specific infection (SSI) after lower third molar extraction included 16 RCTs. Antibiotic did reduce the risk of DS and SSI in health patients but the number needed to treat (NNT) was high so the use should be considered only after a careful assessment of an individual patient’s risk.
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This Cochrane review update looked at local interventions used for the prevention and treatment of alveolar osteitis (dry socket) following tooth extraction. 49 RCTs were included providing moderate certainty evidence for chlorhexidine rinses and gel for probably reduction in dry sockets.
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This review and infection of dry socket after third molar surgery identified 58 RCTs of whihc 34 contributed to a meta-analyses. The findings indicated that metronidazle and amoxicillin did reduce infection but the findings were of low certainty.
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This review of the effectiveness of leukocyte-and platelet-rich fibrin (L-PRF) and advanced-platelet-rich fibrin (A-PRF) in mandibular third molar extraction included 10 RCTs. While the findings suggest some benefits the studies are small and limited in number so the findings should be interpreted cautiously.
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This review of the effectiveness of warm saltwater mouthwashes in preventing incidence of dry socket following tooth extraction included 8 RCTs. Only one of the included studies was considered to be at low risk of bias with the findings indicting that saltwater was more effective than no moutwash but less effective than chlorhexidine.
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This Cochrane review update of the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions included 23 studies. There was very-low certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction compared to placebo.
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This Cochrane review upate compares the relative benefits and risks of different techniques for surgical removal of mandibular wisdom teeth. While the review includes 25 new trials the quality of the studies was variable with many having biases that could have influenced the findings so no meaningful conclusions could be drawn.
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This review of the effectiveness of platelet-rich fibrin (PRF) in reducing postoperative complications of third molar surgery included 10 small RCTs suggesting that PRF may reduce but not prevent some complications.
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This review of the effectiveness of chlorhexidine gel for the prevention of alveolar osteitis (AO) included 10 trials published since 2010. The findings suggest a 57% reduction in incidence of AO similar to other reviews of this topic.
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This review of the effectiveness of chlorhexidine for prevention of dry socket after third molar removal includes 18 RCTs. The finding suggest a 47% (95%CI,38-55) reduction in cases following its use.
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