Key Points
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A previous history of alveolar osteitis predisposed the patient to painful post-operative complications following molar or premolar tooth extraction.
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Topical metronidazole gel was ineffective in preventing either alveolar osteitis or the patient returning with pain.
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Complications following tooth extraction are significantly less in those aged 50 years and over compared with those less than 50 years of age.
Abstract
Objective The purpose of the study was to determine if the intra-alveolar application of topical metronidazole gel could reduce the incidence of alveolar osteitis (dry socket) following routine tooth extraction in molar and premolar extraction sites.
Design This was a multicentre, double blind, randomised, placebo-controlled clinical trial. A total of 302 patients took part, of which 23 returned with alveolar osteitis. Of these, eight had received the metronidazole gel and 15 the placebo.
Setting The study was carried out in three general dental practices by general dental practitioners working in England over the period 2000-2003.
Main outcome measures Following extraction of either a molar or premolar tooth, either a 25% metronidazole gel or KY Jelly was syringed gently into the socket. A painful post operative complication was recorded if either a dry socket was present or the patient returned with pain.
Results and conclusions The difference in the incidence of alveolar osteitis between the placebo and the active gel groups was not significant and it was concluded that 25% topical metronidazole gel was not effective in reducing the incidence of alveolar osteitis. It was found that the incidence of alveolar osteitis reduced with increasing age and was more likely to occur in a patient with a previous history of the condition.
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This study was supported by a grant from the Oral and Dental Research Trust.
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Reekie, D., Downes, P., Devlin, C. et al. The prevention of 'dry socket' with topical metronidazole in general dental practice. Br Dent J 200, 210–213 (2006). https://doi.org/10.1038/sj.bdj.4813253
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DOI: https://doi.org/10.1038/sj.bdj.4813253
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