The combination of oral amoxicillin plus clavulanic acid and chlorhexidine rinses reduces the incidence of alveolar osteitis associated with the extraction of mandibular third molars

Summary Subjects A total of 177 patients, 82 males and 95 females, with a 0689 mean age of 24 years participated in the study. One mandibular third molar was removed from each patient. Exposure Patients were randomly divided into 3 groups. One0689 group rinsed with chlorhexidine before removal of the tooth and twice daily for 7 days following the extraction. A second group also rinsed with chlorhexidine but was also prescribed 500 mg amoxicillin plus 125 mg clavulanic acid twice daily for 5 days following the extraction. A third control group rinsed with sterile saline alone. Main outcome measure The presence of alveolar osteitis was determined at 30689 and 7 days after third molar removal. Alveolar osteitis was diagnosed when the patient reported pain that was unrelieved by paracetamol (acetaminophen) and exposed bone or necrotic tissue was present at the site of the tooth extraction. Main results The incidence of alveolar osteitis was 20.9% in the0689 chlorhexidine-rinse-only group, 8.9% in the chlorhexidine/amoxicillin-plus-clavulanic-acid group, and 23.7% in the saline-rinse-only group. The incidence of alveolar osteitis was significantly less ( P = .001, χ 2 test) in the group that rinsed with chlorhexidine and received the antibiotic. Chlorhexidine rinse alone did not significantly reduce the incidence of dry socket as compared with the control group.