Effectiveness of immediate post-extraction socket irrigation with chlorhexidine, povidone-iodine, and normal saline on pain and wound healing in intra-alveolar extraction

Introduction: Tooth extraction is a common dental procedure. Immediate post extraction irrigation (IPEI) is done to remove tissue debris, metabolic waste, and tissue exudate to reduce microbial burden. However, due to insufficient clinical trials of high- quality evidence, there are still contradictions around IPEI. Aims: This random clinical trial was conducted to 1. Compare pain between groups undergoing IPEI with normal saline (NS), 0.12% chlorhexidine gluconate (CG) and 0.5% povidone iodine (PI). 2. To measure the effect of gender, age, ASA category and clinical status of tooth being extracted on pain, and 3. Compare wound healing between the three groups. Materials and Methods: Eligible patients (n=69) were randomly assigned to three groups (n=23). IPEI was done with either NS, CG or PI. Two primary outcomes were assessed- Pain (VAS score, 0-10) on post operative day (POD) 3, 5 and 7 and wound healing on POD 7. Results: Kruskal-Wallis test conducted for age, pain score and pain score difference, which indicated that all three were comparable across the groups at the assessed time points. Multivariate analysis revealed that none of the covariates had a statistically significant effect on the pain score difference between POD 7-3 and POD 5-3. However, the type of irrigating solution used approached significance in both models. Kruskal-Wallis test showed no significant difference between wound healing scores across the three groups. Conclusion: There was no difference in pain scores or difference in pain scores across the three groups at the assessed time points. The gender, age, ASA category and clinical status of the tooth being extracted had no significant effect on pain. There was no difference in wound healing scores across the 3 groups.