Bioadhesive chlorhexidine gel for reduction of alveolar osteitis incidence: Systematic review and meta-analysis of randomized controlled trials

Introduction: Alveolar osteitis (AO) creates severe and self-limiting pain, which needs to be treated with several postoperative visits, leading to increases in patient′s morbidity and costs. Hence, the most basic and best treatment could be prevention. The aim of this study was to investigate the efficacy of bioadhesive chlorhexidine (CHX) gel in reducing AO occurrence with published studies. Materials and Methods: Medline/PubMed, Scopus, EBSCO, Ovid and Cochrane central registry for control trial were searched up to 28 February 2014 using "alveolar osteitis" and "chlorhexidine" as key words for systematic review and meta-analysis. Inclusion criteria were prospective and randomized controlled trials (RCTs) published on this topic. From the chosen studies, the eligible articles were reviewed. Data were analyzed using Review Manager 5.2 software. Results: Out of 43 studies, seven eligible trials with 593 participants were selected. Bioadhesive 0.2% CHX gel prevented approximately 72% of AO (Odd ratio (OR) = 0.28, 95% confidence Interval (CI): 0.18-0.44; P < 0.001). Conclusion: Bioadhesive 0.2% CHX gel may be effective as a post-medication to reduce incidence of AO