Comparison of the effect of Carvacrol gel, and Chlorhexidine in reducing postoperative pain, and dry socket after surgical removal of impacted mandibular third molars- a clinical trial

Abstract

Background: Extraction of impacted wisdom teeth is one of the most commonly performed oral surgeries, and dry socket is the most common complication following tooth extraction thereby studied in dentistry. Considering that the effects of carvacrol gel on reducing pain and preventing the incidence of dry socket after impacted mandibular third molar surgery had not been investigated, therefore, the aim of the present study was to compare the effect of carvacrol gel with chlorhexidine on reducing pain and the incidence of dry socket following impacted mandibular third molar surgery. Materials and Methods: This study was conducted on 58 candidates for impacted mandibular third molar surgery in Tabriz faculty of dentistry. The patients were randomly divided into 4 groups using permutation block method: group 1(control, no mouthwash), group 2 (rinsing with chlorhexidine mouthwash before surgery), group 3 (placing carvacrol gel after surgery inside the tooth socket), group 4 (vehicle gel). Groups 3 and 4 did not receive any mouthwash before surgery. Carvacrol gel was prepared under the supervision of the consultant professor at the Faculty of Pharmacy of Tabriz University of Medical Sciences. All patients' wisdom tooth surgery was performed by the same surgeon under the same conditions and the surgical procedure was carried out with a standard technique. After surgery, all study participants were prescribed amoxicillin antibiotics and 400 mg of ibuprofen for pain control. Assessment of dry socket incidence was performed on the seventh day after surgery and pain evaluation based on the VAS system was completed on the first, second and seventh days after surgery. The data were analyzed by SPSS v.20 software and ANOVA statistical tests and relevant follow-up tests and chi-square test. Results: The frequency of dry socket and the intensity of pain in the patients of the four studied groups (control, chlorhexidine, carvacrol and carrier) did not have a statistically significant difference, but the average amount of painkillers consumed on the first and second day in the carvacrol group and then chlorhexidine was the lowest and in the control group the highest amount. Albeit there was no statistically significant difference in the frequency of dry socket between the groups, the carvacrol group did not have a dry socket complication. The amount of analgesics received in the first days in the carvacrol group was lower than in other groups and similar to chlorhexidine. Conclusion: Carvacrol had no significant effect in reducing the incidence of dry socket and the intensity of pain after impacted mandibular third molar surgery; however, it can be hoped that carvacrol will reduce the amount of analgesics received by the patients in the first days.