COMPARATIVE EVALUATION OF CHLORHEXIDINE AND METRONIDAZOLE IRRIGATION IN THIRD MOLAR SURGERY - A RANDOMIZED COMPARATIVE CLINICAL STUDY

Abstract Background: Surgical removal of impacted third molars often involves significant bone removal and manipulation of inflamed or infected soft tissues, making the surgical site highly susceptible to bacterial contamination and postoperative complications such as infection and alveolar osteitis. Intraoperative irrigation plays a vital role in flushing out debris, controlling microbial load, and promoting a clean surgical field, which directly impacts the healing outcome. Chlorhexidine and Metronidazole have gained attention for their broad-spectrum antimicrobial properties, particularly when mechanical debridement alone is insufficient. Objective: To compare the efficacy of 0.12% Chlorhexidine gluconate and 1% Metronidazole irrigating solutions in preventing postoperative infections and enhancing healing after surgical extraction. Materials & methods: A prospective, randomised, comparative study was conducted in the Oral and Maxillofacial Surgery Department on patients requiring surgical extraction of mandibular third molars. The study was explained, and written informed consent was obtained. Patients were randomly allocated to two groups. Parameters were assessed on postoperative day 1, 3 and 7. The mean and standard deviation were calculated for all parameters. Intergroup comparisons were performed using the independent t-test. A p-value < 0.05 was considered statisticallysignificant. Results: Results showed a statistically significant difference between the groups (p = 0.002*), indicating better postoperative outcomes with metronidazole. Conclusion: Metronidazole is a superior irrigation solution in improving postoperative outcomes, especially in surgeries prone to anaerobic contamination like third molar extractions and other oral procedures. Key words: Surgical extraction, Metronidazole, Chlorhexidine gluconate, impaction, Pain, mouth opening, swelling.