Propolis vs. Chlorhexidine Gluconate and Benzydamine Hydrochloride on Sequelae After Third Molar Surgery: A Randomized Controlled Trial

Background. Impacted lower third molar surgery is characterized by postoperative sequelae such as pain, edema, and trismus. While chlorhexidine (CHX) is the gold-standard antiseptic, its side effects prompt the search for natural alternatives. The aim of this study is to examine the effects of propolis gargle on wound healing following third molar surgery and to compare it with chlorhexidine gluconate and benzydamine hydrochloride (CHX+BENZ). Methods. In this prospective, randomized, double-blind, active-controlled trial, 52 patients were assigned to 3% Propolis (n = 24) or 0.12% CHX+BENZ (n = 28) groups. Mouthwashes were applied twice daily from postoperative days 2 to 7, and pain (VAS), edema, and trismus were evaluated preoperatively and on days 2 and 7. Statistical significance was set at p < 0.05. Results. No significant differences were found in pain and trismus (p > 0.05). However, the Propolis group exhibited significantly lower edema on day 2 compared to the CHX+BENZ group (p = 0.004), and complication rates were also notably lower in the Propolis group. Conclusions. The novel, non-alcoholic 3% propolis mouthwash demonstrated no statistically significant differences in short-term pain and trismus outcomes compared to CHX+BENZ, alongside a statistically smaller day-2 facial edema measurement. While these findings support its potential as a supportive oral rinse following third molar surgery, adequately powered prospective trials are warranted to validate these preliminary observations before routine clinical adoption.