title: Postoperative socket irrigation with drinking tap water reduces the risk of inflammatory complications following surgical removal of third molars: a multicenter randomized trial.
abstract: OBJECTIVE
  The primary aim of the present study was to evaluate the effectiveness of postoperative irrigation of the socket with drinking tap water on inflammatory complications following lower third molar removal.
  
  
  METHODS
  A multicenter randomized controlled trial was carried out from June 2013 to June 2014. In one arm of the study, patients were instructed to irrigate the tooth socket and surgical site with a Monoject® Curved 412 Tip Syringe (Tyco/healthcare-Kendall, Mansfield, MA, USA) with tap water. In a second arm of the study, the standard postoperative instructions did not include irrigation instructions. The incidences of alveolar osteitis and wound infection were recorded for each group and analyzed by the Fisher's exact test.
  
  
  RESULTS
  A total of 280 patients with 333 mandibular third molars were analyzed. According to the intention-to-treat (ITT) analysis, inflammatory complications occurred in 18 cases in the Monoject® group (11.4 %) compared to 34 cases (19.1 %) in the control group (p = 0.04). These complications were associated with significant worse outcomes regarding quality of life, pain, and trismus and caused significantly more missed days of work or study. Female gender, age >26, bone removal, deep impacted third molars, less experienced surgeons, and a high amount of debris at the surgical site were also identified as risk factors for developing inflammatory complications following lower third molar removal.
  
  
  CONCLUSIONS
  Irrigation of the surgical site with drinking tap water using a curved syringe following removal of third molars is effective in reducing the risk of inflammatory complications.
  
  
  CONCLUSIONS
  Water is a very accessible, cost-effective irrigant without side effects and the results from this study have proven that it can be used to reduce the risk of inflammatory complications and associated morbidity following lower third molar removal.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands. hossein.ghaeminia@radboudumc.nl.
authors.forename: H
authors.initials: H
authors.lastname: Ghaeminia
authors.affiliation: Department of Oral and Maxillofacial Surgery, Rijnstate Hospital Arnhem, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands.
authors.forename: Th J M
authors.initials: TJ
authors.lastname: Hoppenreijs
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Xi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Rijnstate Hospital Arnhem, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands.
authors.forename: J P
authors.initials: JP
authors.lastname: Fennis
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: T J
authors.initials: TJ
authors.lastname: Maal
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.|Oral and Maxillofacial Surgery, ZBC Private Clinic Nijmegen, Groenewoudseweg 315, 6524 TX, Nijmegen, The Netherlands.
authors.forename: S J
authors.initials: SJ
authors.lastname: Bergé
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.|Implantology & Periodontology, Radboud University Medical Center, Phillips van Leydenlaan 25, 6525 EX, Nijmegen, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: Meijer
mesh_terms: D000293:Adolescent; D000328:Adult; D060766:Drinking Water; D004368:Dry Socket / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control; D013594:Syringes; D007507:Therapeutic Irrigation / Q000379:methods*; D020390:Tooth Socket; D014095:Tooth, Impacted / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D060766:Drinking Water
keywords: Drinking water; Irrigation; Oral health impact profile; Pain; Prevention; Quality of life; Risk factors; Trismus