The Effects of Intraoperative Povidone-Iodine and Normal Saline Irrigations on Postoperative Inflammatory Sequelae and Bleeding in Mandibular Third Molar Disimpactions: A Comparative Study
DOI:
https://doi.org/10.61172/c4xvz716Keywords:
Povidone iodine, normal saline, irrigation, third-molar disimpactionAbstract
Background
Mandibular third molar disimpactions(M3-Disimpactions) is often associated with postoperative sequalae of pain, swelling, trismus and dysphagia1 which disturb patients’ Poor bone drilling efficiency and irrigation of the surgical site during M3-Disimpactions may worsen the postoperative morbidity and delay wound healing due to persistence of debris and devitalized bone fragments in the surgical site. It is therefore necessary to improve cutting efficiency and remove M3-Disimpaction site debris and devitalized tissues via copious irrigation and lavage to prevent worsening of the postoperative inflammatory sequelae.
Aim
The study aimed to compare the effects of Povidone iodine solution(PI) and normal saline(NS) irrigants on postoperative pain, swelling, trismus, and immediate postoperative bleeding(IPB) in M3-Disimpactionsn at the Aminu Kano Teaching Hospital, Kano, Nigeria(AKTH).
Methodology
The study was a randomized controlled study conducted among M3-Disimpaction patients who presented to the Oral surgery clinic of AKTH between May to November 2018. A sample size of 76 was calculated and convenience sampling was used to recruit subjects who were randomly assigned into a study group(SG) and a control group(CG). Each group comprised 38 subjects. The disimpaction irrigants were PI(0.5mg/ml solution) and NS in the SG and CG respectively. Immediate postoperative bleeding(IPB) was assessed for all disimpactions. Pain was assessed on postoperative days 1, 2 and 7(POD1, POD2 and POD7) while swelling and trismus were measured on POD2 and POD7. Statistical comparisons of outcome measures were done within and across groups with significance level set at p≤0.05.
Results
All recruited 38 subjects of each comparative group in the study completed the study. Each group had a similar M:F ratio of 1:1.3. Within-group analyses revealed that both PI and NS had significant effects on control of postoperative pain (PI: p=0.0001, NS: p=0.0001), swelling (PI: p=0.0001, NS: p=0.0001) and trismus (PI: p=0.0001, NS: p=0.001). Intergroup comparisons of outcome measures taken on POD1 ,POD2 and POD7 showed there were no significant differences in the means of postoperative pain scores (POD1: p=0.414, POD2: p=0.079, POD7: p=0.213), swelling measures (POD2: p=0.127, POD7: p=0.333 ) and Trismus values (POD2: p=0.599, POD7: p=0.566) of both groups. Mean IPB of both groups was significantly different (p=0.0001) with lower mean bleeding outcomes in the PI group.
Conclusion
PI and NS irrigations have similar significant effects on post-operative pain, swelling and trismus in M3-Disimpactions. However, PI has better haemostatic activity than NS. Clinicians should consider PI irrigation in M3-Disimpactions to reduce peri-operative bleeding.
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Copyright (c) 2025 Mustapha, Saheed Olawale, Suleiman, Abdul Rasheed, Abdullahi, Adam Sheikh Mohammed, Amole, Olushola Ibiyinka, Efunkoya, Akinwale Adeyemi, Omeje, Kelvin Uchenna
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