A comparative study on the effectiveness and safety of Azadirachta indica leaf extract versus chlorhexidine mouth rinses on postoperative complications following mandibular third molar surgeries: a randomized, double-blinded controlled study. - Trial PACTR202301888753718

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Summary

The utilization of antimicrobial mouthrinses has been considered a useful adjunct to oral hygiene and effective in the control of complications following oral and periodontal surgeries. Several compounds have been evaluated for their antimicrobial effectiveness including bisbiguanides (such as chlorhexidine gluconate), and essential oils. Some of these substances are very expensive and unaffordable in a lower middle-income country like Nigeria and they also have been associated with side-effects that incapacitate their long-term use, and such new formulations are needed. Neem toothpastes and mouthwashes prevent cavities, heal gum diseases and rejuvenate the tissues of the mouth. Neem contains one of the strongest natural analgesics known, with results very apparent within few hours. The mechanism of its anti-inflammatory action is by inhibiting production of prostaglandin E and 5 HT. The antibacterial action can be explained by “Azadiachtin” that is known to destroy bacterial cell wall and thus inevitably inhibit the growth of bacteria.To the best of my knowledge, no randomized control trials have been done to assess the use of neem mouthwashes in oral and maxillofacial surgery despite showing promising results when used in other arears of dentistry. Hence, this study will be undertaken to come up with a novel and cost-effective neem mouthwash, to be used after third molar surgeries to reduce the occurrence of surgical complications. The effectiveness of this neem mouthwash will be compared with the already known two mouthwashes (chlorhexidine and warm saline). The aim of this research is to determine the effects of Azadirachta indica leaf extract and chlorhexidine on surgical outcomes in patients undergoing impacted mandibular third molar surgeries. Additionally, this paper will evaluate and compare their efficacy on pain, swelling, trismus, wound healing, alveolar osteitis and infection after surgical extraction of the impacted mandibular third molars.

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