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NCT Number: NCT06587880

The Effect of Different Types of Mouthwash on Extraction Sockets' Healing

The goal of this clinical trial is to assess the effect of four different types of mouthwash on socket healing after surgical extractions in male or female patients aged 18 years and older who have a unilateral impacted mandibular third molar indicated for extraction. The main questions it aims to answer are:

The effect of Bone Bioactive Liquid (BBL) mouthwash, Hyaluronic Acid (HA) mouthwash, the Chlorhexidine digluconate (CHX) mouthwash and Warm Saline Mouth Rinse (WSMR) on socket healing after surgical extractions.

The effect of BBL mouthwash, HA mouthwash, the CHX mouthwash and WSMR on patient related factors and their quality of life.

Recruited Participants will be randomized into four intervention groups:

1. First group will receive BBL mouthwash. 2. The second group will receive CHX mouthwash. 3. The third group will be prescribed HA mouthwash. 4. The fourth group will receive Warm Saline Mouth Rinse.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

University of Jordan hospital

Amman, 11941, Jordan

Location status: Recruiting

Location contact

Ahmad Hamdan, Ph.D. in Periodontics

CONTACT

[email protected]

+ 962779099199

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male or female patients aged 18 years and older who have a unilateral impacted mandibular third molar that is indicated for extraction with bone removal and the presence of an adjacent second molar.

Exclusion criteria

  • Soft tissue impaction that will not need any bone removal.
  • Presence of any acute oral infection including active Pericoronitis.
  • Patients who have undergone radiotherapy in the head and neck region, chemotherapy or systemic long-term corticosteroid treatment.
  • Patients receiving medications known to induce gingival hyperplasia; anticonvulsant (phenytoin), immunosuppressant (cyclosporine A), and various calcium channel blockers (nifedipine, verapamil, diltiazem).
  • Patients who have taken systemic antibiotics less than 3 months prior to baseline.
  • Presence of uncontrolled diabetes, severe nutritional deficiencies and endocrine disturbances.
  • Presence of immune deficiency or any immune disease.
  • Intravenous bisphosphonates or Oral bisphosphonate intake for more than 3 years.
  • Smokers and alcoholics.
  • Pregnant or lactating females.
  • Hypersensitivity to one of the ingredients listed in any of the mouthwashes, especially chlorhexidine as reactions to this has been reported in the literature.

Treatment and study plan

Chlorhexidine gluconate

Drug

Prescribed for 7 days period 2 times a day starting 24 hours post-extraction, the patient is instructed to pour 10 ml of the mouthwash into a measuring cup, rinse for 1 minute at an alternative time to teeth brushing. Do not eat or drink for 30 min after use.

Bone Bioactive Liquid

Drug

Prescribed for 7 days period 2 times a day starting 24 hours post-extraction.

Hyaluronic Acid mouthwash

Drug

Prescribed for 7 days period 3-4 times a day starting 24 hours post-extraction, the patient is instructed to pour 20 ml of the mouthwash into a measuring cup and rinse for 1 minute, at an alternative time to teeth brushing. Do not eat or drink for 30 mins after use.

Warm Saline Mouth Rinse

Drug

Prescribed for 7 days period 2 times a day starting 24 hours post-extraction.

Primary outcomes

  1. Extraction socket soft tissue healing

    Time frame: Measured at 3, 7, 14 days, 3 and 6 months postoperatively.

    Using a new socket wound healing scale that is a combination of the gingival healing index of Landry et al. and the wound healing scale used by Cervelli et al. to assess the post-extraction wounds in terms of wound dehiscence, epithelialization, quality of granulation tissue filling the post-extraction socket, and depth between early granulation tissue and wound margin.

    A blunt periodontal probe with millimetric markers will be used for this assessment to score a number between 0 (best) and 4 (worst) for the healing socket.

Secondary outcomes

  1. Extraction socket Bone healing

    Time frame: Radiographs will be taken at baseline and at 6 months after extraction.

    Using panoramic radiographs and following the Longitudinal radiographic assessment (LRA) technique categorized as: A. The empty socket is completely radiolucent, and lamina dura is observed clearly around the socket. B. Socket region is hazy and lamina dura is observed around the socket. C. There is a mixed radiolucent-radiopaque appearance inside the socket and lamina dura has been partially disappeared. D. Mature bone is seen inside the socket and lamina dura has disappeared completely (no difference between the socket and normal bone).

  2. The resulting periodontal defect of the adjacent second molar

    Time frame: Preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively, we may call the patients for further assessment at 9 and 12 months

    Will be evaluated using a UNC 15 perio probe with three clinical parameters: the first is probing depth (PD) measured in mm at three sites of the second molar tooth: Distal (D), disto-buccal (DB), and disto-lingual (DL).

  3. The resulting periodontal defect of the adjacent second molar

    Time frame: Preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively, we may call the patients for further assessment at 9 and 12 months

    Will be evaluated using a UNC 15 perio probe with three clinical parameters: the second is gingival recession (GR) measured in mm at three sites of the second molar tooth: Distal (D), disto-buccal (DB), and disto-lingual (DL).

  4. The resulting periodontal defect of the adjacent second molar

    Time frame: Preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively, we may call the patients for further assessment at 9 and 12 months

    Will be evaluated using a UNC 15 perio probe with three clinical parameters: the third is bleeding on probing (BOP) measured as present or not at three sites of the second molar tooth: Distal (D), disto-buccal (DB), and disto-lingual (DL).

  5. Quality of life of the patients (QOL) after extraction

    Time frame: At 3, 7, 14 days, 3 and 6 months postoperatively.

    Assessed based on a questionnaire that addresses different aspects including social and work isolation, ability to eat and speak, impairment of sleep schedule, their physical appearance related to swelling, bleeding and Paresthesia. Answers to the presented questions are in the form of a four-point scale regarding their experience at the time the participants given the form to fill.

  6. Pain at the extraction side

    Time frame: At 3, 7, 14 days, 3 and 6 months postoperatively.

    Assessed using a 10cm long visual analog scale (VAS) where 0= no pain and 10= maximum amount of pain.

  7. Trismus

    Time frame: Pre-operatively and at 3, 7, 14 days, 3 and 6 months postoperatively.

    By measuring the interincisal distance at the maximum mouth opening pre-operatively and at 3, 7, 14 days, 3 and 6 months postoperatively, then the difference between pre- and postoperative will be taken.

  8. Facial swelling at the extraction side

    Time frame: Preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively.

    Assessed using a soft tape to measure the distance between the lowest point of the tragus and the soft tissue pogonion, the lowest point of the tragus and the lateral corner of the mouth, the lateral corner of the eye and the angle of the mandible. These measurements will be taken preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively. Then the difference between the pre-operative and postoperative values will be divided by the value obtained in the preoperative period and multiplied by 100 to have the final percentage for the post-operative day.

  9. Socio-demographic factors and medical history

    Time frame: Once preoperatively.

    Data taken from participants using a form.

  10. Peri-operative factors

    Time frame: During the surgical procedure.

    Operation time (min) categorized as <=20, >20 to 30, >30 to 40, >40.

  11. Peri-operative factors

    Time frame: During the surgical procedure.

    Amount of anesthesia administered.

  12. Peri-operative factors

    Time frame: During the surgical procedure.

    Tooth sectioning (done, not done).

  13. Peri-operative factors

    Time frame: During the surgical procedure.

    The surgeon's perception of difficulty categorized as <=9, >9 to 12, >12 to 16, >16.

  14. Pre-operative factors

    Time frame: Once preoperatively.

    The radiographic anatomical relationship between the tooth roots and mandibular canal as it appears on the radiographic image taken preoperatively, categorized as: No association between root structure and the superior border of the canal, Root structure impinging the superior border of canal, Overlapping root structure and canal.

  15. Pre-operative factors

    Time frame: Once preoperatively.

    Prior symptoms related to the third molar to be extracted categorized as: present, absent.

  16. Pre-operative factors

    Time frame: Once preoperatively.

    Indication for the surgical extraction of the third molar categorized as: prophylactic extraction, pain related to the third molar, orthodontic indication.

Study contacts

Contact information is provided by the study sponsor or research team.

Ahmad Hamdan, Ph.D. in Periodontics

CONTACT

[email protected]

+ 962779099199

Sponsors and collaborators

Lead sponsor

University of Jordan

Other

Registry information

Official study title

A Randomized Controlled Trial on the Effect of Different Types of Mouthwash on the Healing of Extraction Sockets

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Sep 19, 2024
Registry last updated
May 7, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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