Effects of lavage techniques with third molar surgery.

A comparison study of 206 mandibular third-molar surgical sites, half of which were irrigated with high volumes of isotonic normal saline solution with a conventional hand syringe and half of which were irrigated with high volumes of isotonic normal saline solution by means of a mechanical pulsating lavage instrument, revealed the following: 1. No cases of localized osteitis occurred with the use of mechanical irrigation in 103 surgical sites (0%). 2. One case of localized osteitis occurred with regular irrigation in 103 surgical sites (0.97%). 3. The over-all incidence of localized osteitis was one case in 206 surgical sites (0.49%). 4. One case of infection occurred with mechanical lavage (0.97%). 5. Two cases of infection occurred with conventional lavage (1.96%). 6. The over-all incidence of infection was three cases in 206 surgical sites (1.45%). 7. No significant differences occurred at the 0.95 level of confidence when the two groups' 3- and 5-day healing were compared. 8. A fairly even distribution of postoperative infections and/or localized osteitis was noted among the cases handled by the three surgeons directly involved in the performance of the operations. 9. Three hundred fifty milliliters of isotonic normal saline solution under pressure (whether electrical or conventional) appreciably reduced the reported incidence of localized osteitis without the use of antibiotics. 10. The mechanical irrigator was less cumbersome and faster (30 seconds for 350 ml.) than the conventional hand syringe (4 to 5 minutes for 350 ml.). 11. The sterilization procedure was more complicated for the mechanical irrigator (gas autoclave) than for the conventional hand syringe (presterilized disposable type). 12. Loose (unattached) soft tissue and bony spicules were thoroughly removed by 350 ml. of irrigation.