***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Alveolar osteitis ( AO ) is a common complication after third molar surgery . One of the most studied agents in its prevention is chlorhexidine ( CHX ) , which has proved to be effective . Objectives : The aim of this r and omized double-blind clinical trial was to evaluate the efficacy of 0.2 % bioadhesive chlorhexidine gel placed intra-alveolar in the prevention of AO after the extraction of m and ibular third molars and to analyze the impact of risk factors such as smoking and oral contraceptives in the development of AO . Study Design : The study was a r and omized , double-blind , clinical trial performed in the Ambulatory Surgery Unit of Hospital Vall d’Hebron and was approved by the Ethics Committee . A total of 160 patients r and omly received 0.2 % bioadhesive gel ( 80 patients ) or bioadhesive placebo ( 80 patients ) . Results : 0.2 % bioadhesive chlorhexidine gel applied in the alveolus after third molar extraction reduced the incidence of dry socket by 22 % compared to placebo with differences that were not statistically significant . Smoking and the use of oral contraceptives were not related to higher incidence of dry socket .  Female patients and the difficulty of the surgery were associated with a higher incidence of AO with statistically significant differences . 0.2 % bioadhesive chlorhexidine gel did not produce any of the side effects related to chlorhexidine rinses . Conclusions : A 22 % reduction of the incidence of alveolar osteitis with the application of 0.2 % bioadhesive chlorhexidine gel compared to placebo with differences that were not statistically significant was found in this clinical trial . The lack of adverse reactions and complications related to chlorhexidine gel supports its clinical use specially in simple extraction s and adds some advantages compared to the rinses in terms of duration of the treatment and reduction of staining and taste disturbance . Key words : Alveolar osteitis , dry socket , chlorhexidine bioadhesive gel , m and ibular third molar surgery PRINCIPLES Alveolar osteitis ( dry socket ) is the most common complication following the extraction of permanent teeth . This study was undertaken to compare the effect of two chlorhexidine rinse protocol s on the incidence of alveolar osteitis in patients undergoing surgical removal of impacted m and ibular third molar teeth . METHODS A prospect i ve r and omized clinical trial was conducted among 99 subjects . Patients were r and omly assigned into two groups . Subjects were instructed to rinse twice daily with 15 ml of chlorhexidine rinse 30 seconds for one week before and one week after surgery ( group I ) or one week after surgery ( group II ) . Postoperatively , all patients were instructed to return in one week or sooner if bothersome pain increased or persisted . Data were collected regarding abnormal healing , presence of necrotic tissue , exposed bone , and absence of clot . RESULTS The results indicated group I and group II were not statistically significant different in the reduction of alveolar osteitis . CONCLUSIONS To reduce alveolar osteitis after impacted third molar surgery , it was observed use of postoperative chlorhexidine rinse was adequate . The postoperative use of chlorhexidine is more feasible than both preoperative and postoperative use Objectives : To evaluate socket healing , incidence of acute alveolar ostieitis ( AO ) and associated pain following single molar tooth extraction in patients who receive intra-alveolar 0.2 % chlorhexidine ( CHX ) gel , and those who rinsed with 0.12 % CHX rinse .  Study Design : A prospect i ve r and omized clinical trial was conducted on two parallel groups of patients . Group1 ( 141 patients ): Rinsed with 0.12 % CHX rinse from the second postoperative day , two times daily for a week . Group2 ( 160 patients ): Who had direct intra-alveolar application of 0.2 % CHX gel and day 3 post-operatively . The socket was evaluated 3 and 7 day post operatively for the presence of AO by checking probing tenderness in the socket , empty socket , food debris , halitosis and pain assessment by VAS . Results : Forty-eight AO cases were diagnosed out of 301 extraction s ( 15.9 % ) . In Group1 , 25 cases were found ( 17.7 % ) while 23 cases were found in Group2 ( 14.4 % ) . The difference was not statistically significant ( p=0.428 ) . Presence of empty socket and food debris in Group1 were higher than in Group2 but the difference was not statistically significant ( p= 0.390 & p = 0.415 ) . Occurrence of halitosis in Group2 was more than Group1 , but the difference was not significant ( p= 0.440 ) . Statistical significance was found between AO in extraction done by root separation ( 29 % ) and those routinely extracted ( 12.3 % ) ( p=0.001 ) . Conclusions : Postoperative evaluation of molar extraction sockets that received direct intra-alveolar application of 0.2 % CHX gel showed insignificant less occurrence of AO when compared with 0.12 % CHX rinse . Key words : Chlorhexidine rinse , bio adhesive gel , alveolarosteitis , dry socket , molar teeth extraction , post- extraction socket PURPOSE The main purpose of the present investigation was to determine whether intra-alveolar chlorhexidine ( CHX ) gel is an effective preventative treatment for alveolar osteitis ( AO ) , as has been strongly suggested by previous investigators . Another goal was to evaluate whether there is a correlation between the use of analgesics during the postoperative week and the development of AO , a correlation that could be a supplement to the commonly used diagnostic criteria for AO . MATERIAL S AND METHODS A double-blinded r and omized study was performed to assess whether intra-alveolar administration of CHX decreases AO . To achieve this objective , the extraction and postoperative course of 100 impacted m and ibular third molars were studied . Ninety-seven percent of teeth operated on had a diagnosed pathology . The extraction alveoli were treated with CHX or placebo . The intake of analgesics was recorded for 7 days after the operation . RESULTS Statistically important differences in AO between the control and experimental groups were not found . The intake of analgesics reflected the occurrence of AO with a high degree of importance . CONCLUSION The present study did not verify that application of CHX gel improves healing after removal of impacted third molars . The patients ' postoperative analgesic intake reflected the development of AO OBJECTIVES The purpose s of this study were to evaluate the use of 0.12 % chlorhexidine gluconate as a prophylactic therapy for the prevention of alveolar osteitis and to further examine subject-based risk factors associated with alveolar osteitis . STUDY DESIGN The trial was a r and omized , double-blind , placebo-controlled , parallel-group study conducted among 279 subjects , each of whom required oral surgery for the removal of a minimum of one impacted m and ibular third molar . Subjects were instructed to rinse twice daily with 15 ml of chlorhexidine or placebo mouthrinse for 30 seconds for 1 week before and 1 week after the surgical extraction s. This regimen included a supervised presurgical rinse . Alveolar osteitis diagnosis was based on the subjective finding of increasing postoperative pain at the surgical site that was not relieved with mild analgesics , supported by clinical evidence of one or more of the following : loss of blood clot , necrosis of blood clot , and exposed alveolar bone . RESULTS In comparison with use of the placebo mouthrinse , prophylactic use of the chlorhexidine mouthrinse result ed in statistically significant ( p < 0.05 ) reductions in the incidence of alveolar osteitis . With chlorhexidine therapy , the subject- and extraction -based incidences of alveolar osteitis in the evaluable subset ( 271 subjects ) were reduced , relative to placebo , by 38 % and 44 % , respectively . The corresponding odds ratios that describe the increased odds of experiencing alveolar osteitis in the placebo group were 1.87 and 2.05 for subject- and extraction -based analyses , respectively . In comparison with nonuse of oral contraceptives , the use of oral contraceptives in female subjects was related to a statistically significant increase in the incidence of alveolar osteitis ( odds ratio = 1.92 , p = 0.035 ) . Relative to male subjects , the observed incidence of alveolar osteitis for female subjects not using oral contraceptives was not statistically significant ( odds ratio = 1.18 , p = 0.64 ) . Smoking did not increase the incidence of alveolar osteitis relative to not smoking ( odds ratio = 1.20 , p = 0.33 ) . CONCLUSIONS These data confirm that the prophylactic use of 0.12 % chlorhexidine gluconate mouthrinse results in a significant reduction in the incidence of alveolar osteitis after the extraction of impacted m and ibular third molars . In addition , oral contraceptive use in females was confirmed to be a risk factor for the development of alveolar osteitis Purpose : Alveolar osteitis ( AO ) is the most common postoperative complication of dental extraction s. The purpose of this study was to compare the effectiveness of 1 % versus 0.2 % chlorhexidine ( CHX ) gel in reducing postoperative AO after surgical extraction of m and ibular third molars , and assess the impact of treatment on the Oral HealthRelated Quality of Life ( OHRQoL ) . Material and Methods : This clinical study was a r and omized , double-blind clinical trial . Eighty eight patients underwent surgical extraction of one retained m and ibular third molar with the intra-alveolar application of 0.2 % CHX gel . Afterwards , they were assigned to one of two groups : 1 % CHX gel ( n=42 ) or 0.2 % CHX gel ( n=46 ) . The patients applied the gel twice a day to the wound for one week . All patients were evaluated for AO . Results : In the 0.2 % CHX gel group , 13 % of AO incidence was found , while in the 1 % CHX gel group , AO incidence was 7 % , a difference that was not statistically significant . Variables such as sensation of pain and inflammation at baseline and during one week , as well as OHRQoL of the patients at 24 hours and 7 days post- extraction , gave no statistically significant differences . Conclusions : There are no significant differences in AO after surgical extraction of m and ibular third molars , when comparing applying 1 % CHX gel twice a day for 7 days with 0.2 % CHX gel . Key words : Alveolar osteitis , chlorhexidine gel , third molar Background Dry socket is one of the most studied complications in dentistry and several studies have sought an effective and safe method for its prevention and treatment . The aim of this study was to evaluate the effectiveness of intra-alveolar gel chlorhexidine in preventing dry socket after the surgical removal of third molars . Material and Methods The sample involved the treatment of 40 patients who required extraction of third molars impacted , which were r and omly assigned to research groups : experimental group ( chlorhexidine gel 0.12 % ) and control group ( placebo gel ) . Performed the extraction was administered 1 mL of chlorhexidine gel or 1 mL of placebo gel within the socket . The removal of suture was on the fifth postoperative day in which the presence or absence of dry socket was evaluated . Results No relationship between the appearance of dry socket after application of chlorhexidine gel or placebo gel ( X2 test , p = 0.311 ) was found . However , significant differences ( U Mann-Whitney test , p = 0.036 ) in the pain presented on the fifth postoperative day were evident ( VAS ) . Conclusions The administration of intra-alveolar chlorhexidine gel 0.12 % could generate a better response to postoperative pain after the removal of third molars . Key words : Third molar surgery , dry socket , chorhexidine gel A double-blind study evaluated the ability of 0.12 % chlorhexidine rinse to decrease the incidence of localized alveolar osteitis after the removal of m and ibular third molar teeth . One hundred sixty extraction sites in 80 patients were evaluated . A statistically significant decrease in the incidence of dry socket was seen in patients using the chlorhexidine rinse with no significant adverse reactions . Thus a 0.12 % chlorhexidine rinse is shown to be an effective means of decreasing alveolar osteitis that may follow removal of third molar teeth OBJECTIVE The purpose of this study was to evaluate whether immediate placement of medicated dry socket packing would decrease the incidence of alveolar osteitis ( dry socket ) with lower third molar extraction s. STUDY DESIGN In 100 patients , 200 lower third molars were extracted . One half of the sockets were packed to the crest of the alveolar ridge with a one-quarter-inch radiograph-detectable filament gauze that contained 9 % eugenol , 36 % balsam of Peru , and 55 % petroleum jelly . The medicated packing was removed 1 week after surgery . None of the patients were taking antibiotics . Patients were instructed to increase their oral hygiene before and after surgery and were to use 0.12 % chlorhexidine gluconate 2 days before and 3 days after surgery . RESULTS ; Two hundred bilateral lower third molars of varying difficulty were extracted . 
    Output:
    
The use of chlorhexidine , in any formulation , concentration , or regimen , is efficacious and effective in preventing AO in patients who have undergone third molar extraction .
Chlorhexidine gel was found to be moderately more efficacious than the rinse formulation