International Journal of Dental Sciences and Research
ISSN (Print): 2333-1135 ISSN (Online): 2333-1259 Website: Editor-in-chief: Marcos Roberto Tovani Palone
Open Access
Journal Browser
International Journal of Dental Sciences and Research. 2020, 8(1), 27-30
DOI: 10.12691/ijdsr-8-1-5
Open AccessA Clinical Study

The Effects of Bio Adhesive Chlorhexidine Gel, NSAIDs on Post-operative Sequelae after Periapical Surgery of Upper Anterior Teeth

Ziad H. Deleme1, and Abdul Hameed N. Aldabagh1

1Department of Oral and Maxillofacial surgery, College of Dentistry, Mosul University, Ninavah, Iraq

Pub. Date: January 28, 2020

Cite this paper:
Ziad H. Deleme and Abdul Hameed N. Aldabagh. The Effects of Bio Adhesive Chlorhexidine Gel, NSAIDs on Post-operative Sequelae after Periapical Surgery of Upper Anterior Teeth. International Journal of Dental Sciences and Research. 2020; 8(1):27-30. doi: 10.12691/ijdsr-8-1-5


Although dropping need for apecoectomy as the modern endodontic therapy carry greatly promising outcomes but it is regularly done in dental clinics and may accompanied by some bothering points as ache, edema, so the main goal of this research is to evaluate the usefulness of dissimilar modalities in reducing edema and pain succeeding to the periapical surgery. Materials and Methods: This research done by involving twenty cases with periapical lesion need apecoectomy. Ten of them was given Chlorhexidine 0.2% (PerioKIN) gel to operative area and the other 10 patients given Diclofenac sodium (Voltarin) tablet 50mg, 3 periods a day for 7 days. Edema was assessed by a subjective clinical examination, ache using a visual analogue scale. Estimations done in the first 24 hours and on 72 hours and on 7 days. Results: No significant alterations were recognized for the edema but significant differences observed at seventh day after operation, pain values there was a highly significant difference at day three and day one and day seven there wasn’t important differences between study groups after operation. Conclusions: Administration of PerioKIN in form of gel showed effects resemble to diclofenac tablets in dropping the edema and pain readings, Chlorhexidine could be used as an additional therapy in some medical conditions like heart diseases or with active pulmonary illnesses or gravid women or with stomach sore or inability of prescribing NSAIDs that is utilized empirically to diminish pain and edema consequent to periapical surgical procedures.

Chlorhexidine gel Diclofenac sodium periapical surgery

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Amagasa T, Nagase M, Sato T, Shioda S: Apecoectomy with retrograde gutta percha root filling. Oral Surgery Oral Medicine Oral Pathology. 1989; 68:339-42.
[2]  Morse D, Bhambhani S. A dentist's dilemma nonsurgical endodontic therapy or periapical surgery for teeth with apparent pulpal pathosis and an associated periapical radiolucent lesion. Oral surgery. 1990; 70: 333-4.
[3]  Rapp E, Brown C, Newton C. An analysis of success and failure of apicoectomies: Journal of Endodontics. 1991; 17(10): 508-12.
[4]  Paiano G, Brito J. Materiais. retro-obturadores atualmente disponiveis limitacoes para o vedamento apical. Revista Odonto Ciencia. 2000; 15 (29): 57-64.
[5]  Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. Journal of Endodontics 2006; 32: 601-623.
[6]  Kang M, In Jung H, Song M, Kim SY, Kim HC, Kim E. Outcome of nonsurgical retreatment and endodontic microsurgery: a meta-analysis. Clinical Oral Investigations. 2015; 19: 569-582.
[7]  Garcia B, Larrazabal C, Penarrocha M, Penarrocha M. Pain and swelling in periapical surgery. A literature update. Medicina Oral patologia oral cirugia Bucal. 2008;13(11): 726-9.
[8]  Shah Sh, Khan I, Kanwal H. Effectiveness of submucosal Dexamethasone to control post-operative pain and swelling in apecoectomy of maxillary anterior teeth. International journal of Health Sciences. 2011; 5(2): 156-165.
[9]  Guyton A, textbook of medical physiology. 10th ed. Philadelphia: WB Saunders Co. 2000; Pp. 552-5.
[10]  Haesman P, Haesman L, Stacey F, Cracken G. local delivery of chlorhexidine Gluconate (Periochipt) in periodontal maintenance patient. Journal of clinical periodontology. 2001; 28: 90-95.
[11]  Fardal O, Turnbull RS. A review of the literature on use of Chlorhexidine in dentistry. Journal of American Dental Association. 1986; 112: 863-869.
[12]  Epstein J, McBride B, Stevenson-Moore P, Merilees H, Spinelli J. The efficacy of Chlorhexidine gel in reduction of Streptococcus mutans and Lactobacillus species in patients treated with radiation therapy. Oral Surgery Oral Medicine Oral Pathology. 1991; 71: 172-178.
[13]  Clark D, Morgan J, Mac Entee M. Effects of a 1% Chlorhexidine gel on the cariogenic bacteria in high-risk elders: a pilot study. Special Care Dentist 1991; 11: 101-103.
[14]  Enrile de Rojas F, Alemany A, Burguera A, Dios P. Aplicaciones clínicas adicionales de colutorios antisépticos. Periodoncia 2006; 16: 95-104.
[15]  Henrikson P, Thilander H, Wahlander L. Voltarin as analgesic after surgical removal of a lower wisdom tooth. International Journal of Oral Surgery. 1985; 14: 333-8.
[16]  Denton G.W. 1991. Chlorhexidine. In: Disinfection, Sterilization and preservation. Block SS (Editor). 4th ed. Philadelphia: Lea & Febiger, 1991; Pp.274-289.
[17]  Caci F, Gluck G, Hackensack N. Double blind study of Prednisolone and Papase as inhibitors of complications after oral surgery. Journal of American Dental Association. 1976; 93: 325-7.
[18]  Bailey B, Zaki G, Rotman H, Woodwards R. A double-blind comparative study of soluble Aspirin and Diclofenac dispersible in the control of post-extraction pain after removal of impacted third molars. International Journal of Oral Maxillofacial Surgery. 1993; 22: 238.
[19]  Sisk A, Bonnington G. Evaluation of Methylprednisolone and Flurbiprofen for inhibition of post-operative inflammatory response. Oral Surgery Oral Medicine Oral Pathology Oral Radiology. 1985; 60:137.
[20]  Walton G, Rood J, Snowdon A, Rickwood D. Ketorolac and diclofenac for postoperative pain relief following oral surgery. British Journal of Oral and Maxillofacial Surgery. 1993; 31: 158-60.
[21]  Zuniga J, Phillips C, Shugars D, Lyon J, Peroutka S, Swarbrick J. Analgesic safety and efficacy of Diclofenac sodium soft gels on post-operative third molar extraction pain. Journal of Oral and Maxillofacial Surgery. 2004; 62: 806-15.
[22]  Hyrkas T, Ylipaavalniemi P, Oikarinen V, Paakkari I. Preoperative intravenous Diclofenac for post-operative pain prevention in outpatients. British Journal of Oral and Maxillofacial Surgery. 1993; 31: 35.
[23]  Grossi G, Maiorana C, Garramone R, Borgonovo A, Beretta M, Farronato D, Santoro F, effect of sub mucosal injection of dexamethasone on post-operative discomfort after third molar surgery: a prospective study Journal of oral and maxillofacial surgery. 2007; 65: 2218-2226.
[24]  Payers M, Jakse N, Pertl C, Truschnegg A, Lechner E, Eskici A. the clinical effect of LLLT in endodontic surgery: a prospective study on 72 cases. Oral surgery oral medicine oral pathology oral radiology and endodontics. 2005: 100(3): 375-9.
[25]  Brignardello Petersen R. Chlorhexidine reduces the risk of developing alveolar osteitis after mandibular third-molar extractions, 2017; 148(6): 74.
[26]  Sánchez F, Andrés C, Calvo I. Does Chlorhexidine prevent alveolar osteitis after third molar extractions? Systematic review and meta-analysis. Journal of oral maxillofacial surgery. 2017; 75(5): 901-914.
[27]  Haraji A, Rakhshan V, Khamverdi N, Alishahi HK., Effects of intra-alveolar placement of 0.2% chlorhexidine bio-adhesive gel on dry socket incidence and postsurgical pain: a double-blind split-mouth randomized controlled clinical trial, Journal of Orofacial Pain. 2013; 27(3): 256-62.
[28]  Gomes B, Lilley J, Drucker D. Variations in the susceptibility of components of the endodontic microflora to biomechanical procedures. International Endodontic Journal 1996; 29: 235-241.
[29]  Vianna M, Gomes B, Berber V, Zaia A, Ferraz C, de Souza Filho F. In vitro evaluation of the antimicrobial activity of chlorhexidine and sodium hypochlorite. Oral Surgery Oral Med Oral Pathology Oral Radiology Endodontics, 2004; 97: 79-84.