What do systematic reviews say?

Iodine tampon vs Saline irrigation (monoject syringe)

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  Iodine tampon versus rinsing with saline in a syringe (Tuk 2019): Iodine tampon 0/54 Monoject with saline 0/54; no events (effect not estimable)
  1 study · 108 participants
  GRADE not reported

Alvogyl vs no treatment

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
  Alvogyl versus No treatment (Kaya 2011): data not usable (medians presented with error bars). Text reports differences in clinical signs and symptoms between control and all 3 treatment groups significant (P<0.05) at…
  1 study
  GRADE not reported

Delicate surgery and wound closure by primary intention vs Non-traumatic tooth avulsion and wound closure by secondary intention

• Interventions for managing medication‐related osteonecrosis of the jaw 2022 · Cochrane All outcomes
  In both study arms, no case of postoperative MRONJ was observed (700 participants; 1 RCT); effect not estimable.
  1 study · 700 participants
  GRADE not reported

Zinc oxide and eugenol (ZOE) vs Alvogyl (old formulation)

It is very uncertain whether zinc oxide eugenol changes pain (VAS 0-10) compared with alvogyl (old formulation) (very low certainty).

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Day 7
  MD 1.40 [1.04, 1.75]
  2 studies · 80 participants
  Very low

Neocone vs Zinc oxide and eugenol (ZOE)

Neocone led to lower time to complete resolution of pain (days) compared with zinc oxide eugenol; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Complete resolution of pain
  MD -3.79 [-4.04, -3.54]
  1 study · 78 participants
  GRADE not reported

Metronidazole gel 25% (local antibiotic) vs Placebo gel

Metronidazole gel (25%, intrasocket) showed no clear difference in presence of dry socket compared with placebo gel; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.53 [0.23, 1.20]
  1 study · 302 participants
  GRADE not reported

Herbal mouthrinse vs Chlorhexidine 0.2% mouthrinse

Herbal mouthrinse showed no clear difference in presence of dry socket compared with chlorhexidine 0.2% mouthrinse; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.50 [0.05, 5.17]
  1 study · 50 participants
  GRADE not reported

Acellular dermal matrix grafts (ADMG) vs control

Acellular dermal matrix led to lower presence of dry socket compared with control; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.15 [0.04, 0.67]
  1 study · 300 participants
  GRADE not reported

Autologous platelet‐rich plasma vs placebo or no treatment

It is very uncertain whether platelet rich plasma changes presence of dry socket compared with placebo or no treatment (very low certainty).

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.51 [0.19, 1.33]
  2 studies · 127 participants
  Very low

Artemisia desertorum spreng (Yunnan) vs placebo

Artemisia desertorum spreng (Yunnan) showed no clear difference in presence of dry socket compared with placebo; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.28 [0.06, 1.28]
  1 study · 182 participants
  GRADE not reported

Acellular dermal matrix grafts (ADMG) vs no treatment

Acellular dermal matrix patch led to lower presence of dry socket compared with no treatment; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.07 [0.01, 0.50]
  1 study · 400 participants
  GRADE not reported

Chlorhexidine 0.2% socket irrigation (monoject syringe) vs Chlorhexidine 0.2% mouthrinse

Chlorhexidine 0.2% socket irrigation (monoject syringe) led to lower presence of dry socket compared with chlorhexidine 0.2% mouthrinse; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.26 [0.09, 0.71]
  1 study · 95 participants
  GRADE not reported

Topical anaesthetic gel (prilocaine-lidocaine) vs Eugenol

Topical anaesthetic gel (prilocaine-lidocaine) showed no clear difference in pain at 48 hours (VAS 0-10) compared with eugenol; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  48 hours
  MD -0.20 [-1.87, 1.47]
  1 study · 35 participants
  GRADE not reported

Chlorhexidine gel (0.2%, intrasocket) vs Chlorhexidine mouthrinse

Chlorhexidine gel (0.2%, intrasocket) showed no clear difference in presence of dry socket compared with chlorhexidine rinse (0.12%) (low certainty).

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.74 [0.46, 1.20]
  2 studies · 383 participants
  Low

Tap water irrigation (monoject syringe) vs No rinsing

Tap water irrigation (monoject syringe) led to lower presence of dry socket compared with no rinsing; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.36 [0.18, 0.74]
  1 study · 336 participants
  GRADE not reported

Chlorhexidine gel vs Chlorhexidine, 0.2% to 2% (solution or gel)

Chlorhexidine gel 1% showed no clear difference in presence of dry socket compared with chlorhexidine gel 0.2%; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.55 [0.15, 2.05]
  1 study · 88 participants
  GRADE not reported

Honey (Manuka, topical) vs Chlorhexidine rinse (0.2%)

Honey (Manuka, topical) showed no clear difference in presence of dry socket compared with chlorhexidine rinse (0.2%); GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 1.32 [0.41, 4.22]
  1 study · 100 participants
  GRADE not reported

Chlorhexidine gel (0.2%, intrasocket) vs placebo or no treatment

Chlorhexidine gel (0.2%, intrasocket) probably leads to lower presence of dry socket compared with placebo or no treatment (moderate certainty).

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  OR 0.44 [0.27, 0.71]
  7 studies · 753 participants
  Moderate

Artemisia desertorum spreng (Shahaosan) vs Artemisia desertorum spreng (Yunnan)

Artemisia desertorum spreng (Shahaosan) showed no clear difference in presence of dry socket compared with artemisia desertorum spreng (Yunnan); GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.47 [0.04, 5.06]
  1 study · 178 participants
  GRADE not reported

Oral tissue patch vs placebo or control

Oral tissue patch led to lower presence of dry socket compared with placebo or control; GRADE not reported.

• Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes

  Follow-up: median 7 days
  RR 0.13 [0.02, 0.98]
  1 study · 200 participants
  GRADE not reported