What do systematic reviews say?

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

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

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

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

Autologous platelet‐rich plasma vs placebo or no treatment

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

  Follow-up: median 7 days
  No adverse events were reported in these two trials.
  2 studies
  GRADE not reported

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Systemic antibiotic prophylaxis (any regimen; topical therapy… may leads to lower dry socket compared with placebo (low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  1st to 7th day
  RR 0.66 [0.45, 0.97]
  13 studies · 1882 participants
  Low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Systemic antibiotic prophylaxis (any regimen; topical therapy… may leads to lower postsurgical infectious complications compared with placebo (low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  1st to 14th day
  RR 0.34 [0.19, 0.64]
  12 studies · 1728 participants
  Low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes swelling (7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  7th day
  RR 0.80 [0.50, 1.27]
  4 studies · 452 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes pain (continuous, VAS 0-10 cm, 7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  6th to 7th day
  MD -0.26 [-0.59, 0.07]
  4 studies · 422 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes presence of pain (dichotomous, yes/no on 6th-7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  6th to 7th day
  RR 0.59 [0.31, 1.12]
  3 studies · 675 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes adverse effects compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  1st to 7th day
  RR 1.46 [0.81, 2.64]
  8 studies · 1277 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes trismus (dichotomous, 7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  7th day
  RR 0.77 [0.42, 1.41]
  3 studies · 199 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs Placebo

The review found no eligible studies for this question.

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
  No studies: none of the 23 included trials evaluated tooth extraction in immunocompromised patients; subgroup analysis based on immune status was not possible as no such studies were identified.
  0 studies
  No studies found

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes fever (6th-7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  6th to 7th day
  RR 0.66 [0.24, 1.79]
  4 studies · 475 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs Placebo

The review found no eligible studies for this question.

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
  No studies in general dental practice for removal of decayed teeth. PUB3 added one routine intra-alveolar extraction trial and one complex oral surgery trial (2 of 23 non-third-molar), but the single intra-alveolar…
  0 studies
  No studies found

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo)

The review found no eligible studies for this question.

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  This outcome was not reported in either of the trials.
  0 studies
  No studies found

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo)

The review found no eligible studies for this question.

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  No randomised or quasi-randomised controlled trials in people with Von Willebrand disease met the inclusion criteria; no eligible VWD trials were identified.
  0 studies
  No studies found

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo)

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  Only reported in the Walsh (EACA) trial: in none of the 31 included participants was blood transfusion required.
  1 study · 31 participants
  GRADE not reported

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo)

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  Mean fall in haemoglobin. Forbes (TXA): 1.4 g/100 mL (placebo) vs 0.3 g/100 mL (TXA). Walsh (EACA): 6.3% (placebo, both centres) vs 3.9% and 3.7% (EACA, centres 1 and 2); differences not significant. Reported in…
  2 studies · 59 participants
  GRADE not reported