Effect of Ringer's Lactate versus normal saline irrigation on postoperative morbidity after surgical removal of mandibular impacted third molars: a randomized split-mouth clinical trial
Abstract
BACKGROUND: Normal saline remains the most commonly used irrigant during third molar surgery despite evidence that balanced crystalloids may reduce inflammation and acidosis in other surgical fields. This study compared the effect of intraoperative irrigation with lactated Ringer’s solution versus normal saline on postoperative pain, trismus, and facial swelling after bilateral impacted mandibular third molar removal. METHODS: A prospective, double-blind, split-mouth randomized clinical trial was conducted in 28 healthy patients. Each patient received 10 mL of normal saline on one side and 10 mL of lactated Ringer’s solution on the contralateral side immediately after extraction. Pain (VAS 0–10), maximum mouth opening, and facial swelling (three linear measurements) were assessed on postoperative days 1, 3, 7, and 14. Inter-side differences were compared using the Wilcoxon signed-rank test for pain scores and paired t-tests for mouth opening and facial swelling measurements, with data analysed using SPSS version 27 (IBM Corp., Armonk, NY, USA). RESULTS: Twenty-eight healthy patients completed the study. Pain intensity was significantly lower on the lactated Ringer’s side at all time points (day 1: 4.36 ± 2.71 vs. 6.71 ± 1.59; all P 0.05). No infections or adverse events occurred. CONCLUSION: In this small randomized trial, intraoperative irrigation with lactated Ringer’s solution was associated with lower postoperative pain at all assessed time points and improved late…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 28 participants or records.
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