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Aim <p>To compare the effectiveness of povidone-iodine and normal saline irrigation in reducing postoperative sequelae following mandibular third molar extraction.</p> Methods <p>This systematic review and meta-analysis was conducted according to the PRISMA 2020 guidelines. Two independent reviewers performed study selection and data extraction. Risk of bias was assessed using the Cochrane ROB-2 tool. Standardized mean difference (SMD) was calculated for continuous outcomes and risk ratio (RR) for dichotomous outcomes with 95% confidence intervals (CI). A fixed- or random-effects model was applied based on heterogeneity. Statistical significance was set at <i>p</i> &lt; 0.05.</p> Results <p>Six randomized controlled trials (<i>n</i> = 339 patients) were included in the qualitative synthesis, and four studies were pooled for meta-analysis. Compared with normal saline, povidone-iodine was associated with reduced pain at day 2 (SMD − 1.04; 95% CI: −1.43 to − 0.66) and day 7 (SMD − 0.46; 95% CI: −0.75 to − 0.17). Improved interincisal opening was observed at day 2 (SMD 1.32; 95% CI: 0.91 to 1.73) and day 7 (SMD 1.01; 95% CI: 0.69 to 1.33). Swelling was reduced at day 2 (SMD − 0.63; 95% CI: −0.99 to − 0.28) and day 7 (SMD − 1.07; 95% CI: −1.41 to − 0.73). No statistically significant differences were found in the incidence of infection (RR 1.10; 95% CI: 0.67 to 1.80) or alveolar osteitis (RR 0.97; 95% CI: 0.49 to 1.93). The certainty of evidence was rated as moderate. Follow-up duration was limited to short-term assessment (up to 7 days).</p> Conclusion <p>Povidone-iodine irrigation may provide short-term improvements in postoperative pain, swelling, and trismus compared with normal saline after mandibular third molar surgery. However, given the limited number of pooled studies, short follow-up duration, and moderate certainty of evidence, these findings should be interpreted cautiously. Larger, well-designed randomized controlled trials with standardized protocols and longer follow-up are required to confirm these results.</p>

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The Efficacy of Irrigating Solutions in Surgical Removal of Third Molar: A Systematic Review and Meta Analysis

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Rushil P. Patel,
  • Pushkar P. Waknis,
  • Amar Kumar Shaw,
  • Unnati Mehta,
  • Sagar Sanjay Kadadhekar

摘要

Aim

To compare the effectiveness of povidone-iodine and normal saline irrigation in reducing postoperative sequelae following mandibular third molar extraction.

Methods

This systematic review and meta-analysis was conducted according to the PRISMA 2020 guidelines. Two independent reviewers performed study selection and data extraction. Risk of bias was assessed using the Cochrane ROB-2 tool. Standardized mean difference (SMD) was calculated for continuous outcomes and risk ratio (RR) for dichotomous outcomes with 95% confidence intervals (CI). A fixed- or random-effects model was applied based on heterogeneity. Statistical significance was set at p < 0.05.

Results

Six randomized controlled trials (n = 339 patients) were included in the qualitative synthesis, and four studies were pooled for meta-analysis. Compared with normal saline, povidone-iodine was associated with reduced pain at day 2 (SMD − 1.04; 95% CI: −1.43 to − 0.66) and day 7 (SMD − 0.46; 95% CI: −0.75 to − 0.17). Improved interincisal opening was observed at day 2 (SMD 1.32; 95% CI: 0.91 to 1.73) and day 7 (SMD 1.01; 95% CI: 0.69 to 1.33). Swelling was reduced at day 2 (SMD − 0.63; 95% CI: −0.99 to − 0.28) and day 7 (SMD − 1.07; 95% CI: −1.41 to − 0.73). No statistically significant differences were found in the incidence of infection (RR 1.10; 95% CI: 0.67 to 1.80) or alveolar osteitis (RR 0.97; 95% CI: 0.49 to 1.93). The certainty of evidence was rated as moderate. Follow-up duration was limited to short-term assessment (up to 7 days).

Conclusion

Povidone-iodine irrigation may provide short-term improvements in postoperative pain, swelling, and trismus compared with normal saline after mandibular third molar surgery. However, given the limited number of pooled studies, short follow-up duration, and moderate certainty of evidence, these findings should be interpreted cautiously. Larger, well-designed randomized controlled trials with standardized protocols and longer follow-up are required to confirm these results.