ClinicalTrials.gg
RecruitingNCT06587880Updated May 7, 2026

The Effect of Different Types of Mouthwash on Extraction Sockets' Healing

A Phase 4 interventional study of Chlorhexidine Gluconate and Bone Bioactive Liquid in Extraction Socket Healing, Quality of Life and Postoperative Complications, sponsored by University of Jordan. Recruiting at 1 site in Jordan. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-07.

Sponsored by University of Jordan · Phase 4, Interventional, and Supportive care

From the registry’s dates

  • Started Aug 2025; still recruiting 1 year 3 months later.
Phase
Phase 4
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this clinical trial is to assess the effect of four different types of mouthwash on socket healing after surgical extractions in male or female patients aged 18 years and older who have a unilateral impacted mandibular third molar indicated for extraction. The main questions it aims to answer are:

The effect of Bone Bioactive Liquid (BBL) mouthwash, Hyaluronic Acid (HA) mouthwash, the Chlorhexidine digluconate (CHX) mouthwash and Warm Saline Mouth Rinse (WSMR) on socket healing after surgical extractions.

The effect of BBL mouthwash, HA mouthwash, the CHX mouthwash and WSMR on patient related factors and their quality of life.

Recruited Participants will be randomized into four intervention groups:

  1. First group will receive BBL mouthwash.
  2. The second group will receive CHX mouthwash.
  3. The third group will be prescribed HA mouthwash.
  4. The fourth group will receive Warm Saline Mouth Rinse.
02

Conditions studied

  • Extraction Socket Healing
  • Quality of Life
  • Postoperative Complications

Keywords

  • Clinical trial
  • Mouthwash
  • Socket healing
  • Postoperative complications
  • Quality of life
03

In context

Postoperative Complications

1,332 studies on the registry are indexed under Postoperative Complications; 311 are open to participants now.

This study's planned enrollment of 100 is below the median of 114 across 766 interventional studies indexed under Postoperative Complications.

Browse Postoperative Complications studies →

Lead sponsor

University of Jordan is the lead sponsor of 131 studies on the registry; 20 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male or female patients aged 18 years and older who have a unilateral impacted mandibular third molar that is indicated for extraction with bone removal and the presence of an adjacent second molar.

Exclusion criteria

Exclusion Criteria:

  • Soft tissue impaction that will not need any bone removal.
  • Presence of any acute oral infection including active Pericoronitis.
  • Patients who have undergone radiotherapy in the head and neck region, chemotherapy or systemic long-term treatment.
  • Patients receiving medications known to induce gingival hyperplasia; anticonvulsant (phenytoin), (cyclosporine A), and various calcium channel blockers (nifedipine, verapamil, diltiazem).
  • Patients who have taken systemic antibiotics less than 3 months prior to baseline.
  • Presence of uncontrolled diabetes, severe nutritional deficiencies and endocrine disturbances.
  • Presence of immune deficiency or any immune disease.
  • Intravenous bisphosphonates or Oral bisphosphonate intake for more than 3 years.
  • Smokers and alcoholics.
  • Pregnant or lactating females.
  • to one of the ingredients listed in any of the mouthwashes, especially chlorhexidine as reactions to this has been reported in the literature.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 4
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
100 participants (estimated)

Study arms

  • Active comparator
    Bone Bioactive Liquid

    Bone bioactive liquid (BBL) is a saline solution used as a mouthwash that contains calcium chloride (CaCl2) and magnesium dichloride hexahydrate (MgCl2-6H2O) with a net negative charge.

    Drug: Bone Bioactive Liquid

  • Active comparator
    Chlorhexidine Gluconate

    It is a strong bisbiguanide base, with cationic structure at physiological pH (positively charged), and has a broad-spectrum antibacterial activity that works against Gram-positive and Gram- negative bacteria and certain mycetes.

    Drug: Chlorhexidine Gluconate

  • Active comparator
    Warm Saline Mouth Rinse

    Prescribing WSMR as a prophylactic postoperatively is due to the fact that the heat of the solution results in a therapeutic increase in blood flow to the extraction socket.

    Drug: Warm Saline Mouth Rinse

  • Active comparator
    Hyaluronic Acid mouthwash

    It is a high molecular weight non-sulphated polysaccharide. It is biocompatible, non-immunogenic, biodegradable, viscoelastic that make it a preferable biomaterial for medical and pharmaceutical applications without adverse events.

    Drug: Hyaluronic Acid mouthwash

Interventions

  • Prescribed for 7 days period 2 times a day starting 24 hours post-extraction, the patient is instructed to pour 10 ml of the mouthwash into a measuring cup, rinse for 1 minute at an alternative time to teeth brushing. Do not eat or drink for 30 min after use.

  • DrugBone Bioactive Liquid

    Prescribed for 7 days period 2 times a day starting 24 hours post-extraction.

  • Prescribed for 7 days period 3-4 times a day starting 24 hours post-extraction, the patient is instructed to pour 20 ml of the mouthwash into a measuring cup and rinse for 1 minute, at an alternative time to teeth brushing. Do not eat or drink for 30 mins after use.

  • DrugWarm Saline Mouth Rinse

    Prescribed for 7 days period 2 times a day starting 24 hours post-extraction.

06

What researchers measure

Primary outcomes

  1. Extraction socket soft tissue healing

    Using a new socket wound healing scale that is a combination of the gingival healing index of Landry et al. and the wound healing scale used by Cervelli et al. to assess the post-extraction wounds in terms of wound dehiscence, epithelialization, quality of granulation tissue filling the post-extraction socket, and depth between early granulation tissue and wound margin. A blunt periodontal probe with millimetric markers will be used for this assessment to score a number between 0 (best) and 4 (worst) for the healing socket.

    Time frame: Measured at 3, 7, 14 days, 3 and 6 months postoperatively.

Secondary outcomes

  1. Extraction socket Bone healing

    Using panoramic radiographs and following the Longitudinal radiographic assessment (LRA) technique categorized as: A. The empty socket is completely radiolucent, and lamina dura is observed clearly around the socket. B. Socket region is hazy and lamina dura is observed around the socket. C. There is a mixed radiolucent-radiopaque appearance inside the socket and lamina dura has been partially disappeared. D. Mature bone is seen inside the socket and lamina dura has disappeared completely (no difference between the socket and normal bone).

    Time frame: Radiographs will be taken at baseline and at 6 months after extraction.

  2. The resulting periodontal defect of the adjacent second molar

    Will be evaluated using a UNC 15 perio probe with three clinical parameters: the first is probing depth (PD) measured in mm at three sites of the second molar tooth: Distal (D), disto-buccal (DB), and disto-lingual (DL).

    Time frame: Preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively, we may call the patients for further assessment at 9 and 12 months

  3. The resulting periodontal defect of the adjacent second molar

    Will be evaluated using a UNC 15 perio probe with three clinical parameters: the second is gingival recession (GR) measured in mm at three sites of the second molar tooth: Distal (D), disto-buccal (DB), and disto-lingual (DL).

    Time frame: Preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively, we may call the patients for further assessment at 9 and 12 months

  4. The resulting periodontal defect of the adjacent second molar

    Will be evaluated using a UNC 15 perio probe with three clinical parameters: the third is bleeding on probing (BOP) measured as present or not at three sites of the second molar tooth: Distal (D), disto-buccal (DB), and disto-lingual (DL).

    Time frame: Preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively, we may call the patients for further assessment at 9 and 12 months

  5. Quality of life of the patients (QOL) after extraction

    Assessed based on a questionnaire that addresses different aspects including social and work isolation, ability to eat and speak, impairment of sleep schedule, their physical appearance related to swelling, bleeding and Paresthesia. Answers to the presented questions are in the form of a four-point scale regarding their experience at the time the participants given the form to fill.

    Time frame: At 3, 7, 14 days, 3 and 6 months postoperatively.

  6. Pain at the extraction side

    Assessed using a 10cm long visual analog scale (VAS) where 0= no pain and 10= maximum amount of pain.

    Time frame: At 3, 7, 14 days, 3 and 6 months postoperatively.

  7. Trismus

    By measuring the interincisal distance at the maximum mouth opening pre-operatively and at 3, 7, 14 days, 3 and 6 months postoperatively, then the difference between pre- and postoperative will be taken.

    Time frame: Pre-operatively and at 3, 7, 14 days, 3 and 6 months postoperatively.

  8. Facial swelling at the extraction side

    Assessed using a soft tape to measure the distance between the lowest point of the tragus and the soft tissue pogonion, the lowest point of the tragus and the lateral corner of the mouth, the lateral corner of the eye and the angle of the mandible. These measurements will be taken preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively. Then the difference between the pre-operative and postoperative values will be divided by the value obtained in the preoperative period and multiplied by 100 to have the final percentage for the post-operative day.

    Time frame: Preoperatively and at 3, 7, 14 days, 3 and 6 months postoperatively.

  9. Socio-demographic factors and medical history

    Data taken from participants using a form.

    Time frame: Once preoperatively.

  10. Peri-operative factors

    Operation time (min) categorized as \<=20, \>20 to 30, \>30 to 40, \>40.

    Time frame: During the surgical procedure.

  11. Peri-operative factors

    Amount of anesthesia administered.

    Time frame: During the surgical procedure.

  12. Peri-operative factors

    Tooth sectioning (done, not done).

    Time frame: During the surgical procedure.

  13. Peri-operative factors

    The surgeon\'s perception of difficulty categorized as \<=9, \>9 to 12, \>12 to 16, \>16.

    Time frame: During the surgical procedure.

  14. Pre-operative factors

    The radiographic anatomical relationship between the tooth roots and mandibular canal as it appears on the radiographic image taken preoperatively, categorized as: No association between root structure and the superior border of the canal, Root structure impinging the superior border of canal, Overlapping root structure and canal.

    Time frame: Once preoperatively.

  15. Pre-operative factors

    Prior symptoms related to the third molar to be extracted categorized as: present, absent.

    Time frame: Once preoperatively.

  16. Pre-operative factors

    Indication for the surgical extraction of the third molar categorized as: prophylactic extraction, pain related to the third molar, orthodontic indication.

    Time frame: Once preoperatively.

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Osunde OD, Adebola RA, Adeoye JB, Bassey GO. Comparative study of the effect of warm saline mouth rinse on complications after dental extractions. Int J Oral Maxillofac Surg. 2014 May;43(5):649-53. doi: 10.1016/j.ijom.2013.09.016. Epub 2013 Dec 5. PubMed 24314857 ↗
  • Adekunle AA, Egbunah UP, Erinoso OA, Adeyemo WL. Effectiveness of warm saline mouth bath in preventing alveolar osteitis: A systematic review and meta-analysis. J Craniomaxillofac Surg. 2021 Oct;49(10):980-988. doi: 10.1016/j.jcms.2021.09.001. Epub 2021 Sep 4. PubMed 34509363 ↗
  • Cho H, Lynham AJ, Hsu E. Postoperative interventions to reduce inflammatory complications after third molar surgery: review of the current evidence. Aust Dent J. 2017 Dec;62(4):412-419. doi: 10.1111/adj.12526. Epub 2017 Jun 14. PubMed 28498604 ↗
  • Maria de Souza G, Elias GM, Pereira de Andrade PF, Andrade Sales KN, Galvao EL, Moreira Falci SG. The Effectiveness of Hyaluronic Acid in Controlling Pain, Edema, and Trismus After Extraction of Third Molars: Systematic Review and Meta-Analysis. J Oral Maxillofac Surg. 2020 Dec;78(12):2154.e1-2154.e12. doi: 10.1016/j.joms.2020.07.005. Epub 2020 Jul 14. PubMed 32771444 ↗
  • Canellas JVDS, Fraga SRG, Santoro MF, Netto JNS, Tinoco EMB. Intrasocket interventions to prevent alveolar osteitis after mandibular third molar surgery: A systematic review and network meta-analysis. J Craniomaxillofac Surg. 2020 Sep;48(9):902-913. doi: 10.1016/j.jcms.2020.06.012. Epub 2020 Jul 8. PubMed 32718882 ↗
  • Afat IM, Akdogan ET, Gonul O. Effects of leukocyte- and platelet-rich fibrin alone and combined with hyaluronic acid on early soft tissue healing after surgical extraction of impacted mandibular third molars: A prospective clinical study. J Craniomaxillofac Surg. 2019 Feb;47(2):280-286. doi: 10.1016/j.jcms.2018.11.023. Epub 2018 Dec 3. PubMed 30579747 ↗
  • Yilmaz N, Demirtas N, Kazancioglu HO, Bayer S, Acar AH, Mihmanli A. The efficacy of hyaluronic acid in postextraction sockets of impacted third molars: A pilot study. Niger J Clin Pract. 2017 Dec;20(12):1626-1631. doi: 10.4103/1119-3077.224131. PubMed 29378998 ↗
  • Koray M, Ofluoglu D, Onal EA, Ozgul M, Ersev H, Yaltirik M, Tanyeri H. Efficacy of hyaluronic acid spray on swelling, pain, and trismus after surgical extraction of impacted mandibular third molars. Int J Oral Maxillofac Surg. 2014 Nov;43(11):1399-403. doi: 10.1016/j.ijom.2014.05.003. Epub 2014 Jun 10. PubMed 24924267 ↗
  • Ibraheem W, Jedaiba WH, Alnami AM, Hussain Baiti LA, Ali Manqari SM, Bhati A, Almarghlani A, Assaggaf M. Efficacy of hyaluronic acid gel and spray in healing of extraction wound: a randomized controlled study. Eur Rev Med Pharmacol Sci. 2022 May;26(10):3444-3449. doi: 10.26355/eurrev_202205_28838. PubMed 35647824 ↗
  • Kim JJ, Song HY, Ben Amara H, Kyung-Rim K, Koo KT. Hyaluronic Acid Improves Bone Formation in Extraction Sockets With Chronic Pathology: A Pilot Study in Dogs. J Periodontol. 2016 Jul;87(7):790-5. doi: 10.1902/jop.2016.150707. Epub 2016 Mar 18. PubMed 26991484 ↗
  • Gocmen G, Gonul O, Oktay NS, Yarat A, Goker K. The antioxidant and anti-inflammatory efficiency of hyaluronic acid after third molar extraction. J Craniomaxillofac Surg. 2015 Sep;43(7):1033-7. doi: 10.1016/j.jcms.2015.04.022. Epub 2015 May 6. PubMed 26027861 ↗
  • Rodrigues SV, Acharya AB, Bhadbhade S, Thakur SL. Hyaluronan-containing mouthwash as an adjunctive plaque-control agent. Oral Health Prev Dent. 2010;8(4):389-94. PubMed 21180677 ↗
  • Romano CL, De Vecchi E, Bortolin M, Morelli I, Drago L. Hyaluronic Acid and Its Composites as a Local Antimicrobial/Antiadhesive Barrier. J Bone Jt Infect. 2017 Jan 1;2(1):63-72. doi: 10.7150/jbji.17705. eCollection 2017. PubMed 28529865 ↗
  • Phillips C, White RP Jr, Shugars DA, Zhou X. Risk factors associated with prolonged recovery and delayed healing after third molar surgery. J Oral Maxillofac Surg. 2003 Dec;61(12):1436-48. doi: 10.1016/j.joms.2003.08.003. PubMed 14663809 ↗
  • Sasaki T, Watanabe C. Stimulation of osteoinduction in bone wound healing by high-molecular hyaluronic acid. Bone. 1995 Jan;16(1):9-15. doi: 10.1016/s8756-3282(94)00001-8. PubMed 7742090 ↗
  • Gizligoz B, Ince Kuka G, Tunar OL, Ozkan Karaca E, Gursoy H, Kuru B. Plaque Inhibitory Effect of Hyaluronan-Containing Mouthwash in a 4-Day Non-Brushing Model. Oral Health Prev Dent. 2020 Feb 14;18(1):61-70. doi: 10.3290/j.ohpd.a43936. PubMed 32051972 ↗
  • Varoni E, Tarce M, Lodi G, Carrassi A. Chlorhexidine (CHX) in dentistry: state of the art. Minerva Stomatol. 2012 Sep;61(9):399-419. English, Italian. PubMed 22976567 ↗
  • Ferres-Amat E, Al Madhoun A, Ferres-Amat E, Al Demour S, Ababneh MA, Ferres-Padro E, Marti C, Carrio N, Barajas M, Atari M. Histologic and Histomorphometric Evaluation of a New Bioactive Liquid BBL on Implant Surface: A Preclinical Study in Foxhound Dogs. Materials (Basel). 2021 Oct 19;14(20):6217. doi: 10.3390/ma14206217. PubMed 34683810 ↗
  • Ferres-Amat E, Al Madhoun A, Ferres-Amat E, Carrio N, Barajas M, Al-Madhoun AS, Ferres-Padro E, Marti C, Atari M. Comparison of 0.12% Chlorhexidine and a New Bone Bioactive Liquid, BBL, in Mouthwash for Oral Wound Healing: A Randomized, Double Blind Clinical Human Trial. J Pers Med. 2022 Oct 16;12(10):1725. doi: 10.3390/jpm12101725. PubMed 36294864 ↗
  • Oginni FO, Ugboko VI, Assam E, Ogunbodede EO. Postoperative complaints following impacted mandibular third molar surgery in Ile-Ife, Nigeria. SADJ. 2002 Jul;57(7):264-8. PubMed 12271954 ↗
  • Yamada SI, Hasegawa T, Yoshimura N, Hakoyama Y, Nitta T, Hirahara N, Miyamoto H, Yoshimura H, Ueda N, Yamamura Y, Okuyama H, Takizawa A, Nakanishi Y, Iwata E, Akita D, Itoh R, Kubo K, Kondo S, Hata H, Koyama Y, Miyamoto Y, Nakahara H, Akashi M, Kirita T, Shibuya Y, Umeda M, Kurita H. Prevalence of and risk factors for postoperative complications after lower third molar extraction: A multicenter prospective observational study in Japan. Medicine (Baltimore). 2022 Aug 12;101(32):e29989. doi: 10.1097/MD.0000000000029989. PubMed 35960058 ↗
  • Araujo MG, Silva CO, Misawa M, Sukekava F. Alveolar socket healing: what can we learn? Periodontol 2000. 2015 Jun;68(1):122-34. doi: 10.1111/prd.12082. PubMed 25867983 ↗

Individual participant data

Plan to share: Yes — The plan is to share only IPD used in the results publication

Supporting information: Study protocol

Time frame: Beginning from publication with no end date

Access criteria: The principal investigator will review requests for IPD sharing according to the predetermined set of criteria. The criteria that must be met in order for data to be shared are: having a study protocol that has been approved by an independent review committee identified for IPD meta-analyses. The study protocol must be submitted through email then when reviewed data requestors will need to sign a data access agreement. The data requestor will be provided with the IPD file that can be accessed by them only by having their email listed as a viewer in the sharing list of a folder stored on the DropBox website, this folder has the data excel sheet file and the study protocol as the supporting material.

Data sharing details ↗ · www.dropbox.com

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Aug 2025 (actual). Primary completion is estimated for Dec 2026, 16 months after the start.

Of 45 non-industry phase 4 interventional studies under Postoperative Complications, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 19 and three quarters within 32. This study's planned 16 months is below that.

Counting every sponsor, half of 46 studies reached it within 25 months; a quarter within 19 and three quarters within 32.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 31, 2024
First posted
Sep 19, 2024
StartActual
Aug 10, 2025
Primary completionEst.
Dec 2026
CompletionEst.
Dec 2026
Last update
May 7, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 7, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06587880
Responsible party
Ahmad Abdel-Salam Hamdan (Associate Professor, Periodontology, University of Jordan) — Principal investigator
First posted
Sep 19, 2024
Start date
Aug 10, 2025
Primary completion
Dec 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
May 7, 2026

Study contacts

Ahmad Hamdan, Ph.D. in Periodontics
Contact
Ahmad.hamdan@ju.edu.jo
+ 962779099199
Ahmad Hamdan, Ph.D. in Periodontics
principal investigator · Faculty of Dentistry - University of Jordan

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Chlorhexidine gluconate · Hyaluronic Acid

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