Alveolar Iodine Tampon Packing Reduces Postoperative Morbidity After Third Molar Surgery

J Oral Maxillofac Surg. 2019 Dec;77(12):2401-2411. doi: 10.1016/j.joms.2019.06.175. Epub 2019 Jul 1.


Purpose: The aim of this study was to assess the efficacy of an iodine tampon after mandibular third molar surgery on oral health-related quality of life (OHRQoL), use of painkillers, postoperative sequelae, and self-care behaviors in the first postoperative week.

Materials and methods: This prospective, crossover, randomized controlled study included patients undergoing surgical removal of bilateral symmetrically, horizontally impacted mandibular third molars. The surgical site was randomly allocated to receive an iodine tampon after surgery or wound closure and rinsing with a Monoject syringe (Tyco/Healthcare-Kendall, Mansfield, MA). The primary outcomes measured each day during the first postoperative week were the Oral Health Impact Profile 14 score and postoperative sequelae, including pain, swelling, limited mouth opening, postoperative infection, and alveolar osteitis. The secondary outcome measures were several self-care behaviors. Data were analyzed using repeated-measures analysis of variance and paired-samples t tests.

Results: A total of 54 patients (25 men and 29 women; mean age, 25.1 years) were enrolled, with a total of 108 surgically removed impacted mandibular third molars. The use of an iodine tampon resulted in a significantly lower impact on OHRQoL (mean of 21.5 [standard deviation (SD), 9.6] vs 26.5 [SD, 10.6]) on the first postoperative day, which was observable until the seventh postoperative day. In addition, after removal of the impacted third molar, patients with the iodine tampon condition reported less pain (mean of 5.2 [SD, 1.9] vs 6.1 [SD, 2.1] on day 1, lasting throughout the week), less use of painkillers, less limited mouth opening, fewer problems chewing, less swelling, and earlier recovery.

Conclusions: The use of postoperative iodine packing after the removal of impacted mandibular third molars significantly reduces OHRQoL and postoperative sequelae.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Edema
  • Female
  • Humans
  • Iodine*
  • Male
  • Mandible
  • Molar, Third / surgery
  • Pain, Postoperative
  • Postoperative Complications* / prevention & control
  • Prospective Studies
  • Quality of Life
  • Tooth Extraction*
  • Tooth, Impacted* / surgery


  • Iodine