Effect of manuka honey socket dressing on postoperative sequelae and complications following third molar extraction: A randomized controlled study.

2023-04-01
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery 51(4)
- Emmanuel Onyebuchi Onuoha
- Adegbayi Adeola Adekunle
- Sunday Olusegun Ajike
- Olalekan Micah Gbotolorun
- Wasiu Lanre Adeyemo

PubMed: 37164834
DOI: 10.1016/j.jcms.2023.05.001

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 112
Population: 112 participants with mandibular third molar extraction sockets, 56 per group
Methods: prospective randomized study, intrasocket application of manuka honey vs mucosal flap closure without honey, transalveolar extractions using distobuccal bone guttering technique
Blinding: Open-label
Duration: 7 days
Funding: Unclear

Large Human Trial

To evaluate the effect of manuka honey on the healing of mandibular third molar extraction sockets. This was a prospective randomized study at a tertiary health institution in Lagos, Nigeria. All extractions were transalveolar, using the distobuccal bone guttering technique. Participants were randomized into two study groups. Group A underwent intrasocket application of manuka honey, after which sockets were completely closed using the mucosal flap, while participants in group B underwent mucosal flap closure of the socket without application of manuka honey. The primary outcome was healing of the extraction socket at 7 days postoperatively. The secondary outcomes measured were postoperative sequelae, namely pain, swelling, and trismus on postoperative days 1, 3, and 7, and socket healing complications - specifically inflamed socket, infected socket, and alveolar osteitis. In total, 112 participants completed the study, with 56 participants per group. There were no significant differences in demographic variables between both groups. On the 7th day postoperatively, 26.8% of participants in group B had an unhealed extraction site, compared with 10.3% of participants in group A (p = 0.029). A significant difference was observed between pre- and postoperative pain scores in both study groups (p = 0.001). A comparison of postoperative mean facial swelling between the two groups showed no statistically significant differences on all the review days (p = 0.66). The difference in postoperative socket healing complication rate between both groups was statistically significant (χ² = 4.747, p = 0.029). Within the limitations of the study it seems that the application of manuka honey appears to aid earlier healing of the third molar extraction socket, with a significantly lower frequency of complications. Therefore, the application of manuka honey is recommended whenever appropriate.

Research Insights

Manuka Honey→Improved Healing of Extraction Socket
26.8% of participants in group B had an unhealed extraction site, compared with 10.3% of participants in group A (p = 0.029)
Effect
Beneficial
Effect size
Moderate
Dose
intrasocket application (not quantified as dose per day)
Manuka Honey→Improved Socket Healing
On the 7th day postoperatively, 26.8% of participants in group B had an unhealed extraction site, compared with 10.3% of participants in group A (p = 0.029).
Effect
Beneficial
Effect size
Large
Dose
intrasocket application (not quantified as dose per day)
Manuka Honey→Reduced Facial Swelling
A comparison of postoperative mean facial swelling between the two groups showed no statistically significant differences on all the review days (p = 0.66).
Effect
Neutral
Effect size
Small
Dose
intrasocket application (not quantified as dose per day)
Manuka Honey→Reduced Pain
A significant difference was observed between pre- and postoperative pain scores in both study groups (p = 0.001)
Effect
Beneficial
Effect size
Moderate
Dose
intrasocket application (not quantified as dose per day)
Manuka Honey→Reduced Socket Healing Complication
The difference in postoperative socket healing complication rate between both groups was statistically significant (χ² = 4.747, p = 0.029)
Effect
Beneficial
Effect size
Moderate
Dose
intrasocket application (not quantified as dose per day)
Manuka Honey→Reduced Swelling
A comparison of postoperative mean facial swelling between the two groups showed no statistically significant differences on all the review days (p = 0.66)
Effect
Neutral
Effect size
Small
Dose
intrasocket application (not quantified as dose per day)
Manuka Honey→Reduced Trismus
The secondary outcomes measured were postoperative sequelae, namely pain, swelling, and trismus on postoperative days 1, 3, and 7, and socket healing complications...
Effect
Neutral
Effect size
Small
Dose
intrasocket application (not quantified as dose per day)