Effect of Menstrual Cycle on Frequency of Alveolar Osteitis in Women Undergoing Surgical Removal of Mandibular Third Molar: A Single-Blind Randomized Clinical Trial

Purpose: To measure the association between the menstrual cycle and the frequency of alveolar osteitis (AO). Materials and Methods: In a study with a single-blind design, patients with bilateral impacted third molar teeth underwent randomized surgical extraction: one tooth during the menstrual period and one during the middle of the cycle. The postoperative examiner was unaware of the menstrual cycle status of the patients. The predictor variable was the timing of the menstrual cycle and was grouped as mid-cycle and menstrual period. The outcome variable was AO, which was measured (without knowledge of the menstrual cycle timing) at 2 to 7 days postoperatively. Other study variables included oral contraceptive (OC) use, smoking status, irrigation used during surgery, extraction difficulty, surgeon experience, number of local anesthetic cartridges used, and patient age. Appropriate bi- and multivariate statistics were computed, and the level of statistical significance was set at P < .05. Results: A total of 145 female patients, with a mean age of 24 years, underwent 290 third molar extractions. The overall frequency of AO was 23.45%. The frequency of AO was significantly greater in the middle of the cycle than during the menstrual period inboth the OC users and nonusers (P < .05). Although OC users revealed a significantly greater frequency of AO compared with nonusers (P < .05), no statistically significant differences were found between the 2 groups during the menstrual period (P > .05). Conclusions: According to the results of the present study, the menstrual cycle could be a determinant risk factor in the frequency of AO. We recommend that elective procedures be performed during the menstrual period in both OC users and nonusers to eliminate the effect of cycle-related hormonal changes on the development of AO. (C) 2013 American Association of Oral and Maxillofacial Surgeons