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Etiology, Prevention & Management of Alveolar osteitis
2
Etiology, Prevention & Management of Alveolar Osteitis
Presented by / Raghad Khaled Al-Harkan.
Fourth year student.
Supervisor / Dr. Suzan Salem.
Etiology, Prevention & Management of Alveolar Osteitis
Prevention
Etiology
Flap Design
Oral Contraceptives
Objectives :
Haraji et al., reported that the modified triangular flap decreases the incidence of Alveolar Osteitis more than the buccal envelope flap.
Introduction
Clinical Features of Alveolar osteitis
In 2015, A study was made to test whether the use of oral contraceptive can promote the incidence of dry socket in females following impacted mandibular third molar extraction, The incidence of dry socket was greater in the oral Contraceptives groups than in the control groups.
Haraji A, Motamedi MH, Rezvani F. Can flap design influence the incidence of alveolar osteitis ? Gen Dent. 2010;58:e187–89
James R. Hupp, Myron R. Tucker & Edward Ellis .Contemporary Oral and Maxillofacial Surgery. 6th ed. Mosby. 2014;186:187–11.
Xu JL, Sun L, Min X, Xia R., “Effect of oral contraceptive use on the incidence of dry socket in females following impacted mandibular third molar extraction” Int J Oral Maxillofac Surg. 2015 Sep;44(9):1160-5.
Alveolar Osteitis is a postoperative pain inside and around the extraction site, which increases in severity at any time between the first and third day after the extraction, accompanied by a partial or total disintegrated blood clot within the alveolar socket with or without halitosis.
- Define alveolar osteitis.
- Identify the clinical features of alveolar osteitis.
- Discuss the the risk factors of alveolar osteitis.
- State the different methods for prevention of alveolar osteitis.
- Explain the diffrent options for the Management of alveolar osteitis.
3- The area of the socket has a bad odor, and the patient frequently complains of a foul taste
1- Pain develops on the third or fourth day after removal of the tooth. The pain is moderate to severe & usually throbbing in nature, and frequently radiates to the patient’s ear.
2- The tooth socket appears to be empty, with a partially or completely lost blood clot, and some bony surfaces of the socket are exposed.
Antifibrinolytics
.
Antibiotics
Blum IR: Contemporary views on dry socket: A clinical appraisal of standardization, aetiopathogenesis and management: A critical review. Int J Oral Maxillofac Surg 31:309, 2002.
In 2016, A study was made to assess the efficacy of systemic antibiotics in reducing the frequencies of dry socket and they found to be sufficiently great in reducing the risk of alveolar ositis.
Anand KP et al. , studied the efficacy of tranexamic acid, an antifibrinolytic in reducing of incidence of alveolar ositis , and they concluded that tranexamic acid has several advantages also when used for simple dental extractions.
Smoking
Surgical Trauma and Difficulty of Surgery
Mohammed H, et al., in their study at 2011 they concluded that the incidence of dry socket was higher in smokers.
Bortoluzzi MC et al., observed the incidence of dry socket and they reported that there were higher pain levels and pain persisting longer than two days were observed with more traumatic surgeries.
Ramos E, G, Barbier L, Arteagoitia I., “Do systemic antibiotics prevent dry socket and infection after third molar extraction?' Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Oct;122(4):403-25.
Anand KP, Patro S, Mohapatra A, Mishra S. . The Efficacy of Tranexamic Acid in the Reduction of Incidence of Dry Socket: J Clin Diagn Res. 2015 Sep;9(9):ZC25-8.
Bortoluzzi MC, Manfro R, De Déa BE, Dutra TC. Incidence of dry socket, alveolar infection, and postoperative pain following the extraction of erupted teeth. J Contemp Dent Pract.2010;11:E033–40.
Mohammed H, Abu Younis, Ra’ed O Abu Hantash. Dry socket: frequency, clinical picture, and risk factors in a palestinian dental teaching center. Open Dent J. 2011;5:7–12 .
Patient's Gender
Extraction Site
“Gelatamp” Colloidal Silver Gelatin Sponge
Chlorhexidine
In 2011, , Hasan Momeni, et al., select and included 4779 patients in their study, and 28 of them returned with dry socket phenomena. The results showed that the incidence of dry socket was 0.6% and females were more common involved than males (0.08% versus 0.04%) .
There were an agreement that alveolar osteitis is more common following the extraction of mandibular third molars.
In 2014, Haraji & Rakhshan agreed that intra-alveolar application of chlorhexidine gel is advocated in order to reduce the incidence of dry socket.
Wang YZ et al, studied the clinical effect of "gelatamp" on preventing dry socket. The results demonstrate that it can prevent the occurrence of dry socket after teeth extraction.
Muhammad AS. Pathogenesis and management of dry socket(alveolar osteitis). Pakistan Oral and Dental Journal Vol 30 ,No.2 2010.
Momeni Hasan, Shahnaseri Shirin, Hamzeheil Zeinab. Evaluation of relative distribution and risk factors in patients with dry socket referring to Yazd dental clinics. Dent Res J (Isfahan)2011;8:S84–87.
Haraji A, Rakhshan V. Single-dose intra-alveolar chlorhexidine gel application, easier surgeries, and younger ages are associated with reduced dry socket risk. J Oral Maxillofac Surg.2014;72:259–65.
Wang YZ, Guan QL, Jia MY, Deng Y. "[Use of "gelatamp" colloidal silver gelatin sponge to prevent dry socket a". Shanghai Journal of Stomatology;Feb2013, Vol. 22 Issue 1, p108.
Management
Thank You
Acknowlgment :
Special thanks to Dr.Suzan for her great efforts.
Honey
Antibiotics
In 2016, A 60 patients with dry socket were selected and honey was used as a dry socket dressing in all the patients. There was significant reduction in inflammation, hyperemia, and swelling after honey dressing. No side effect of honey was observed in their study, so it can be used as an alternative for the management of dry socke.
A study made by In Ataoğlu H et al, with 150 patients. they were divided randomly into three groups. One of the groups was given amoxicillin 2g combined with clavulanic acid. The second group was given similar medications The third was given no antibiotic agents. They found that there were no critical differences among the gatherings in the frequency of these complications.
Hassan S, Shah A, Hakim T, Teli Z. Honey in the Management of Dry Socket. Ann. Int. Med. Den. Res. 2016;2(1):255-57.
Ataoğlu H, Oz GY, Candirli , Kiziloğlu. Routine antibiotic prophylaxis is not necessary during operations to remove third molars.Br J Oral Maxillofac Surg. 2008 Mar;46(2):133-5.
Dressing Materials
Laser
Faizel et al., made a study to evaluate and compare the effectiveness of Neocone, Alvogyl and Zinc Oxide Eugenol for the management of dry socket. Alvogyl was superior to the other two medications for providing initial pain relief. Neocone was healing faster .
Rani A et al., studied effects of laser on healing of alveolar osteitis. They found that the diode laser is an acceptable and effective non-dressing treatment modality for treating alveolar osteitis.