Systemic Review of Dry Socket: Aetiology, Treatment, and Prevention

Abstract

Our systemic review is to make a comprehensive review about the aetiology, treatment and the prevention of dry socket, the inclusion criteria were all the studies that discuss the dry socket and its etiology, treatment and prevention and exclusion criteria were all the studies that discuss the other complications of tooth extraction, the materials and methods used for this systemic review was to search in the Pub Medline database between 2008 to 2013, using specific words "dry socket, aetiology, treatment and prevention" and published in the English language, the articles were screened by abstract for relevance to aetiology, treatment and prevention of dry socket, 82 papers were identified in pub med but a total of 36 out of Publications were included in the final systemic review according to the specific keywords and materials mentioned above. The occurrence of dry socket in an everyday oral surgery or dental practice is unavoidable. The risk factors are smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anaesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery and the previous surgical site infection in addition to oral Contraceptives, menstrual cycle and immediate postextraction socket irrigation with normal saline. The traditional options of treatment are directed toward palliative care, such as the irrigation of the surgical site, avoiding curetting the extraction socket, Packing with a zinc oxide- eugenol paste on iodoform gauze can be considered to relieve acute pain episodes, there is also new agents in the market can accelerate the healing of the socket such as PRGF and GECB. The prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, the other preventive measures such as chlorhecidine rinse or gel can be effective in the reduction of dry socket incidence.

The efficacy of intra‐alveolar 0.2% chlorhexidine gel on alveolar osteitis: a meta‐analysis

“…The occurrence of AO is unavoidable in everyday tooth extractions (Tarakji et al, 2015). The average incidence ranges from 1% to 4% in usual dental extractions (Butler and Sweet, 1977;Blum, 2002;Sanchis et al, 2004).…”

Contemporary exodontia

“…The traditional method of extracting the tooth requires various forces; gripping, rocking and twisting to be applied to the tooth by means of forceps or elevators. The forces involved are quite large; gripping -146Nm (126-167), rocking AE200Nm (74-266) and twisting AE20Nm (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Nine point eight Nm (9.80) is approximately 1 kg.…”

“…The most common complication of exodontia is alveolar osteitis or dry socket. 6 In this common condition the blood clot undergoes fibrinolysis and the bony walls of the socket become exposed (Fig. 9a).…”

“…The incidence is 3-5% of extractions with risk factors being traumatic extraction, smoking, posterior teeth and mandible more than maxilla, but it is usually unpredictable. 6 If there are signs and symptoms beyond the alveolus then the diagnosis needs to be reviewed as it's not a 'dry socket' but a spreading infection. Excessive granulation tissue usually is as a result of residual pieces of tooth or bone ( Fig.…”

Antibiotic prescribing practices of dentists at Medunsa Oral Health Centre

“…The range of treatments for a dry socket includes non-dressing and dressing interventions directed locally to the socket and, where appropriate, the prescription of systemic antibiotics. 23,24 The level of evidence for effectiveness of most management guidelines was found to be low. 24,25 They were found to be based on expert opinions and clinical experience.…”