Analysis of Different Treatment Approaches to Prevent Alveolar Osteitis: Treatment to Prevent Alveolar Osteitis

Muhammad Shairaz Sadiq; Maria Noor; Yaser Ishaq; Tooba Saeed; Amna Javed Syed; Sobia Siddique

doi:10.54393/pjhs.v5i04.1393

Authors

Muhammad Shairaz Sadiq Department of Oral Medicine, CMH Lahore Medical College/ Institute of Dentistry, Lahore, Pakistan
Maria Noor Department of Oral Medicine, FMH College of Medicine and Dentistry, Lahore, Pakistan
Yaser Ishaq Department of Oral and Maxillofacial Surgery, Akhtar Saeed Medical and Dental College, Lahore, Pakistan
Tooba Saeed Department of Oral and Maxillofacial Surgery, University College of Medicine and Dentistry, The University of Lahore, Lahore, Pakistan
Amna Javed Syed FMH College of Medicine and Dentistry, Lahore, Pakistan
Sobia Siddique Department of Oral Pathology, Watim Medical and Dental College, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i04.1393

Keywords:

Chlorhexidine, Alveolar Osteitis, Saline Irrigation, Postoperative Outcomes

Abstract

Alveolar Osteitis (AO) is a complication that can arise after tooth extraction. It refers to a socket following extraction that lacks epithelium, blood clot, and has an exposed bony surface, often causing intense and radiating pain. Objectives: To determine the incidence of AO among different treatment groups undergoing tooth extraction. Methods: A prospective comparative study was conducted. Patients were enrolled and allocated into treatment groups: Control, Saline Irrigation, and chlorhexidine (CHX) Rinse. Outcome measures included the incidence of AO. Statistical analysis was performed to compare outcomes between treatment groups. Results: The overall occurrence rate of dry socket was 14.22%, with the highest incidence observed in patients who received saline irrigation. Conversely, the use of chlorhexidine rinse once postoperatively resulted in the lowest incidence rate. Conclusions: It was concluded that post-operative use of chlorhexidine rinse shows a promising and favorable outcome in preventing AO among patients. However, this study does not support the justification for irrigation with saline. Further well-designed clinical trials are necessary to validate these findings.

References

Colby RC. The general practitioner's perspective of the etiology, prevention, and treatment of dry socket. General Dentistry. 1997 Sep; 45(5): 461-7.

Blum IR. Contemporary views on dry socket (alveolar osteitis): a clinical appraisal of standardization, aetiopathogenesis and management: a critical review. International Journal of Oral and Maxillofacial Surgery. 2002 Jun; 31(3): 309-17. doi: 10.1054/ijom.2002.0263. DOI: https://doi.org/10.1054/ijom.2002.0263

Mudali V and Mahomed O. Incidence and predisposing factors for dry socket following extraction of permanent teeth at a regional hospital in Kwa-Zulu Natal. South African Dental Journal. 2016 May; 71(4): 166-9.

Khan AH. Prevalence and association of dry socket in oral health and dental management. Oral Health and Dental Management. 2017; 16(4): 1-6.

Torres-Lagares D, Gutierrez-Perez JL, Infante-Cossio P, Garcia-Calderon M, Romero-Ruiz MM, Serrera-Figallo MA. Randomized, double-blind study on effectiveness of intra-alveolar chlorhexidine gel in reducing the incidence of AO in mandibular third molar surgery. International Journal of Oral and Maxillofacial Surgery. 2006 Apr; 35(4): 348-51. doi: 10.1016/j.ijom.2005.08.002. DOI: https://doi.org/10.1016/j.ijom.2005.08.002

Singh G, Aggarwal A, Singh P. Risk factors for dry socket following extraction of permanent teeth: A clinical study. Journal of Advanced Medical and Dental Sciences Research. 2016 Nov; 4(6).

Sanchez FR, Andrés CR, Calvo IA. Does chlorhexidine prevent AO after third molar extractions? Systematic review and meta-analysis. Journal of Oral and Maxillofacial Surgery. 2017 May; 75(5): 901-14. doi: 10.1016/j.joms.2017.01.002. DOI: https://doi.org/10.1016/j.joms.2017.01.002

Tarakji B, Saleh LA, Umair A, Azzeghaiby SN, Hanouneh S. Systemic review of dry socket: aetiology, treatment, and prevention. Journal of Clinical and Diagnostic Research. 2015 Apr; 9(4): ZE10. 10.7860/JCDR/2015/12422.5840. DOI: https://doi.org/10.7860/JCDR/2015/12422.5840

Wang YZ, Guan QL, Li YX, Guo JL, Jiang L, Jia MY et al. Use of" gelatamp" colloidal silver gelatin sponge to prevent dry socket after extracting mandibular impacted teeth. Shanghai kou Qiang yi xue= Shanghai Journal of Stomatology. 2013 Feb; 22(1): 108-10.

Preetha S. An overview of dry socket and its management. IOSR Journal of Dental and Medical Sciences. 2014; 13(5): 2. doi: 10.9790/0853-13523235. DOI: https://doi.org/10.9790/0853-13523235

Motamedi MR. To irrigate or not to irrigate: Immediate postextraction socket irrigation and alveolar osteitis. Dental Research Journal. 2015 May; 12(3): 289-90.

Tolstunov L. Influence of immediate post-extraction socket irrigation on development of AO after mandibular third molar removal: a prospective split-mouth study, preliminary report. British Dental Journal. 2012 Dec; 213(12): 597-601. doi: 10.1038/sj.bdj.2012.1134. DOI: https://doi.org/10.1038/sj.bdj.2012.1134

Bhoi S, Patel S, Jayanna R, Kumar G. Does excessive saline irrigation causes dry socket? A surgeons dilemma. International Journal of Applied Dental Sciences. 2020; 6(2): 223-5.

Supe NB, Choudhary SH, Yamyar SM, Patil KS, Choudhary AK, Kadam VD. Efficacy of alvogyl (combination of iodoform+ butylparaminobenzoate) and zinc oxide eugenol for dry socket. Annals of Maxillofacial Surgery. 2018 Jul; 8(2): 193-9. doi: 10.4103/ams.ams_167_18. DOI: https://doi.org/10.4103/ams.ams_167_18

Almutairi BM. Dry sockets–a systemic review. Advancements in Life Sciences. 2019 Nov; 7(1): 48-57.

Punia SC, Garg S, Yadav R. Clinical aspects of dry socket. Rama University Journal of Dental Sciences. 2016; 3: 21-6.

Khan ZA, Prabhu N, Maqsood A, Issrani R, Ahmed N, Abbasi MS et al. Frequency and etiological denominators of AO at Northern Province of Kingdom of Saudi Arabia—An observational study. SAGE Open Medicine. 2023 Dec; 11: 20503121231219420. doi: 10.1177/20503121231219420. DOI: https://doi.org/10.1177/20503121231219420

Lenka S, Rathor K, Varu R, Dalai RP. Comparison between Alvogyl and Zinc Oxide Eugenol Packing for the Treatment of Dry Socket: A Clinical Study. Indian Journal of Public Health Research and Development. 2019 Nov; 10(11). doi: 10.5958/0976-5506.2019.03595.2. DOI: https://doi.org/10.5958/0976-5506.2019.03595.2

Arbildo-Vega H, Sime M, Infantes E, Cruzado F, Castillo T. Efficacy of chlorhexidine in the prevention of AO after permanent tooth extraction. Systematic review and meta-analysis. Journal of Oral Research. 2019 Feb; 8(5): 406-15. doi: 10.17126/joralres.2019.065. DOI: https://doi.org/10.17126/joralres.2019.065

Mínguez-Serra MP, Salort-Llorca C, Silvestre-Donat FJ. Chlorhexidine in the prevention of dry socket: effectiveness of different dosage forms and regimens. Medicina Oral, Patología Oral y Cirugía Bucal. 2009 Sep; 14(9): e445-9.

Zhou J, Hu B, Liu Y, Yang Z, Song J. The efficacy of intra‐alveolar 0.2% chlorhexidine gel on alveolar osteitis: a meta‐analysis. Oral Diseases. 2017 Jul; 23(5): 598-608. doi: 10.1111/odi.12553. DOI: https://doi.org/10.1111/odi.12553

Kaur J, Raval R, Bansal A, Kumawat V. Repercussions of intra-alveolar placement of combination of 0.2% chlorhexidine & 10 Mg metronidazole gel on the occurrence of dry sockets-A randomized control trial. Journal of Clinical and Experimental Dentistry. 2017 Feb; 9(2): e284. doi: 10.4317/jced.53262. DOI: https://doi.org/10.4317/jced.53262

AlHindi M. Dry socket following teeth extraction: effect of excessive socket saline irrigation. Journal of Oral Health and Dental Science. 2017 Oct; 1(1): 2-5. doi: 10.18875/2577-1485.1.105. DOI: https://doi.org/10.18875/2577-1485.1.105

Cardoso CL, Rodrigues MT, Júnior OF, Garlet GP, de Carvalho PS. Clinical concepts of dry socket. Journal of Oral and Maxillofacial Surgery. 2010 Aug; 68(8): 1922-32. doi: 10.1016/j.joms.2009.09.085. DOI: https://doi.org/10.1016/j.joms.2009.09.085